Educational objective:

Malrotation with midgut volvulus usually presents in neonates with bilious vomiting and abdominal
distension. Untreated volvulus can progress to frank bowel ischemia, bloody stools, and
perforation. An upper gastrointestinal contrast study is the gold standard for diagnosing
malrotation.

Educational objective:
Neonatal bilious emesis signifies bowel obstruction and requires immediate x-ray to evaluate the
need for emergency surgery or further diagnostic studies. Contrast studies should be performed
in stable patients to determine the level of obstruction.

1
Educational objective:
Beckwith-Wiedemann syndrome is characterized by macrosomia, macroglossia, umbilical
hernia/omphalocele, hemihyperplasia, and hypoglycemia Children must be closely monitored for
development of Wilms tumor or hepatoblastoma

2
Educational objective:

Constipation is a common problem in toddlers due to transition to solid food and cow's milk, toilet

3
Educational objective:
Breastfeeding failure jaundice manifests as unconjugated hyperbilirubinemia and dehydration in
the first week of life. Inadequate stooling results in suboptimal bilirubin elimination and increased
t h r · 1 r f bT b. I

4
Educational objective:

Treatment of breastfeeding failure jaundice consists of optimizing lactation and increasing

breastfeeding frequency If the mother's milk supply is inadequate, supplementation with a cow's

milk-based formula can be considered, but breastfeeding should not be discontinued.

5
Educational objective:

Hirschsprung disease should be suspected in any newborn with failure to pass meconium within

48 hours after birth, especially in the setting of Down syndrome The presentation is consistent

with complete bowel obstruction (eg, poor feeding, abdominal distension, absent air in the

rectum)

6
Educational objective:

Gastroesophageal reflux is common in infants due to a shorter esophagus, incomplete closure of

the lower esophageal sphincter, and greater time spent in the supine position. Parents should be

reassured by the infant's adequate weight gain and be advised to hold the infant upright after

feeds.

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