Chilled Infants
Newborn infants that have been chilled (usually after being abandoned and found in the sleeping box, or on the bottom of the cage) require special care. If a newborn infant has been off the parents for any length of time, it will rapidly become hypothermic. It is imperative that infants remain on the back of the father, mother or sibling at all times for the first two weeks, as these infants are unable to maintain their body temperature and will rapidly become hypothermic if they are left on their own for any length of time. In the normal family, the father will carry the infant the majority of the time, and will pass it over to the mother for nursing duties when the baby starts searching for a nipple. In an inexperienced family, the male may not assume parenting duties, and the female may become irritated if she carries the infant all or most of the time. If the members of the family do not participate in carrying infants, the mother may either injure the infant or abandon it.
If an infant is found abandoned in the cage, sleeping quarters or hanging on the cage wire, a decision must be made whether to try to allow the family a second chance at carrying it, or if the infant(s) should be removed for bottle-feeding. This is a major decision, as hand-rearing infants is a major undertaking and requires a serious commitment. However, attempting to return the infant(s) to the family group is also a decision to not be made lightly, as there is a good chance that the baby will be rejected again, and may be injured or die as a result of this decision. If it is not possible to watch the family very closely, then it is probably safer to remove the infant for bottle-feeding.
If the chilled infant is removed for bottle-feeding, it must be warmed up rapidly to a safe temperature. The use of a bird brooder is often the safest way to warm up infants. Set the baby on a small stuffed animal (if it can still hold on) and place it in the bird brooder, set at 99-101 degrees F. Check the baby frequently as it warms up. It is also possible to use a stuffed animal that has been opened up and filled with rice. If the stuffed animal is then warmed in the microwave oven, the rice will warm up, and will provide a more natural source of radiant heat for the infant (or as an alternative, a rubber glove filled with very warm water can be inserted into a stuffed animal or a terrycloth towel can be wrapped around it). In an emergency, human body heat can be used to keep an infant warm. Using a small piece of terrycloth for the infant to cling to, place the baby against your chest, using your hand to provide additional heat and protection for the baby.
It has been my experience that chilled infants require broad-spectrum antibiotics for their first seven days of life in order for them to stay alive and thrive. I am not sure what the mechanism is that causes them to require antibiotic therapy, but my survival rate for chilled infants has been very high since I began treating them immediately after the initial warming. I have had the best success using AugmentinTM PO BID. Fluoroquinolones should be avoided in infants since it may cause bone/cartilage damage. Please don't attempt dosing and treatment without the help of an experienced NHP (non-human primate) veterinarian. If your vet is not experienced with primates, he or she can call the lab that they use for their testing, and ask for a consultation with someone experienced in NHP medicine. For example, I do part-time consultations for Antech Diagnostic Labs, and can assist vets who use that lab.
Chilled infants that are being treated with antibiotics usually do not develop any problems as a result of the antibiotic therapy, i.e. diarrhea, candidiasis or enteritis.
It is also important that any infants that have been chilled as a result of being abandoned by the parents should NOT become chilled again, and care must be taken to ensure that the babies are kept at a consistent temperature until they are able to regulate their own body temperature.
Injured InfantsOn occasion, parents may injure an infant, either by mistaking the tail for the umbilical cord, resulting in partial amputation, or by just chewing on limbs or tail. It is my opinion that parents are sometimes bothered by the infant's tail curling around and irritating the axilla of an inexperienced adult, resulting in them grabbing the tail and chewing on it.
Regardless of the cause, bite wounds should always be taken seriously. Injured infants should be removed for hand-feeding, as it will not be possible to medicate them while they remain with the parents.
Injured infants should have the wounds cleaned with hydrogen peroxide, followed by a povidone-iodine flush, taking care to not allow the infant to become hypothermic during treatment.
If a limb has been injured, it may be necessary to further amputate the limb to remove jagged bone ends and fragments, and it may be possible to fashion a muscle pad to cover the stump. While the general rule in veterinary medicine is to NOT suture closed bite wounds, if the wound is well-cleaned and debrided, it has been my experience that suturing a stump closed is safe and provides the best way for adequate healing to occur. Inserting a drain is not necessary, in my opinion.
If a tail has been partially chewed on and partially amputated, it is best to amputate the tail proximal to any bite marks to provide the best chance for healing. The tail stump may be sutured closed, using a mattress suture, with non-absorbable sutures, or the stump may be left open to granulate in. Cleaning with hydrogen peroxide and povidone iodine should be performed (not at the same time, as an explosion may occur if hydrogen peroxide and povidone iodine are mixed together).
Head wounds are very serious. I have had infants that had bite wounds through the skin and had punctured the calvarium, and with appropriate care, they have survived and thrived. In these cases, I have used cefotaxime (ClaforanTM), an antibiotic that crosses the blood-brain barrier, which is an injectable antibiotic that has proved life-saving in several cases.
All infants that have been injured should receive antibiotic therapy for 7-10 days. Again, I have had great success using AugmentinTM, orally every 12 hrs. As an alternative, trimethoprim/sulfa also has worked well.
Ill Infants
Occasionally, a mother may not be producing milk, due to illness, or for some other reason, the infant may not be nursing properly. It takes three days for a normal infant to die if it is not nursing. Usually, by the second day, the baby will be riding lower on the parent's back, as it is weaker and not able to hold on as well, or it may start falling off. Another sign of a weak, ill infant is that the tail will begin hanging straight down and not remain curled tightly against the body of the parents. Sometimes the infant will develop diarrhea, which may be visible as a wet area under the tail and around the perineum. Diarrhea and dehydration may result in a weak infant falling off the adults.
Infants that are very ill may be abandoned by the family, as they seem to realize that the baby is in serious trouble. While running blood tests on infants is very difficult, Gram's stains of the feces and bacterial culture of the stool are easily performed. Infants that are sick are often dehydrated, and will benefit from warmed sub-cutaneous fluids (with the addition of hyaluronidase, WydaseTM, at 100 units/liter of lactated ringers solution). I have found that by adding the hyaluronidase, it is often not necessary to set an intravenous catheter or intraosseous catheter, which is problematic in infants. Sub-cutaneous fluids are well-absorbed if hyaluronidase is added to the fluids. SQ fluids have saved many a dehydrated, weak infant. Always remember that warmth and hydration are the first orders of business, and once they come around, they will often develop a nursing response.
With a sick infant, it is necessary to be aggressive. Heat, fluids and antibiotics can make the difference between life and death for these fragile little monkeys. How you treat them during their first 12 hours in your care will most likely determine whether they live or die.
Right now, I have a little marmoset, Lefty, who was attacked by his mother, who ate off most of his tail and right hind leg. After emergency surgery to make him a stump, and to clean up his tail wounds, he is now a thriving, three-legged toddler who has no idea that he is disadvantaged, as this life is all he knows. He runs, climbs, plays and gets into trouble, just like his brother, Rudy, who was unscathed. I should mention that injured infants will usually not grow as large as an uninjured one, as they are putting a lot of metabolic energy in healing, and I think this somewhat stunts their growth.
I hope this information helps you and your vet in providing the best care for your callitrichid babies. For additional information on hand-rearing infants, please consult my paper on callitrichids.
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