Professional Documents
Culture Documents
Characteristic of Newborn
Characteristic of Newborn
The end of your journey has come after 40 weeks. The fruit of your labour (literally) will soon be in your hands.
There are a few things you might want to know about your new arrival. Typically, a newborn baby has the following
characteristic appearance:
• Weight: Average 2.8 kg for Indian babies (range 2.5 – 3.2 kg). Babies below 2.5 kg at birth are considered
to be low birth weight and need special evaluation.
• Length: Approximately 50 cm. Remember, small women have small babies and many genetic factors also
play a role in determining the length of the baby.
• Head: Your baby’s head appears large for the body and may have an elongated shape or appear to have
some ‘bumps’. This is due to changes called molding, which occurs in labour and delivery. Small bumps
called ‘caput’ usually disappear in 1 – 2 days. Soon the head gets rounder. The head circumference is 33 –
35 cm.
• Soft spots or Fontanelles: There are 2 areas on the head where bone formation is incomplete at birth. The
larger one, in front of the head closes by 6 – 18 months. The smaller one at the back usually closes by 6
weeks.
• Hair: As all people vary, so does their hair. Your baby may have lots of hair or none at all! It depends on
familial and racial factors.
• Heart beats: Usually the heart rate is 120 – 140 beats per minute.
• Respiratory rate (breathing): It is faster than adults, usually 30 – 40 breaths / minute. Breathing may be
noisy or stop for many seconds. This is not uncommon.
• Colour: Depending on the parents, the skin colour of newborn varies. In general, newborn babies look
flushed and pink all over. However, the palms and soles of the feet may look dusky or little bluish soon
after birth.
Axillary temperature measurement. The thermometer should remain in place for 3 minutes. The nurse presses the
newborn’s arm tightly but gently against the thermometer and the newborn’s side, as illustrated
Ophthalmia neonatorum
Any conjunctivitis with discharge occuring during the first two weeks of life. It typically appears 2-5 days
after birth, although it may appear as early as the first day or as late as the 13th.
silver nitrate (used before) – 2 drops lower conjunctiva (not used now)
Administering Erythromycin or Tetracycline Ophthalmic Ointment
These ointments are the ones commonly used nowadays for eye prophylaxis because they do not cause eye
irritation and are more effective against Chlamydial conjunctivitis.
Apply over lower lids of both eyes, then, manipulate eyelids to spread medication over the eyes.
Wipe excess ointment after one minute Č sterile cotton ball moistened Č sterile water.
Principles of cleanliness at birth: Handwashing
Clean hands Before entering the nursery or caring for a baby
Clean perineum In between newborn handling or after the care of
Nothing unclean to be introduced into the vagina each baby
Clean delivery surface Before treating the cord
Cleanliness in cutting the umbilical cord After changing soiled diaper
Cleanliness for cord care of the newborn baby Before preparing milk formula.
Preventing Hemorrhage
As a preventive measure, 0.5mg (preterm) to 1 mg (full term) Vit. K or Aquamephyton is injected IM in the
NB’s vastus lateralis (lateral anterior thigh)muscle
Vit-K – to prevent hemorrhage R/T physiologic hypoprothrombinemia
Aquamephyton, phytomenadione or konakion
.1 ml term IM, vastus lateral or lateral ant thigh
.05 ml preterm baby
Vit K – synthesized by normal flora of intestine
Vit K – meds is synthetic due intestine is sterile
Procedure for vitamin K injection. Cleanse area thoroughly with alcohol swab
and allow skin to dry. Bunch the tissue of the upper outer thigh (vastus
lateralis muscle) and quickly insert a 25-gauge 5/8-inch needle at a 90-degree
angle to the thigh. Aspirate, then slowly inject the solution to distribute the
medication evenly and minimize the baby’s discomfort. Remove the needle
and gently massage the site with an alcohol swab.
