UC Davis Health
Department of Pediatrics

Newborn | Pediagogy Podcast | Department of Pediatrics | UC Davis Health

Newborn

  • BRUE

    Today we talk about BRUE – brief, resolved, unexplained, events – and try to breakdown what it is and what we do for low-risk versus high-risk cases.

    This episode was written by Tammy Yau and Lidia Park with content support from Eunice Kim, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Brief, resolved, unexplained events in patients <1 year of age with color change, tone change, abnormal breathing, or altered level of consciousness.
    • BRUE can be classified as low versus high risk based on age of patient, frequency of events, and exam or history findings
    • Only brief observation is needed in low risk BRUE.
    • High risk BRUE requires more extensive workup.

    Supplemental Information:

  • Erythromycin Prophylaxis in Newborns

    Ever wonder why babies receive erythromycin eye ointment at birth and if it’s really necessary? We’re going to answer that and many other EYE-opening questions in today’s episode!

    Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.com

    This episode was written by pediatricians Lidia Park and Tammy Yau with content support from Dean Blumberg (UC Davis pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Erythromycin eye ointment is given to newborn babies to prevent against gonococcal infection, it does not cover chlamydia infections. 10% of babies who are exposed to gonococcus can still get eye infections even when given erythromycin
    • Gonococcal eye infections (ophthalmia neonatorum) can cause ulcers, rupture, and blindness. Disseminated infections can cause arthritis, bacteremia, and meningitis

    Sources:

  • HIV and Breastfeeding

    Can someone with HIV breastfeed their child? You might be surprised at the answer!

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

    This episode was written by Tammy Yau and Lidia Park, with content support from Laura Kair. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • New guidelines from the CDC recommend allowing mothers with HIV on antiretroviral therapy (ART) with an undetectable viral load to breastfeed their child if they desire, whether or not they live in a developed or underdeveloped country. The risk for HIV transmission through breastmilk in these cases is 0.6%
    • In the US, you can call the national perinatal HIV/AIDS hotline at 1-888-448-8765 for advice

    Sources:
    CDC 2023 Infant Feeding for Individuals with HIV in the US: https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/hiv.html

  • Newborn Vitamin K

    This episode was written by Tammy Yau and Lidia Park, with content support from Lisa Rasmussen. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Vitamin K is important in preventing early and late onset bleeding in newborns (up to 6 months of age), most importantly, intracranial bleeding.
    • Intramuscular vitamin K is most effective but oral vitamin K regimens are used outside of the US and are better than not giving any vitamin K

    Sources/Supplemental Information:
    AAP Pediatrics 2022, Handout: https://doi.org/10.1542/peds.2021-056036
    CDC Vitamin K Handout: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/vitamin-k.html

  • Obstructive Sleep Apnea

    Have you ever wondered if your patient's snoring is concerning or not? Learn about how we screen for obstructive sleep apnea in pediatric patients in this episode.

    Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.com

    This episode was written by pediatricians Lidia Park, Tammy Yau, and Jessica Ahn with content support from Ambika Chidambaram (UCD pediatric pulmonology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points

    • Obstructive sleep apnea (OSA) occurs when there is either complete or partial narrowing of the upper airway during sleep that causes an awakening from sleep and/or results in at least 3% drop in oxygen saturation and lasts 2 breath lengths.
    • Symptoms of OSA can include episodes of apnea, gasping, choking, frequent awakenings, sleep enuresis, attention difficulties, behavioral problems, daytime sleepiness.
    • On physical exam, watch out for enlarged tonsils and/or adenoids, micrognathia, retrognathia, or hypotonia.
    • Untreated OSA is an independent comorbid factor for many conditions such as failure to thrive, obesity, and cardiovascular diseases like insulin resistance, fatty liver disease, and hypertension.
    • Disorders associated with OSA include Down syndrome, Duchenne Muscular Dystrophy, Prader Willi, achondroplasia, hypothyroidism, and acromegaly.
    • The gold standard for diagnosis of OSA is polysomnography and is based off of AHI scores: 1-5 is mild, 6-10 is moderate, and 11 or greater is severe.
    • First line treatment for most children is adenotonsillectomy. If this fails, second line treatment is CPAP or BiPAP.

    References

    • Krishna J, Kalra M, McQuillan ME. Sleep disorders in childhood. Pediatrics in Review. 2023;44(4):189-202. doi:10.1542/pir.2022-005521
    • American Academy of Sleep Medicine. Obstructive Sleep Apnea.; 2008. https://aasm.org/resources/factsheets/sleepapnea.pdf. Accessed October 29, 2024.
    • Benedek P, Balakrishnan K, Cunningham MJ, et al. International Pediatric Otolaryngology group (IPOG) consensus on the diagnosis and management of pediatric obstructive sleep apnea (OSA).International Journal of Pediatric Otorhinolaryngology. 2020;138:110276. doi:10.1016/j.ijporl.2020.110276
    • Basha S, Bialowas C, Ende K, Szeremeta W. Effectiveness of adenotonsillectomy in the resolution of nocturnal enuresis secondary to obstructive sleep apnea. The Laryngoscope. 2005;115(6):1101-1103. doi:10.1097/01.mlg.0000163762.13870.83

  • Asthma

    Learn about asthma management in the outpatient and acute setting including 2020 NIH guideline changes.

    This episode was written by Tammy Yau and Lidia Park with content support from Rory Kamerman-Kretzmer, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Ask about common triggers for asthma like smoke or allergens as well as medication adherence
    • Asthma is a clinical diagnosis but ancillary tests like PFTs may help
    • Symptom frequency and severity can help you classify asthma as intermittent versus persistent
    • Learn about controller/maintenance therapy, including the new SMART therapy
    • Learn about steroid use for acute exacerbations as well as next line medications like magnesium, ipratropium, and epinephrine

    Supplemental Information:

  • Bronchiolitis

    Listen to this episode’s topic on bronchiolitis and how we manage it in the hospital!

    This episode was written by Tammy Yau and Lidia Park with content support from Rory Kamerman-Kretzmer, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Bronchiolitis is seen in kids under the age of 2 and most commonly caused by RSV
    • Treatment is supportive including fluids, oxygen, and suction
    • Learn about palivizumab and other new preventive therapies against bronchiolitis

    Supplemental Information: