• persistent weight < 5th percentile for age or "falling off the growth curve," i.e. crossing 2 percentile lines on a growth chart
• infants will first fall of weight curve, then the height curve, and then the head circumference curve.

• organic: d/t underlying medical condition: CF, congenital heart disease, celiac disease, pyloric stenosis, chronic infxn (HIV), GERD
• non-organic: d/t psychosocial factors, i.e. maternal depression, neglect, or abuse

• hypotonia
• macroglossia
• umbilical hernia
• increased head circumference

• caudal regression syndrome
• TGA
• duodenal atresia and small left colon
• anencephaly/NT defects

• Sx begin few days to weeks after initiating feeding
• Sx: liver failure (hepatosplenomegaly, direct hyperbilirubinemia, coagulation problems), abnormal renal function, emesis, anorexia, acidosis, glycosuria

• HGPRT deficiency (purine metabolism)
• commonly presents ~6 mo with hypotonia and persistent vomitting
• sx: self-mutiliation, MR, neuro sx (dystonia, spasticity, choreoathetosis), gouty arthritis, obstructive nephropathy
• tx: allopurinol, high fluid intake 

• birth weight <10th percentile
• may have:
• hypoxia
• perinatal asphyxia
• meconium aspiration
• hypothermia
• hypoglycemia
• hypocalcemia
• polycythemia (d/t increase in EPO in response to fetal hypoxia)

• flat, salmon-colored vascular lesion commonly seen over glabella, eyelids, and neck
• usually disappears in early childhood

• irregularity, crepitus, decreased movement of arm; usually on right side
• associated with shoulder dystocia, traumatic delivery, LGA
• no tx necessary (just avoid tension on arm)

• neonate with:
• bloody diarrhea
• eosinophils in stool
• FHx of atopy/asthma

1. GBS (75% of late onset GBS = meningitis, ~2 wks old)
2. E Coli
3. Listeria (also causes abscesses and pneumonia)

• microcephaly
• microophthalmia
• hepatosplenomegaly
• chorioretinitis
• hydrocephalus
• scattered intracranial calcifications 

• excessive traction on the arm causes injury of C7, C8, and long thoracic nerve
• seen in newborns
• results in hand paralysis and ipsilateral Horner's syndrome

• seen in neonate
• injury of C5 and C6
• neonate has absent moro reflex, but intact grasp reflex in affected arm 
• holds arm adducted and internally rotated with forearm protonated

• Presentation: infant with cyanosis that is aggravated by feeding and relieved by crying
• Dx: cannot pass catheter thru nose to oropharynx; confirmed by CT with intranasal contrast showing narrowing at the level of the pterygoid plate
• Management: oral airway and lavage feeding until infant can undergo surgical repair

caput succadaneum vs. cephalohematoma -

2 distinguishing features

• caput succadaneum: may extend cross midline/across sutures line; can have discoloration
• cephalohematoma (subperiosteal hemorrhage): limited to surface of 1 cranial bone; no discoloration

10 days

• transplacental transmission of toga virus
• maternal infxn: sx occur after 2-3 week incubation period and include arthralgia, rash, generalized lymphadenopathy
• infant: most severe infxn if transmission occurs in early pregnancy → spontaneous abortion or CRS
• infxn in first 4 weeks of pregnancy: 50% risk of CRS
• infxn in 3rd trimester: 1% risk of CRS

• sensorineural deafness, cardiac malformations (ASD, PDA), cataracts, blueberry muffin spots (thrombocytopenia)
• other s/sx: IUGR and subsequent growth retardation CNS involvement, hepatosplenomegaly, bone dz, etc
• Dx in mom: IgM + or 4-fold increase in IgG on 2 serum samples taken 2 weeks apart
• Dx in infant: IgM + or IgG + beyond 6 mo
• note:  moms should not receive vaccine during pregancy

• periventricular calcifications
• sensorineural hearing loss
• purpura/petechiae
• chorioretinitis
• hepatosplenomegaly
• IUGR
• microcephaly

• infants may be asymptomatic OR
• cutaneous lesions on palms & soles, hepatosplenomegaly, jaundice, anemia, rhinorrhea, intermittent fevers
• XR: metaphyseal dystrophy and periostitis (osteitis or osteochondritis)

• sx of coughing/choking, regurgitation, and drooling occur with first feeding
• XR: air in stomach;can also have aspiration pneumonia, pneumonitis, and atelectasis (gastric fluid getting into trachea) 

• irritability
• mild to moderate mental retardation
• hypoplastic maxilla
• long philtrum
• thin upper lip border
• microcephaly

• exposure of fetus to phenytoin or carbamezapine
• hypoplastic nails, cleft palate, vitamin K deficiency (bleeding)
• others: IUGR, microcephaly, developmental delay, MR, heart defects 

• trisomy 18
• MR, micrognathia, low-set ears, rocker-bottom feet, prominent occiput, clenched hands