Bathing
• oil bath – initial
• to cleanse baby & spread vernix caseosa
Fx of vernix caseosa
1. insulator
2. bacterio- static
Babies of HIV + mom – immediately give full bath to lessen transmission of HIV
• 13 – 39% possibly of transmission of HIV
Erythema toxicum • The size & shape vary, but it commonly appears
o Is an eruption of lesions in the on the face. It does not grow in size, does not
area surrounding a hair follicle fade in time and does not blanch. The birthmark
that are firm, vary in size from maybe concealed by using an opaque cosmetic
1-3 mm, and consist of a cream.
white or pale yellow papule or • If convulsions and other neurologic problem
pustule w/ an erythematous accompany the nevus flammeus,----5th
base. cranial nerve involvement.
o It is often called “newborn rash” or “fleabite”
dermatitis Nevus vasculosus (strawberry mark)
o The rash may appear suddenly, usually over • A capillary hemangioma,
o the trunk and diaper area and is frequently consists of newly formed and
widespread. enlarged capillaries in the
o The lesions do not appear on the palms of the dermal and subdermal layers.
hands or soles of the feet. • It is a raised,clearly delineated,
o The peak incidence is 24-48 hours of life. dark-red, rough-surfaced
o Cause is unknown and no treatment birthmark commonly found in
the head region.
Harlequin Sign
o The color of the newborn's body appears to be
half red and half pale. This condition is
transitory and usually occurs with lusty crying. • Such marks usually grow starting the second or
Harlequin Coloring may be associated with to third week of life and may not reach their
an immature vasomotor reflex system. fullest size for 1 to 3 months; disappears at the
age of 1 yr. but as the baby grows it enlarges.
BIRTH MARKS • Birthmarks frequently worry parents. The
mother maybe especially anxious, fearing that
Telangiectatic nevi (stork bites) she is to blame (“Is my baby marked because of
something I did?”) Guilt feelings are common
• Appear as pale pink or red spots and are when parents have misconceptions about the
cause. Identify and explain them to the parents.
frequently found on the eyelids, nose, lower
occipital bone and nape of the neck • Providing appropriate information about the
cause and course of birthmarks often relieves
• These lesions are common in NB w/ light
the fears and anxieties of the family. Note any
complexions and are more noticeable during
bruises, abrasions,or birthmarks seen on
periods ofcrying.
admission to the nursery.
HEAD
• Head circumference should be 2 cm greater
than chest circumference
• Assess fontanelles and sutures - observe for
signs of hydrocephalus and evaluate neurologic
status
• Craniosynostosis
• Microcephaly
• Macrocephaly
3 types Hemangiomas
a.) Nevus Flammeus – port wine stain – macular purple
or dark red lesions seen on face or thigh. NEVER
disappear. Can be removed surgically
b.) Strawberry hemangiomas – nevus vasculosus –
dilated capillaries in the entire dermal or subdermal
area. Enlarges, disappears at 10 yo.
c.) Cavernous hemangiomas – communication network
of venules in SQ tissue that never disappear
with age.
Neurological Status
Assessment begins with period of observation
Observe behaviors - note:
o State of alertness
o Resting posture
o Cry The Moro reflex is often called a
o Quality of muscle tone startle reflex because it usually occurs
o Motor activity when a baby is startled by a loud
sound or movement. In response to
Jitteriness – feeling of extreme nervousness the sound, the baby throws back
Differentiate causative factors his/her head,
Examine for symmetry and strength of extends out the arms and legs, cries,
then pulls the arms and legs back in.
movements A baby's own cry can startle him/her
Note head lag of less than 45 degrees and begin this reflex. This reflex lasts
Assess ability to hold head erect briefly about five to six months.
Immature central nervous system (CNS) of
newborn is characterized by variety of reflexes
o Some reflexes are protective, some aid Step reflex This reflex is also
in feeding, others stimulate interaction called the walking or dance
o Assess for CNS integration reflex because a baby appears to
take steps or dance when held
Protective reflexes are blinking, yawning, upright with his/her feet touching
coughing, sneezing, drawing back from pain a solid
Rooting and sucking reflexes assist with surface.
feeding
“What reflexes should be present in a newborn? Reflexes are
involuntary movements or actions. Some movements are spontaneous,
occurring as part of the baby's usual activity. Others are responses to
certain actions. Reflexes help identify normal brain and nerve activity.
Some reflexes occur only in specific periods of development. The
following are some of the normal reflexes seen in newborn babies”