According to evidence-based guidelines, maintaining a usual, age-appropriate diet (as tolerated) is recommended in dehydrated children with gastroenteritis. In younger children, breastfeeding or administering formula should also continue.

Limiting lactose-containing foods is generally not necessary.

The BRAT diet consists of giving bananas, rice, applesauce, and toast. No evidence currently exists to justify ordering this diet in children with gastroenteritis.

Diet as tolerated is a great idea. Unless the vomiting has stopped and they are sufficiently rehydrated, one should further recommend a low osmo rehydration solution like pedialyte. Also, foods high in simple sugars (eg fruit juice) and fat should be reduced.

90% of newborns have first passage of stool, known as meconium, within the first 24 hours of life. Meconium is a thick, dark, greenish-black substance composed of intestinal cells, lanugo, mucus and bile.

If meconium is not passed within this time frame, consider an intestinal obstruction, anatomic abnormalities, Hirschsprung’s disease or Cystic Fibrosis.

Note that premature infants commonly have delays in passage of first stool (after 24 hours).

The patient history and clinical manifestations are characteristic of Juvenile Myoclonic Epilepsy. Patients with Juvenile Myoclonic Epilepsy initially experience myoclonic jerks upon waking in the morning, with symptoms subsiding later in the day. Typically a few years later, the patient develops generalized tonic-clonic seizures, which can be precipitated by sleep deprivation or other stressors. Onset is usually between ages twelve and sixteen years.

Lafora disease is a type of severe, progressive myoclonic epilepsy that usually appears in children between ages ten and eighteen years. Initial symtoms include myoclonic jerks that increase in intensity and frequency with disease progression. Neurological findings become prominent, particularly mental deterioration within the first year of onset.

Patients with Frontal lobe epilepsy experience seizures originating in the frontal lobe and have manifestations (including motor and behavioral) concurrent to the specific area affected.

Absence seizures often occur in school-age children, and may be mistaken for inattention or daydreaming.

Molluscum Contagiosum is the most likely diagnosis given the history (playmate having similar condition) and physical presentation, particularly the central umbilication and core of the papules.

Molluscum Contagiosum is a viral disease caused by a DNA poxvirus and transmitted via direct skin to skin contact or sharing objects touching the skin. Patients present with flesh-colored papules that contain viral bodies, usually appearing on the extremities, trunk and face. Highest incidence is in children less than 5 years of age. Usually, Molluscum Contagiosum is diagnosed by simple identification of the characteristic central umbilication and core of the papules. Treatment options include topical vesicants and cryotherapy among others. Or, simply waiting for disappearance is advised, as most cases resolve within weeks to months.

Atopic dermatitis, or eczema, is the most common inflammatory skin condition in childhood. It typically presents in skin creases or flexure surfaces as a red, pruritic dermatitis in variable stages of vesicles, scaling and excoriations.

Warts, caused by Human Papilloma Virus, are present in 10-20% of school-aged children. There are many different types, most appearing on the hands and feet.

Granuloma annulare, a benign inflammatory dermatosis, usually presents with groups of papules in an annular arrangement.

Fetal Alcohol Spectrum Disorder (FASD) is the leading cause of mental retardation in the western world. Children with FASD present with both physical and developmental/behavioral abnormalities including growth retardation, craniofacial and skeletal anomalies, developmental delay, hyperactivity, and intellectual impairment.

Mental retardation is an inevitable result of untreated congenital hypothyroidism. Congenital hypothyroidism results from improper development of the thyroid gland in utero, impaired thyroid hormone synthesis or metabolism, thyroid hormone receptor abnormalities, maternal thyroid or autoimmune disease, and deficient TSH or TRH.

Fragile X and Down’s syndrome are the most common genetic disorders causing mental retardation, although there are numerous others.

Other etiologies include congenitally acquired infections such as CMV and rubella, CNS injury, and neurodegenerative diseases.

Reference:
http://emedicine.medscape.com/article/1180709-overview