Newborn Assessment

Detailed Newborn Assessment is explained in this PPT. It is very useful for GNM students.

2. Toidentifynormalcharacteristicsinthe
newborn.
Toidentifyexistingabnormalities,ifany
Tocarryoutimmediateactionifthereisany
deviation.
Toestablishabaselineforfuturephysiological
changes.

3. Keepyourhandsclean,dryandwarm.
Keepyournailsshortandfreeofnailpolish.
Donotexposethebabyunnecessary.
Donotexposethebabytodraftsandchills.
Examinethebabyswiftlynotmorethan8to10
minutes.
Ifnewbornisirritable/cryingduringexamination
allowhimtosuckonanipple.
Informmotheraboutoutcomeofexamination.

4. Taketemperature:(37˚C±0.5˚C)
Countheartrate:120-160beats/minute
Countrespiratoryrate:30-60breaths/minute

5. Weight: 2.7 kg (with a variation of 2.5-3.9 kg or more)
Length: 50 cm (with the range of 48-53cm)
Head Circumference:33-35.5 cm
Chest Circumference:30.5-33 cm

6. Color: skin is pink
Cry: loud and vigorous, immediately after birth.
Activity : good activity.
Lanugos: fine hair on the body.
Skin: smooth and velvety—rose petals.

7. Cyanosis
Skin: Check for …..

8. Petechiaes
Jaundice
Vernix

9. ErythmaToxicum
Milia
MongolianSpots

10. Fontanels:checkforsizeandshapeoffontanels,
oranyotherabnormalitylikeenlarged,bulgingor
sunken.
Anterior FontanelPosterior Fontanel
Diamond shape Triangular shape
Size :2.5 x 4.5 cms Size : 0.5 to 1 cm
Closes : 18 month
(1.5 year)
Closes : 4-6 week
(1.5 month)

11. Head:Checkfor…..
Caputsuccedaneum
Cephalhematoma

13. Molding
Hydrocephalus
Anencephaly
Encephelocele
Overridingofcranialsutureetc.

14. Eye : Check for…..
Conjunctivitis.
Epicanthal fold
Inner canthus
Protrusion of eye ball
Pupilary reflex to light
Congenital cataract

15. Ear : Check for……
Shape, position of ear.
Check for any accessory
lobules.
Check for hearing.
NB : Low set of ear indicates Down’s syndrome.

16. Nose : Check for……
Flaring of nose.
Depressed nose bridge.
Patency of nasal canal
NB : Depressed nasal bridge sign is the indicator of
Down’s Syndrome.

17. Mouth:Checkfor……
CleftlipandCleftpalate.
EpsteinPearl

18. Tonguetie.
Aglossia
Hypoglossia.
Sizeofchin.
NB:SmallchinisindicativesignofPierriRobin’s
syndrometobeconfirmedifassociatedwith
smallheadandpigmyappearance.

19. Neck : Check for……
Any mass in neck.
Torticolis.
Lymph nodes.
Range motion of Neck.
NB: If neck is short & webbed it indicates Turner’s
syndrome.

20. Chest : Check for……
Retraction of the intercostals space.
Breast for size, symmetry, color & any discharge.
(Witch’s Milk)
Auscultate air entry in the lungs.
Respiratory rate.
Auscultate heart sound.
NB : Chest retraction shows
Sever Respiratory Distress.

21. Abdomen:Checkfor……
Contourofabdomen.
(ScaphoidAbdomen)
Omphalocele.

22. Umbilicalcord
(2Arteries,1Vein).
Checkforlever,spleen
Enlargement,anymass
orLump.
Femoralarterypulsationinbothsideofgroin.
Inguinal hernia.

23. Genitals :
Ambiguous Genitals

24. Genitals : Check for……(Female)
Labia majora covers labia minora..
Discharge from vagina. (Pseudomenstruation)
Size and shape of clitoris.
NB : Premature infant’s labia is not full covered.

25. Genitals : Check for…(Male)
Scrotal Swelling (Hydrocele)
Location of Testis

26. Prepuce retraction without any
problem to rule out Phimosis
Urethral opening to rule out Epispadias And
Hypospidiasis

27. Rectum : Check for……
Anal patency.
Passage of Meconium.
Fistula or any abnormal opening.

28. Back : Check for……
Curvature.
Mongolian spot on sacrum.
Spina bifida
Meningocele or Meningomyelocele
Tuft of hairs(if Conceled Spina bifida occulta)

29. Extremities : Check for……
AnyFracture
Fingersandtoesformissingdigits,extra
digits(polydactyly),Fuseddigits(syndactyly)

30. Feettobelookedforanypositionalabnormalities
mainlyclubfoot.
Rangeofmotion,Congenial
Dislocationofhiporanyirregular
position.

31. REFLEXES OF THE NEWBORN:
Rootingreflex:Ifcheekofinfantisrubbed,the
infantwillturnhisheadonthatside.
Suckingreflex:Developedat32-36Weeksof
gestation.

32. Moro’sreflex:Graspthewristofinfantanddrawit
forwardandthandropbackontothebed,the
baby’sbodywillshowsallextremitiesextendingand
flexing. OR
Makealoudsoundbybangingtheexamination
table,thelimbwillextendandflex.
NB:Itdisappearbythe3-4months

33. Dancingreflex:Placethechildinstanding
positionnearthetable,thefeetwilltouchthe
tableandflexalternatelyboththelegsgivingan
appearanceasbabyisdancing.
NB:Itdisappearbythe1-2months

34. Doll’seyereflex:Turntheheadoftheinfantthe
eyemovesintheoppositedirection.
NB:Itdisappearoncethechildisabletofocus.

35. Tonicneckreflex:Wheninfantneckisquickly
turnedtooneside,theextremitiesonthatside
extendandoppositesideflex.

36. Graspingreflex:Putyourfingernearthechild’s
palm,thechildclosesitsfingeraroundit.

37. Gagreflex:Reflexcontractionofbackofthroat
whichmakesimmediatereturnofundigestedfood.
Extrusionreflex:Whentongueis
touchedordepressedchildrespond
byForcingitoutwards.
NB:Itdisappearbythe4months

38. Yawningreflex:Spontaneousresponsetodecreased
oxygenbyincreasingamountofinspiredair.
Sneezingandcoughingreflex:Babies
coughandsneezeforclearingtheir
Nasalpassagesofsomethingirritating,
suchasdust,ortomovemucusorsaliva
outoftheirthroats.

39. Glabellarreflex:Tappingbriskly
onGlabellacauseseyesto
closetightlyorblinking.
Crawlreflex:Babyplacedon
abdomenbabyflexeslegunderas
iftocrawl.