Student name

United States University

FNP-591

Professor Name

Submission Date

4-week-old Female with Fussiness

Amelia Arlington is four weeks old and has had a week to ten days of uncooperative crying. Even though the growth and development are normal, Ms. Arlington is concerned about severe sobbing and pain experienced by Amelia, including pulled-up legs and a hard tummy. The physical exam of Amelia and her vital signs indicate normal findings, which are likely to suggest that Amelia has colic. Infantile colic, characterized by excessive sobbing and irritation, is normally diagnosed through elimination of other causes (Behnaz Bagherian et al., 2021).

Main Diagnosis with Supporting Rationale

Colic is the main diagnosis for Amelia Arlington.

Supporting Rationale

Amelia has the symptoms of colic, or excessive screaming and fussiness among otherwise normal infants. Colic results in three hours of sobbing per day, three days per week, 3 weeks or more (Behnaz Bagherian et al., 2021). Physical examination and developmental milestones of Amelia are normal; nevertheless, she cries for two or three hours a day. This diagnosis is also supported by the absence of any other relevant complaints or findings (Behnaz Bagherian et al., 2021).

 Differential Diagnoses

 GERD

 Amelia has very few instances of drooling milk, possibly due to the implication of reflux, but does not experience frequent vomiting or a feeling of pain in the esophagus (Salvatore et al., 2021). Denies experiencing any GERD pain during or after the feedings; her weight, growth, and feeding are normal.

 Infant Milk Allergy

 The mother of Amelia felt worried about the presence of an allergy to milk, but the child has not displayed severe cases of vomiting or diarrhea, or rashes; therefore, the issue can hardly be considered an allergy (Al-Beltagi et al., 2022). The presence of symptoms of colic is argued to be associated with developmental adaptation, such that the formula or soy may not be of assistance (Ribes-Konickx et al., 2023).

Diagnostic Plan

Observation and History

• Regarding diagnosis, a detailed case history, including the date of the onset of colic and colic duration, and any related behaviors, would have to be provided.
• A feeding problem is also ruled out by an observation of eating and crying (Behnaz Bagherian et al., 2021).

 Physical Checkup

• It should be properly assessed to rule out organic and systemic etiology of irritability, including infection and structural abnormalities at birth (Behnaz Bagherian et al., 2021).

 Tools for Screening

• Depending on the effects of maternal mental health on the care of the babies, the Edinburgh Postnatal Depression Scale (EPDS) or PHQ-9 is an efficient instrument to use when diagnosing postpartum depression (Behnaz Bagherian et al., 2021).

 Parenting Education

• It should be recommended how to address colic, that should contain a message of assurance that it is normal. Moreover, the parents should also be taught more about symptom management (Behnaz Bagherian et al., 2021).

Plan of Treatment

Support and Reassurance

• Convince parents to ignore colic as a normal growing-up process and that it will wear off. Soothe their nerves by assuring them that this is a normal development for Amelia to gain weight and be an ordinary healthy child.
• Give colic and postpartum care information/fliers (Hjern et al., 2020).

Strategies for Behavior

• Swaddling, rocking, and white noise can be used to calm the infant during episodes.
• Provide breaks or support groups to lessen the weariness of the parents. To support the mother, recruit the father in care (Hjern et al., 2020).

Follow-Up

• Revisit Amelia after two weeks to find out her progress and new concerns. Advise the family regarding the family dynamics of both parents and offer supplemental support (Hjern et al., 2020).

Postnatal Mental Health

• In case the PHQ-9 scores indicate PPD, Ms. Arlington has to be referred to a mental health worker by a specialist (Hjern et al., 2020).

Conclusion

With regard to age and the symptoms of Amelia Arlington, her recurrent fussiness and crying are most likely to be the symptoms of colic. She presents no other signs of a developmental disorder and has normal developmental parameters to support this claim. The clinicians did not include gastrointestinal issues and allergies to milk in the list of symptoms that the patient was having. The management plan includes consoling, feeding, and close care. Addressing the emotions of Ms. Arlington and offering the follow-up treatment could help the family to manage their anxieties and ensure the health of Amelia and her mother.