Newborn – the first month

PHYSICAL FEATURES

3. Facial FeaturesFacial Features– a. Eyes – grayish blue or dark, swollen, red splotches

on white of eye, may be cross eyed, no tears for about 3 mths.– b. Mouth – tiny jaw and chin, puffy cheeks, short

tongue, dry lips.– c. Nose – short, flat to make nursing easier– d. Skin – blotchy, pink, dry and peeling, vernix, lanugo,

loose and wrinkly, loose scalp, cold and blue due to poor circulation.

9. LanugoLanugo– Fuzzy hair covering the body to keep the fetus warm and

to give the vernix something to adhere to.

6. Fontanels / Soft SpotFontanels / Soft Spot Two open spaces in the baby’s skull to allow for movement during delivery and for the brain to

grow. These will close together by 2 years old.

19. Reflexes19. Reflexes– a. Rooting / Suckinga. Rooting / Sucking – when cheek is stroked, baby turns head and opens mouth. Sucking movements begin to begin eating. (helps baby find their

food source)

– b. Grasping or Darwinianb. Grasping or Darwinian• Palmar=Palm of hand touched and baby makes fist around it.• Plantar =Bottom of toes touched and toes curl and tighten

– c. Moro (startle)c. Moro (startle) – baby’s arms and legs thrown out, head falls back, and back extends

– d. Tonic Neck/ Fencingd. Tonic Neck/ Fencing – fencer arm position, one arm back and one arm extended forwards.

– e. Babinskie. Babinski – sole of foot stroked and toes fan out

– g. Walking / Stepg. Walking / Step – baby held under arms will make stepping motion.

Watch these Baby Reflexes

Tonic Neck / FencingPalmar Grasp

Rooting

Moro / startle

Babinski

Walking

5. Low Birth Weight5. Low Birth Weight– Born 5.5 lbs or less

8. Vernix 8. Vernix – Cheesy, waxy substance that covers body

while in womb. Sticks to the lanugo.

10. Jaundice10. Jaundice– Yellow coloring in skin and eyes due to liver

not working properly yet.

11. Marks Birth Marks, Angels Kiss, Stork Bite, Mongolian Spot – Pink spots where blood vessels broke –

usually go away

Mongolian Spot

Stork Bite

Angels Kiss

4. Premature4. Premature – Born before 37 weeks

1.1. SizeSize ( height and weight) - 7.5 lbs and 19” long– Thin, wrinkly, splotchy, little body fat

15. Swollen Genitals15. Swollen Genitals– Out of proportion in size due to the

large amounts of mother’s hormones

7. Umbilical Cord7. Umbilical Cord – Cord that connected the baby to the

mother and gave the baby food

and oxygen. Will fall off in 1-3 weeks.

16. Bones and Teeth16. Bones and Teeth– Teeth usually not seen at birth.– Bones are still rubber-like and can bend easily.

• Heal bone formed after birth, knee caps form about 2 years old, and there are 3 bones in a 1yo hand and wrist - 28 in yours.

12. Sucking Blister12. Sucking Blister– Callous in center of top lip

13. Milia13. Milia– Pimples due to oil glands beginning to work. Leave them alone (don’t pinch) or put a warm

towel on them. They will last about 3 weeks.

14. Cradle Cap14. Cradle Cap– Dry, flaky, crusty scalp. Rub the scalp with a baby brush.

22.. Head to Body Proportions Head to Body Proportions – Large head – ¼ body size, Rounded chest and protruding

stomach, short legs compared to arms, Pelvis and hips are narrow. Legs pulled up and bowed out. Short neck.

18. Physical Abilities18. Physical Abilities• a. Head and Neck Control – weak neck muscles and

big heavy head so the head fall backs. Support these.• b. Motor Development – mostly reflexes at first, but

soon gains control of their muscles.

17. Cognitive Abilities / Senses• a. Smell – best developed sense. Knows smell

of mom and mom’s milk.– Likes sweet smells (vanilla) and makes a disgusted face if not like smell.

• b. Hearing – likes high pitched sounds and voices. Will turn towards parents voice.

• c. Taste – natural sweet tooth-avoid sugar.• d. Touch – bond, love, feels safe and secure,

communicates, improves antibodies• e. See – weak limited vision

• 20/700 @ birth. Can see 8-15” away• Sees color around 3-4 months

D. PROCEDURES• 21. Blood Test21. Blood Test

– for Anemia/PKU/Cystic Fibrosis – Done by heel prick and analyzes drops of blood

25. Feeding25. Feeding– Choose between formula and breast milk.– Pro’s and Con’s for both choices.

• 8-12x a day over 24 hours = will spend 3 hours of your day feeding. Their tiny stomachs only hold 2-3oz and they burn it off quickly so they need to eat often.

23. Circumcision23. Circumcision– Removal of foreskin around tip of penis. Optional

procedure. Done for hygiene reasons.

22. APGAR Scoring for Newborns-Tests given to test babies physical skills, ability to adapt, and chance of survival. - A score is given for each sign at one minute and five minutes after the birth. If there are problems with the baby an additional score is given at 10 minutes. - A score of 7-10 is considered normal, while 4-7 might require some resuscitative measures, and a baby with apgars of 3 and below requires immediate resuscitation.

Sign 0 Points 1 Point 2 Points

A Activity (Muscle Tone)

Absent Arms and Legs Flexed

Active Movement

P Pulse Absent Below 100 bpm Above 100 bpm

G Grimace (Reflex Irritability)

No Response Grimace Sneeze, cough, pulls away

A Appearance (Skin Color)

Blue-gray, pale all over

Normal, except for extremities

Normal over entire body

R Respiration Absent Slow, irregular Good, crying

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• http://www.youtube.com/watch?v=Vtxsxv1BQek

27. Meconium27. Meconium– First bowel movement. Black tar like substance. Dangerous if released in womb Will spend about 1 hr of your day changing diapers

24. Sleeping24. Sleeping– Place baby on their back to prevent SIDS (Sudden

Infant Death Syndrome). • Baby on a 4 month jet lag and will spend 17-20 hours sleeping,

but not all at one time. Growing and developing is tiring.

26. Bonding26. Bonding – Forms secure attachments, feelings of trust, safety, and

strengthens the baby. Builds 5 areas of growth and development necessary for success in life.

Watch this Bonding clip

20.20.Silver NitrateSilver Nitrate - Antiseptic put in baby’s eyes to prevent

infections that might have passed from the mother during the vaginal delivery.

- Ie: gonococcus

28. Let Down reflex28. Let Down reflex

- Is when Oxytocin causes milk to come into the mother’s breast.

29. Who is the Pediatrician?29. Who is the Pediatrician?– The doctor that cares for the

baby / child while it is growing up.

T. Berry Brazelton, M.D.