A Typical Newborn

Flexed Puffy Molded Nose breathers Irregular HR and

RR Acrocyanosis Periods of

reactivity

Apgar score: What does it tells us?

HR, Resp. effort, tone, reflexes, color

1 min & 5 min 0-10 Good: 7-10

They do all kinds of weird things

Cross their eyes Holes in their

heads Have dry skin

(after the vernix absorbs)

They sneeze Like being

wrapped up tightly Don’t get spoiled

Know your Patients history!

Prenatal: IDM?, GBS+?, mother’s bld type, significant labs or tests, gen. history

Intrapartum: length of labor, PROM, medications received, anoxia, assisted birth, FSE,

Determining Gestational Age

Neuromuscular Physical

skin lanugo plantar surface breast eye/Ear Genitals

Score: i.e. 30=36 wks

Gestational Age and Weight

AGA LGA SGA LBW (<2500 g) VLBW (<1500 g) IUGR (<rate of

growth)

Erythromycin, Hep B & and Vitamin K!

Newborn Screening

Hypothyroidism PKU Galactocemia Sickle cell (most

common) CF Congenital adrenal

hyperplasia (CAH)

Pulse Oximetry: CDC recommendation

Well newborn screening >24 hours old or at discharge if early discharge.

To detect asymptomatic critical heart defects

At least 95% in right hand or foot and < 3% difference between R hand and foot

Algo hearing test

50% congenital 50% environment

OAE: otoacoustic emissions testing

ABR: auditory brainstem response

They have to be calm and quiet!!!

On a scale of 1-10 rate your pain!

Obvious Subtle

Grimace, eye squeeze, brow contraction, nasolabial furrows

Flexed and rigid Really quiet or

restless Pain scales for Infants:

CRIES or NIPS

Newborn stools

Newborn Reflexes

Circumcision

Informed consent from parents

Pain medication for patient Before and after)

Post op care Check for

bleeding, voiding

Reasons for circumcision

Religious Cultural HIV Prevention? Cleanliness?