Question

Katie is a 7-month-old baby girl, the second child born to her parents. Her mother had a healthy, full-term pregnancy, and Nona’s birth weight was normal. She did not respond well to breastfeeding and was changed entirely to a formula based on cow’s milk at 4 weeks. Between 7 and 12 weeks of age, she was admitted to the hospital twice with a history of screaming after feeding, but was discharged after observation without a specific diagnosis. Elimination of cow’s milk from her diet did not relieve her symptoms; Katie’s mother reported that the screaming bouts were worse after Katie drank juice and that Katie frequently had gas and a distended abdomen. At 7 months she was still thriving (height and weight in the 97^th percentile) with no abnormal findings on physical examination. A stool sample was taken.

1. What is Katie’s diagnosis?

2. What is the cause of Katie’s symptoms?

3. What is needed in order for Katie to be able to feed normally?

4. What testing would be ordered to determine what is happening to Katie?

5. What is the treatment plan that Katie’s mother should follow?

Answer 1

• What is Katie’s diagnosis?

Katie's diagnosis inckude Infantile colic which is characterized as a paroxysms of inconsolable crying which is self-limited process especially after feed.

• What is the cause of Katie’s symptoms?

The possible causes for Katie's symptoms are alterations in fecal microflora, lactose intolerance or other protein intolerance, gastrointestinal immaturity, inflammationreactions, increased serotonin secretion and poor feeding technique.

• What is needed in order for Katie to be able to feed normally?

Infant massanging and gentle rubbing on back could help in relieving the sym[toms. Hot water bath or hot water massage over the belly also found effective.

• What testing would be ordered to determine what is happening to Katie?

Usally done with physician's physical examination and history of bowel movement, eating pattern could help with diagnosis. Stomach ultra sound is employed for differential diagnosis.

• What is the treatment plan that Katie’s mother should follow?

Simethicone drops helps to relieve gas. Probiotic Lactobacillus reuteri is found effective in many cases.