Sex: M
Vaccine: HEP
Symptoms: Decreased appetite, Eructation, Feeding disorder of infancy or early childhood, Hernia, Infantile spitting up
Clinical narrative: Information has been received via a pregnancy registry for GARDASIL vaccine (MSD WAES # 0809USA00718), from physician via medical records concerning a 9 week black male who on 20-MAY-2008 was vaccinated with RECOMBIVAX HB.  On 25-JUL-2008 the baby came in for a well child exam.  The baby's interval history was unremarkable.  The baby is unable to life his head when in a prone position.  The baby developed a nasal congestion, colic, a rash (on face, forehead, cheeks, and chin, bumps, no redness) and an umbilical and reducable hernia was present.  Immunizations on 25-JUL-2008 included PEDIARIX, PREVNAR, and ROTATEQ.  The patient's next well child visit was when the baby was 2 months old.  On 12-SEP-2008 at 3-months-old the baby had a well child visit.  The baby was presented with spitting up, teething, not eating well and decreased appetite.  The baby was not eating as usual and spitting up his formula.  The mother changed his formula 1 week ago.  He used to take 6 oz every 3 hours now he takes 3 to 5 each feeding.  The baby's bowel movement was regular every day, no fever and acting normal.  Positive for spitting up with burping.  The baby had normal bowel sounds, no masses or tenderness; no organomegaly no abdominal or inguinal hernia.  The physician's assessment was loss of appetite.  Since the baby was gaining weight well and spitting up only small amounts with burping, the physician asked the parents to continue with the new formula 1 more week and call to follow-up.  The baby was overfed before and almost tripled his birth weight by 3 months of age.  On 25-SEP-2008 the baby came in for a well child visit at 4 months.  The baby received a second dose of PEDIARIX, PERVNAR and ROTATEQ vaccines.  The baby was positive for "lazy eye" (left).  Upon eye examination lids and conjunctiva were normal; pupils and irises were normal and fundoscopic exam revealed red reflex bilaterally.  The baby had no organomegaly ventral hernia present.  Follow-up was scheduled for a visit in 2 months.  On 14-NOV-2008 the baby came in for a well child visit at 5 months.  The patient was presented with constipation.  This has been a problem for 5 days.  On average, the baby has 2-3 bowel movements per week.  The constipation has been accompanied by bloating, cramping and irritability.  No associated symptoms of abdominal pain, blood in stools, clay-colored stool, failure to pass meconium by 48 hours, hemorrhoids, melena, nausea, vomiting, rectal bleeding, stool incontinence or watery bowel movements.   Diet was adequate for dietary fiber, significant for some constipating type foods, and not enough fluid.  The assessment was constipation and the physician told the mother to give more fluid (4 ounces of water/grape fruit mix).  The patient will come back if the symptoms are not resolved.  On 21-NOV-2008 the baby came in for a well child visit.  The baby's interval history was unremarkable.  The baby was administered with PEDIARIX vaccine, PREVNAR vaccine, ROTATEQ vaccine, FLUZONE vaccine, and hemophilus influenza b vaccine PRP-T conjugate.  Upon eye examination the lids and conjunctiva were normal, PERRLA, strabismus screen revealed intermittent esotropia of the left eye.  The assessment was strabismus (unspecified).  Follow-up visit was scheduled for visit in 3 months.  Upon internal review umbilical hernia and intermittent estropia of the left eye was considered to be a congenital anomaly.  Additional information is not expected.