Characteristics of

Newborn
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A newborn is typically 50 cm long, weighs 2.8-3.5 kg, …

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In medical contexts, newborn or neonate (from Latin, neonatus , newborn) refers to an
infant in the first 28 days after birth.
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Healthy newborn infant born at term, cries immediately after birth and

 
establish satisfactory rhythmic pulmonary respiration.

POSTURE:-

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The newborn assumes theTwitter
same posture after birth as in utero.

MEASUREMENTS:-

 Length – 50 cm (20 inches).

Weight – 2.8 to 3.5 kg.
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Head circumference – 33 – 35 cm.
 Chest circumference – 30 - 33 cm.

VITAL SIGNS OF THE NEWBORN INFANTS

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TEMPERATURE

 Infant’s temperature at birth is slightly higher than the mother’s.

 The temperature drops immediately after birth in response to the extra uterine
environment due to
 Skin is very thin and does not contain much subcutaneous fat.
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The infant’s heat regulating
 this Document
mechanism has not fully developed.
 The temperature rises normal within about 8 hours.
 Normal body temperature for a healthy baby is between 97 and 100.4 degrees
Fahrenheit (36 to 38 degrees Celsius) - American Academy of Pediatrics
(AAP).

PULSE

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 The pulse rate is normally irregular, due to immaturity of the cardiac regulatory
center in the medulla.
 The normal pulse ranges for an infant is 120 to 150 beats per minute (bpm).
 The rate may raise when infant is crying and drop when infant is sleeping.
 The apical pulse is considered the most accurate.

RESPIRATION

 Respirations in the neonate are irregular in depth, rate and rhythm.

 It varies from 35 to 50 per minute.
 Normally, respirations are gentle, quiet, rapid, and shallow.

BLOOD PRESSURE

 In infants the flush and Doppler* methods of blood pressure measurement are
usually used.
 Normal blood pressure at birth is determined by the birth weight of the baby.
 A newborn has a normal blood pressure of about 70 over 42 mm of Hg.

CHARACTERISTICS OF NEWBORN INFANT’S HEAD

 Infant’s head is one fourth of his total body length.

 Normal head circumference is 33–35 cm (13”- 14”).
 FONTANELS (SOFT SPOTS) – The fontanels are openings at the points of union of
the skull bones. There are normally several fontanels on a newborn's skull, mainly
at the top, back, and sides of the head.
1. Anterior fontanel (bregma) –
 The anterior fontanel is diamond shaped and is located at juncture of
two parietal and two frontal bones.
 It is 2 to 3 cm in width and 3 to 4 cm in length.
 It usually closes between 12 to 18 months.
2. Posterior fontanel (lamda) –
 The posterior fontanel is triangular and located between the occipital
and parietal bones.

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 It is much smaller than the anterior fontanel.

 It usually closes between 1 to 2 months.

Figure 1 Sutures of skull

Figure 2 Fontanels

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 MOLDING –
 Molding is the temporary reshaping of the fetal head as it passes through the
birth canal during childbirth.
 During the molding process the over lapping of skull bones occurred and it
reduces the diameter of the skull temporarily.
 This elongated look usually disappears a few hours after birth.

Figure 3 Molding

Figure 4 Molding

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 CAPUT SUCCEDANEUM –

 A caput succedaneum is an edema of the scalp at the neonate’s presenting

part of the head.
 It often appears over the vertex of the newborn’s head as a result of pressure
against the mother’s cervix during labor.
 The edema in caput succedaneum crosses the suture lines.
 It may involve wide areas of the head or it may just be a size of a large egg.

Causes

 Mechanical trauma of the initial portion of scalp pushing through a narrowed

cervix
 Prolonged or difficult delivery
 Vacuum extraction

Management

 Needs no treatment. The edema is gradually absorbed and disappears about

the third day of life.

Figure 5 Caput succedaneum and Cephalhematoma

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 CEPHALHEMATOMA –
 It is an accumulation of blood between the periosteum and a flat skull bone.
 The collection of blood does not cross a suture line.
 A Cephalhematoma may not be evident during the first few days of life
because of the presence of a large caput succedaneum.
 Aspiration of this sanguineous collection should not be done because of
danger of infection.
 The condition usually clears within few weeks.

Causes

 Rupture of a periostal capillary due to the pressure of birth

 Instrumental delivery.

Management

 Observation and support of the affected part.

 Transfusion and phototherapy may be necessary if blood accumulation is
significant.

