Chapter 22: Special Population: Newborns and Infants

IMMUNIZATIONS, INFANTS AND CHILDREN

Population

• – Infants and children age 0–18 y.

Recommendations

Advisory Committee on Immunization Practices (ACIP) 2017

• – Immunize infants and children based on the 2018 immunization schedule.

• – Centers for Disease Control (CDC), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Obstetricians and Gynecologists (ACOG) have approved the schedule.

Source

• – MMWR Morb Mortal Wkly Rep. 2018;67:156-157.

SUDDEN INFANT DEATH SYNDROME (SIDS)

Population

• – Newborns and infants.

Recommendations

AAP 2016

• – Place their infants to sleep on their backs.

• – Use a firm sleep surface without soft objects or loose bedding.

• – Breastfeed.

• – For the first 6–12 m, infants should sleep in parents’ room (but not in parents’ bed).

• – Avoid smoke exposure, alcohol and illicit drug use, overheating.

Source

• – Pediatrics. 2016;138(5):e20162938.

Comments

1. Stomach and side sleeping have been identified as major risk factors for SIDS.

2. Pacifiers may be protective.

GONORRHEA, OPHTHALMIA NEONATORUM

Population

• – Newborns.

Recommendation

USPSTF 2019

• – Give all newborns prophylactic ocular topical medication against gonococcal ophthalmia neonatorum.

Source

• – USPSTF. Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum. 2019.

Comments

1. Erythromycin 0.5% ointment is the only agent available in the United States for this application.

2. Canadian Paediatric Society recommends against universal prophylaxis, given incomplete efficacy of erythromycin, rarity of the condition, and disruption in maternal-infant bonding. Instead, they recommend screening mothers for gonorrhea and chlamydia infection and, if infected with gonorrhea at the time of delivery, treating the infant with ceftriaxone. (Paediatr Child Health. 2015;20:93-96)