Newborn examination

The purpose of examining a newborn is to detect any pathology or to identify any "medical problems", as well as to remove any questions from the mother and difficulties that she has encountered in communicating with her child. Finally, the purpose of the examination is also to give the mother routine advice on caring for the child before it is discharged from the hospital. In the case of home births, advice is given on raising the newborn during the first week of life.

Before examining the newborn, find out its body weight. Find out whether the pregnancy and birth were normal? What is the mother's Rh factor? For the examination, choose a quiet, warm and light room and enlist the help of the baby's mother. Explain to her the purpose of your examination. Pay attention - does she look angry or depressed? If she says something - listen to her carefully. Examine the child according to a certain system, for example, from head to toe.

Head. Measure the circumference of the head and pay attention to its shape (various deformations associated with childbirth usually pass quickly), the condition of the fontanelles (they become tense when the baby cries, as well as with increased intracranial pressure). Eyes: pay attention to whether there is corneal opacity or conjunctivitis? Ears: pay attention to the shape and position of the auricles. Are they located too low (i.e. below the eyes)? Nose: it serves as a kind of indicator of jaundice. Exhaling through the nose with the mouth closed is a test for the presence of choanal atresia. Skin color: in case of pathology, it can be cyanotic, pale, icteric, red. Oral cavity: insert your finger into the baby's mouth and check - is the integrity of the soft and hard palate preserved? Is the sucking reflex sufficiently expressed.

Arms and hands. Individual palmar folds - lines, can be a manifestation of the norm or Down's disease. If the child's hand is in the position of a "waiter waiting for a tip", remember Erb's palsy with damage to the trunks _C5 - _C6.

Chest. Observe the respiratory movements of the chest. If you notice a "grunting" sound when breathing or a shift in the intercostal spaces, this may indicate respiratory distress. Palpate the cardiac and apical impulses in the precordial region. Auscultate the heart and lungs. Inspect the entire spine to detect possible defects in the spinal canal (neural tube).

Abdomen. Wait a little while with palpation of the liver and spleen. Note whether there are any pathological masses in the abdominal cavity. Now carefully examine the navel. Is it healthy? Gather the skin on the abdomen into a fold to assess the skin turgor. Examine the genitals and anus. Are the openings of the urethra and anus clearly visible? 93% of newborns have spontaneous leakage of urine in the first 24 hours. Is the opening of the urethra malpositioned (hypospadias), are both testicles descended? The clitoris in newborns looks quite large. Minor bleeding from the vagina can be considered a normal variant, this is due to the cessation of the flow of maternal estrogens into the child's body.

Lower extremities. Tests for congenital dislocation of the hip joint. Avoid repeated use of these tests, as they are painful and may themselves cause dislocation. Note whether there is a femororadial pulse lag, which may indicate coarctation of the aorta. Is there a persistent deformity of the foot? Now assess the condition of the toes - are there too many, too few, too cyanotic?

Gluteal region and sacrum. Are there any "Mongolian spots" (they are bluish) on the skin of these areas? Fortunately, they are harmless.

Testing the central nervous system. First of all, hold the child in your arms. Now only your intuition can tell you whether the child is sick or healthy? Is he or she prone to flinching (this may indicate hypoglycemia, hypocalcemia, infection)? Already at this stage of development, the child should have slight control over the position of the head. Are the limbs moving normally, is the muscle tone spastic or flaccid? Testing the Moro reflex is rarely informative and, in addition, it is unpleasant for the child. This reflex is tested as follows: the child is seated at an angle of 45°, supporting his or her head. When this support is removed, both of his or her arms are abducted, the palms open, and then the arms are brought together. To evoke the grasping reflex, lightly hit the child on the palm.

It is important to find out whether the birth was late or premature, or whether it occurred exactly on time?

Any deviation from the norm that you discover should be discussed with the child's mother and father.

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