By Bernard Valman, Roslyn Thomas
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Additional resources for ABC of the First Year, 6th Edition (ABC Series)
The screening blood card with four spots is used for the Guthrie test, the tests for hypothyroidism and cystic fibrosis. In some populations with a high prevalence of sickle cell disease, routine haemoglobin electrophoresis is done on a separate blood spot on the first day of life. 16 Holding foot for taking blood. 19). If an abnormality is found during the routine examination, some indication must be given to the mother so that arrangements can be made to see both parents. Particularly if the problem is likely to be long term, the doctor who will continue the long-term care should speak to the parents initially.
Other congenital abnormalities may be present. Evidence of an intrauterine infection such as toxoplasmosis should be sought and the parents should receive appropriate genetic counselling. The diagnosis may be difficult at birth, but the increasing discrepancy between the head circumference centile and the weight and length centiles with developmental delay clarifies the diagnosis. 4). Cleft lip and cleft palate are often associated. Referral to a specialized multidisciplinary team should be made as soon as possible after birth.
A cleft lip, caused by failure of the maxillary process growing towards the midline to fuse with the premaxilla, may be unilateral or bilateral. Minor degrees of cleft palate may be easily missed if the posterior part of the palate is not seen and palpated. Most of these infants feed normally from the breast or bottle. If there are feeding difficulties, a special teat, a large normal teat, a special spade-like spoon, or an ordinary spoon may be tried. 5 Umbilical hernia. age of 1 year. The value of an obturator before operative closure of the palate is controversial.
ABC of the First Year, 6th Edition (ABC Series) by Bernard Valman, Roslyn Thomas