From birth to age one month, the baby is medically known as a

neonate.

The Newborn

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Medical Care and Testing

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Apgar TestTest used to check the physical condition of a

newborn, determining likelihood of survival.Checks for baby’s pulse, breathing, muscle tone,

responsiveness, and skin color. Babies are given either a 0, 1, or a 2 in each category.Heart beat and breathing are the most importantSkin color (a sign of circulation) is the least important.

Test is given 1 minute and 5 minutes after delivery.Umbilical cord is usually attached for 1st test, but not

2nd.2nd score should be higher than 1st.

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Most healthy babies score 6 or 7 at 1 minute, then 8-10 at 5 minutes.

If a baby scores 7 or less at 5 minutes, he/she is tested again at 10 minutes after birth.A low score means the baby needs special

medical care.

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After Apgar test, the nurses put antibiotic drops in eyes, a thermometer is attached to baby’s chest, and the baby wears a snug hat. Most babies receive a vitamin K shot to help clot blood. A sample of blood is taken from the umbilical cord. Injections of penicillin may be given if possible strep infection.

Footprints are made and wrist/ankle bands are placed for identification

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Neonatal Behavioral Assessment ScaleAka Brazelton scale: helps doctors spot any

problems as early as possible. This tests for:Alertness, attention to sound, light, tendency

to cuddleBaby’s general activity level and reflex

behaviorLevels of excitement and irritabilityResponse to stress

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Other Screening TestsScreening can be done for 55 disorders (29 of

which are treatable)Anemia- a condition that occurs when the level

of healthy red blood cells, which carry oxygen to all parts of the body, becomes too low. This can result in fatigue and shortness of breath

Pediatricians test for this in infants

Phenylketonuria- a disease that can cause mental retardation if untreated by diet.

Hearing tests are done to make sure speech and language will not be delayed.

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Hypothyroidism: leads to slow growth & brain development

Galactosemia: the inability to convert a sugar in milk into glucose. If untreated can cause blindness, mental retardation, and

death.Sickle cell anemia: can cause anemia, pain, damage to

vital organs, and death.Early and consistent treatment reduces the problems

Jaundice: a buildup in the blood of a yellow pigment called bilirubin.Baby is placed under bright lights to help reduce yellowing.If untreated, a severe case can lead to cerebral palsy,

hearing loss, and mental retardation.

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Care for Premature Babies+12% of babies are born premature, some

with congenital problems involving heart, digestive tract, spine, or brain.

These babies are placed in an intensive care nursery (ICN)

Newborns who need intensive care live in neonatal intensive care units (NICUs).These consist of heated, completely enclosed

beds.Neonatology: is a branch of medicine

concerned with the care, development, and diseases of newborns.

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CircumcisionAbout 65% of newborn boys are

circumcised.

A surgical procedure in which the skin (foreskin) is removed from the end of the penis.Slight risk of infection.

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Well-Baby CheckupA routine medical visit in which the doctor

examines a baby for signs of good health and proper growth, done within 3 to 5 days after birth.

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ReflexesThe absence or weakness of a reflex may

result from prematurity or congenital problems.

Withdrawal reflex: when soles of feet are pricked, newborns jerk or withdraw their legs

Some reflexes will disappear with time.Rooting reflex: When you touch a

newborn’s cheeks, lips, or skin around the mouth, the baby searches for food. After finding an object, the baby begins to suck.

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Reflexes Cont…Palmar (grasping) Reflex

Newborns’ fingers tighten around any object placed in the palm. Grasp is strong enough to lift them into a sitting position.

Plantar (grasping) Reflex

Newborns’ toes tighten around any object when the ball of the foot is stroked. This reflex disappears between 8-15 months of age.

Babinski Reflex

Newborns’ toes fat out if the outside of the sole is stroked from heel to toe. Reflex ends at about one year of age.

Moro (startle) Reflex

The reflex consists of two movements. Newborns fling arms and legs out and pull them back again when they are startled.

Walking Reflex

When babies’ feet touch a solid surface, alternation steps are taken as in walking. This reflex disappears in three or four months.13

Meeting the Newborn’s Physical Needs

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Breast-feeding vs. formula feedingBreast-feeding Formula-feedingMother’s need to:

Eat a balanced dietDrink at least 8 oz. of

fluid a dayRealize certain foods

you eat may upset the baby

Talk to doctor before taking any over-the-counter drugs

Rest and avoid stressBest 1st food for

newborns

Mother’s need to:Talk to dr. about

which formula to usePowdered, liquid

concentrate, ready-to feed.

Cow’s milk base vs. soy milk base

Throw away unused formula or store in refrigerator

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DiaperingDisposable vs. cloth diapers

Must consider cost and convenienceDaycares require disposable diapersConsider how much time it will take to wash

diapersDiaper services are sometime available- drop

of soiled diapers and clean one are delivered.

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BathingNewborns don’t get too dirty except for

their faces, necks, and diaper areas.

Sponge baths are recommended until the navel has completely healed-up to three weeks after birth.

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SleepingNewborns average about 17 hours of sleep per

day.

Baby should sleep on firm mattress in a crib.Pillows, stuffed toys, flat sheets, and blankets

should only be used after baby is 1 year old.

Babies should be placed on their backs for sleeping.Doing this along with giving baby a clean pacifier

will reduce the risk of SIDSBaby dies without warning while sleeping.

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ExercisingExercise is important for muscle

development, coordination, and even relaxation.

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SchedulingAfter a few weeks, most babies begin to

develop eating-sleeping patterns.These change as baby’s needs change.

Parents can help shape how these schedules look by planning feeding times every two hours for newborns.

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Meeting the Newborn’s Intellectual Needs

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What Newborns Can DoRecognized the human voice and look in

that directions

Move arms and legs rhythmically to human speech

Imitation: copying the actions of another personNewborns can imitate facial and hand

gestures

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Helping Babies LearnFor the first 3-4 weeks, newborns vision is

limited, so mobiles hung above the beds this early are almost useless.

They can however see things safely attached in the corner or sides of their cribs.

Objects should be rotated to keep infant interested.

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Meeting the Newborn’s Social-Emotional Needs

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Alertness of NewbornsBabies learn best when they are in an alert-

inactive state.calm and quiet state of mind.

Babies differ in length of time they are alert.

With each passing week, newborns spend more time in the alert-inactive state.

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Soothing a Fussy BabySome babies cry 1/6 to ¼ of the day!The only way a newborn can communicate is

through crying.Colic: a condition (not a disease) in which the

baby has intense abdominal pain. Allergies, tension, swallowing air, and hunger are

all causes.How to soothe:

Rock the baby in an over-the-shoulder positionCarry the baby around the house/yardSing and play musicTake baby for car or stroller ride

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Meeting the Parents’ Needs

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The Need for RestBeing tired can lead to illness, irritability, and

depression.

Parents of newborns should sleep or rest when the baby is sleeping.

Parents should avoid unnecessary chores or cooking complicated meals.

Parents can take turns getting up with baby at night.

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Taking Care of New BusinessWhile in the hospital, parents should apply

for their baby’s birth certificate and social security number.

Parents will need to add child as a beneficiary to life insurance policies, investment accounts, and their will.

Parents will need to add the baby to their health insurance as well.

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Time to Be with AdultsSpending time with adults each day

restores energy.

Getting out even for a short walk can restore physical and mental energy. This can help make both babies and parents

feel better

It is best to rely on experienced friends, along with the grandparents of the new baby for advice.

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