Differential Diagnosis for Newborn with Sleeping and Feeding Difficulties, Vomiting, Diarrhea, Tachypnea, and Sneezing

• Single Most Likely Diagnosis
  • Congenital Infection (e.g., congenital pneumonia, sepsis): This is a likely diagnosis given the combination of symptoms such as vomiting, diarrhea, tachypnea, and sneezing, which can indicate a systemic infection.
• Other Likely Diagnoses
  • Gastroesophageal Reflux Disease (GERD): Symptoms like vomiting and feeding difficulties could suggest GERD, especially if the newborn is otherwise healthy.
  • Milk Protein Allergy or Intolerance: This could explain gastrointestinal symptoms like vomiting and diarrhea.
  • Respiratory Distress Syndrome: Tachypnea and sneezing might indicate respiratory issues, possibly related to surfactant deficiency or other pulmonary conditions.
• Do Not Miss Diagnoses
  • Necrotizing Enterocolitis: Although more common in premature infants, this condition can be deadly and presents with abdominal symptoms and respiratory distress.
  • Congenital Heart Disease: Can lead to feeding difficulties, respiratory symptoms, and failure to thrive.
  • Botulism: Though rare, infant botulism can cause constipation (less commonly diarrhea), weak cry, and poor feeding, which could be confused with the presented symptoms.
• Rare Diagnoses
  • Congenital Anomalies (e.g., intestinal obstruction, Hirschsprung’s disease): These conditions can cause severe gastrointestinal symptoms.
  • Metabolic Disorders: Certain metabolic disorders can present with nonspecific symptoms like feeding difficulties and respiratory distress.
  • Inborn Errors of Metabolism: Conditions like maple syrup urine disease or organic acidemias can cause severe illness in newborns with nonspecific initial symptoms.