[Newborn] Infant Botulism

1. Food poisoning caused by ingestion of Clostridium botulinum spores.

2. The spores colonize the immature gastrointestinal tract (GI tract) and produce toxin -> toxin inhibits release of acetylcholine at the neuromuscular junction -> muscle paralysis

 

3. Clinical Features: muscle paralysis, Age < 12 months

(i) symmetric descending paralysis,

(ii) hypotonia and decreased head control,

(iii) Oculobulbar palsies - ptosis (droping eye) eye muscles are weaker / Absent gag reflex

(iv) Poor feeding, constipation, generalized weakness, decreased gag reflex (-> initial manifestations:초기발현)

(v) autonomic dysfuction (eg. decreased salivation, fluctuating HR/BP)

 

4. Diagnosis: clinical, supported by abnormal EMG finding (electromyograpy -> CMAP:compound muscle action potential)

Confirmation by stool C botulinum spores or toxins

 

5. Nursing interventions

(1) Recognize symptoms early to avoid respiratory failure.

(2) Antitoxin therapy- IV botulism immune globulin (BIC-IV) :치료법은 아니지만 증상을 약화시키도록 도움.

- Reduces severity and duration of symptoms

(3) Supportive care

-Mechanical ventilation

-Enteral tube feedings

(4) Prevention :AVOID HONEY before 12 months!!!!!

 

 

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신생아 이유식

Small portions (<1 tablespoon) of solid food are appropriate for infants.

Continuing to feed an infant who acts interested in food (eg. turns away) can contribute to future obesity.