A six week old, exclusively breast fed female infant, growing well along the 25th centile presented with a 24 hour history of decreased frequency and duration of breastfeeding. Her mother was especially concerned, as her ‘feeding’, as measured by frequency and duration, was significantly decreased according to her ‘nursing tracker’: an iPhone application her mother had been using since birth to record feeds. This decreased feeding was prodromal to an RSV positive bronchiolitis, which developed 24 hours after initial presentation, with respiratory distress and insufficient feeding. The infant required nasogastric feeding and supplemental oxygen as supportive therapy.
The second case was a seven month old boy presenting with macrocephaly. His father had been inputting his weight, length and head circumference on Total Baby, an iPhone application designed as a log for medical information. Despite no other concerning features, his father was concerned that his head circumference was greater than 2 standard deviations above the mean. Cranial imaging and clinical examination were normal, and the child was discharged from further follow up.
Smartphone usage is now estimated to account for 40% of mobile phone usage, with the biggest growth in the demographic also associated with childbearing (ages 18-25, age 26-40). Whilst the medical profession have been quick to adopt applications which help with diagnosis, intervention and protocol driven practice, there has been little work looking at the way in which parents and children themselves are using the internet and smartphone applications as a source of information and triage for health conditions and concerns. The notion of applications as a dynamic log and surveillance tool must be explored to ensure that smartphone applications use scales, measures and triggers routed in evidence, and can provide parents and carers with a safety net in monitoring child health.