Versatility of infantile tremor syndrome as nutritional emergency - Curse of improper complimentary feeding

• Main Authors: K Madhunandan, Ramesh Pol, Bhuvaneshwari C Yelamali, Ashok V Badakali, Raghavendra Vanaki
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Journal of Pediatric Critical Care
• Subjects: nutritional emergency; infantile tremor syndrome; vitamin b12 deficiency; complimentary feeding
• Online Access: http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2019;volume=6;issue=1;spage=49;epage=50;aulast=Madhunandan

Objective: To delineate various presentation of infantile tremor syndrome (ITS) as nutritional emergency. Material and Methods: All children presenting to emergency who had typical features of ITS admitted in PICU at tertiary care hospital, Bagalkot were analysed. A detailed history and physical examination was carried out. Relevant laboratory investigations were done. Results: A total of 9 cases were seen during this period. All children presented in PICU with life threatening emergencies like severe pneumonia, CCF, convulsions and severe dehydration. Mean age group of 12 months and all of them belong to lower socioeconomic group. Strikingly none of our babies received proper complimentary feeding.All children were on breast milk, 6 babies on exclusive breast feeding, 3 children received improper andinadequate complimentary feeding. Notably all cases were Severe Acute Malnutrition (SAM) as per WHO classification.All children received injection Vitamin B12 and folic acid, intravenous antibiotics and other micronutrients. All children improved,there was no mortality noted and mean duration of hospital stay was 17.8 days. Conclusion: ITS can present as life threating emergency in PICU.All children with ITS has severe acute malnutrition. ITS has good prognosis with proper nutritional rehabilitation and supportive management.