August Week 3: Colic & SIDS

Article for Colic:

Gail M. Cohen and Laurie W. Albertini. Colic. Pediatrics in Review 2012;33;332

A disheveled looking couple brings their 1 month old to your office for a well visit. They report their daughter cries inconsolably “almost all day and night.” Nothing they have tried is working.  They feel like they never sleep, cannot calm their baby, and don’t know what else to try. Dad was reading about colic on the internet and wants to know if they should switch to alimentum.

What is the definition of colic? What are other common features of colic?
What problems or issues can colic increase the risk for?
What other questions will you ask?
How will you advise these parents? Will you change the formula?

What about the following remedies:
Simethicone
Dicyclomine
Herbal teas
H2 blockers and PPIs

Article for SIDS:

Moon R, et al. Sudden Infant Death Syndrome. Peds in Review. 28(6);209-214

Moon R, et al. Sudden Infant Death Syndrome: An Update.  Peds in Review. 33(7): 314-320.

Case 1:
You are seeing a 2 week old for follow up visit. The baby was born at 36 weeks gestation to a G1 now P1 17 year old mom who did not have prenatal care until her 7th month of pregnancy. Mom reports she is living with her parents and boyfriend. In gathering your history, you discover that dad smokes, “always outside the house,” and mom always puts the baby on her side to sleep because she “heard face-down was bad but she doesn’t like to sleep on her back.”

What other questions would you ask mom? 
What are risk factors for SIDS? Discuss how each factor contributes to SIDS. 
What is the role of home apnea monitors in the prevention of SIDS? 
What is the role of “back to sleep” in the prevention of SIDS?
What other protective or preventative measures you would want to counsel mom about? 
What other conditions should be considered in the differential diagnosis of an unexplained infant death? Why is it important to consider these after an infant dies?