DIFFERENCE BETWEEN A CAPUT SUCCEDANEUM AND CEPHALHEMATOMA

INDICATORS CAPUT SUCCEDANEUM CEPHALHEMATOMA

Location Presenting part of the head Periosteum of skull bone and

bone

Extent of Both hemispheres; CROSSES Individual bone; DOES NOT

Involvement the suture lines CROSS the suture lines

Period of Absorption 3 to 4 days Few weeks to months

Treatment None Support

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CHARACTERISTICS OF NEWBORN INFANT’S SKIN

A baby's skin colour often changes with environment and health. In fact, right
after a baby is born the colour if his skin may appear dark red or purple, but as the infant
breathes his colour brightens to a red. This redness should fade during the first 24 hours,
but the baby's feet and hands may continue to have a bluish hint for several days. Good
elasticity, or turgor, is evidence that an infant is in good condition.

1. LANUGO –

 Lanugo is the downy hair on the body of the fetus and newborn baby.
 It is the first hair to be produced by the fetal hair follicles, usually appearing on the
fetus at about five months of gestation.
 It is very fine, soft, and usually unpigmented.
 It is normally shed before birth around seven or eight months of gestation.
 It is sometimes present at birth.
 It will disappear within a few days or weeks of its own accord.

Figure 6 Lanugo

2. VERNIX CASEOSA –

 Vernix caseosa, also known as Vernix, is the waxy or cheese-like yellowish white
substance found coating the skin of newborn human babies.
 It consists of secretions from the sebaceous gland and epithelial cells.

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 It appears primarily in full term infants, while premature and post mature births
generally lack any.

Functions

 Moisturizing the infant's skin, and facilitating passage through the birth canal.
 It serves to conserve heat and protect the delicate newborn skin from
environmental stress.
 Vernix is also thought to have an antibacterial effect.
 Chemical role of Vernix in protecting the infant from infection.

Figure 7 Vernix caseosa

3. MILIA –

 Tiny white spots very often appear on a newborn's face and gums during the first
week. The spots are called milia (say "MIL-ee-uh").
 Sometimes they also appear on the roof of the mouth (palate), where they are called
Epstein pearls.

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 Milia occur when dead skin becomes trapped in small pockets at the surface of the
skin or mouth.
 Milia are common in newborn infants.
 Milia go away by themselves in a few weeks and aren't harmful.

Figure 8 Milia

4. STROKE BITES –

 A stork bite is a common type of birthmark seen in a newborn.

 It is most often temporary.
 The medical term for a stork bite is nevus simplex.
 A stork bite is also called a salmon patch.
 A stork bite usually looks pink and flat.
 A baby may be born with a stork bite, or the birthmark may appear in the first
months of life.
 Stork bites may be found on the forehead, eyelids, nose, upper lip, or back of the
neck.

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 A stork bite is due to a stretching (dilation) of certain blood vessels.

 It may become darker when the child cries or the temperature changes.
 It may fade when you push on it.
 No treatment is needed.

Figure 9 Stroke bite

5. HEMANGIOMA - Hemangiomas are simply a collection of extra blood vessels in the skin.
They may have different appearances depending on the depth of the increased numbers of
blood vessels.

 Strawberry Hemangioma is an abnormal collection of blood vessels in the skin

characterized by a bright red color and well-defined border.

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 A Deep or Cavernous Hemangioma is a large, collection of blood vessels beneath

the skin surface characterized by a soft, bluish, or skin colored mass.

 A Combined Hemangioma is a combination of a deep and superficial (strawberry)

hemangioma.

TYPICAL GROWTH PATTERN OF HEMANGIOMAS

Age of Child Hemangiomas

Birth often not present or noticeable

1-2 months becomes noticeable

1-6 months grows most rapidly

12-18 months begins to shrink (involute)

Figure 10 Hemangioma

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6. MONGOLIAN SPOTS (CONGENITAL DERMAL MELANOCYTOSIS OR DERMAL

MELANOCYTOSIS) –

 Mongolian spots are flat, blue, or blue-gray skin markings near the buttocks that
commonly appear at birth or shortly thereafter.
 Mongolian spots are noncancerous skin markings and are not associated with
disease.
 The markings may cover a large area of the back.
 Symptoms include:

a) Blue or blue-gray spots on the back, buttocks, base of spine, shoulders, and
other body areas
b) Flat area with irregular shape and unclear edges
c) Normal skin texture
d) The spots are usually 2 - 8 centimeters wide

Figure 11 Mangolian spot

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