Does he look puffy to you?

Author: Rebecca Humphreys, Andrew Maxted, Vikram Baicher / Editor: Sarah Edwards / Codes: NepC4, RC2, SLO5 / Published: 16/12/2022

You’re working in CED where you see Patrice, a 16-day-old baby boy, who is brought in by his dad.

The father is concerned because the baby has had a bit of a runny nose and on 2 occasions there has been a small amount of streaky blood in the coryza.

Patrice was born at 39 weeks by normal delivery. Antenatal scans were normal and he has been bottle fed around 3oz of standard formula milk every 3-4 hours. He has surpassed his birth weight.

The baby has no history of fevers, rashes, vomiting or diarrhoea. He’s had no pale, floppy or unresponsive spells and has generally been a content baby.

Patrice has a 3-year-old brother, who is in good health but has a cough, cold and runny nose.

On examination the baby appears well and is interacting appropriately. His respiratory rate is 24, saturations 98% in air, heart rate 124, femoral pulses normal, chest auscultation and heart sounds normal. His umbilicus looks normal and he has a soft tummy with no masses. The baby’s tone is normal, and you witness him take a bottle feed without any issues.

The father informs you that Patrice had his vitamin K injection after birth and has not had any bleeding from anywhere else other than his nose. There is no evidence of bleeding inside the nose.