ChoiceHub
Sign in
A 7-day-old breastfed girl is admitted with a two-day history of poor feeding and vomiting. She is deeply jaundiced, lethargic and hypothermic, with a liver edge 3 cm below the costal margin. Blood cultures taken on admission grow a Gram-negative rod within twelve hours. Total bilirubin is 260 micromol/L, of which 70 micromol/L is conjugated; blood glucose is 2.1 mmol/L and the urine tests positive for reducing substances. Her newborn bloodspot card was collected at 50 hours and no result is yet available. In addition to antibiotics, which one of the following changes to her feeding is most likely to be life-saving?
Shared by Mornienniche

Keep going — a set of ten like this one, one at a time.

Practise more

More from Paediatrics

See all

A 5-month-old girl is brought to the emergency department because her left thigh is swollen and she cries when it is moved. Her father says she rolled off a cou…

Pre-internship · common

You are the intern attached to a regional public health unit. Its annual child health profile for a town of 4,000 people reports: two-dose measles-mumps-rubella…

Pre-internship · niche

You are the intern in a regional hospital's paediatric outpatient clinic. A 3-year-old Aboriginal boy has bilateral middle ear effusions and a 35 dB conductive…

Pre-internship · middle twist

A coastal local government area has recorded four drownings of children under five years of age in five years, every one of them in a backyard swimming pool at…

Pre-internship · middle twist

You are a general practice registrar in a regional town of 6,000 people. Over six weeks the public health unit has confirmed seven cases of measles, four of the…

Clinical rotations · common