APPEARANCE OF

THE NEWBORN
Presented by: Deloso, Hagnaya, Ilustrisimo, Mandingiado, Lianza
EYES
 Lacrimal ducts are not fully mature until 3 months of age
 Irises are gray or blue, sclera appears blue due to its thinness
 Small subconjunctival hemorrhage sometimes appears due to pressure during
childbirth
 Bleeding is slight, requires no treatment
 Edema around the orbit remains for the 1st 2 to 3 days until the kidneys are
capable of evacuating fluid more efficiently
 White pupil suggests congenital cataract
Nose
• Test for Choanal Atresia by
closing the mouth and
compressing 1 naris at a time
with the fingers
• Note any discomfort or distress
with breathing
MOUTH
NB's mouth should move evenly; otherwise, check
for cranial nerve injury
EPSTEIN'S CYST- 1 or 2 small, round,
glistening, well-circumscribed cysts on the palate,
a result of the extra load of Calcium deposited in
utero; require no treatment & disappear
spontaneously within 1 week
THRUSH- a Candida albicans infection appearing
as white or gray patches on the tongue & sides of
cheeks
NATAL TEETH- evaluate for stability; all teeth
not covered by gum membrane should be removed
because they can loosen & may be aspirated
NECK &
CHEST
• Neck looks short in newborns because it
tends to get lost in the chubby cheeks
and folds of skin.

• You may readily feel or see your baby's

upper chest move with each heartbeat
since an infant's chest wall is thin. There
is no need for fear as this is usual.
• Newborns might develop enlarged
breasts in both males and females.
ABDOMEN
- It is normally slightly protuberant
- If scaphoid or sunken, it suggests missing abdominal contents or
diaphragmatic hernia
- Bowel sounds should be present within 1 hour after birth
- Edge of the liver is usually palpable 1 to 2 cm below the right costal
margin; the spleen 1 to 2 cm below the left costal margin
- After cord cutting, count the cord (AVA); 1 artery is associated with a
congenital heart or renal abnormality
- After the 1st hour, umbilical stump begins to dry & shrink, turning
brown; 2nd to 3" day, black
- Stump falls off by day 6 to 10 leaving a granulating area that heals in
1 week
- Moist or odorous cord suggests infection; treat to prevent septicemia
- * PATENT URACHUS - a canal that connects the bladder to the
umbilicus as manifested by moistness at the base of the cord caused
by urine flow - Check for umbilical hernia; if < 2 cm, it closes on its
own by school age
- - Newborn kidneys are the size of a walnut; right kidney is lower than
the left
CONGENITAL
TORTICOLLIS
- Caused by injury to the
sternocleidomastoid muscle during
birth manifested by rigidity of the
neck
- In the newborn’s whose membranes
were ruptured > 24h before birth,
nuchal rigidity suggests meningitis
- Thymus gland will triple in size by 3
years of age & remains the same size
till 10 years old then shrinks
Anogenital
Area
- Anal patency is tested by gently
inserting the tip of the little finger,
gloved & lubricated.
- If newborn does not pass meconium
within the 1st 24 hours, suspect
meconium ileus or imperforate anus.
Two Types of Genitalia:
• Male
• Female
MALE
GENITALIA
Cremasteric Reflex- elicited by
stroking the internal side of the
thigh causing the testis on that side
to move up upward
FEMALE
GENITALIA
- Vulva may be swollen due to
maternal hormones
- Pseudomenstruation – mucus vaginal
secretion, sometimes blood-tinged
ABDOMINAL
REFLEX
To finish an abdominal assessment,
elicit an abdominal reflex. Stroking
each quadrant of the abdomen with a
finger should cause the umbilicus to
move or “wink” in that direction. This
superficial abdominal reflex, a test of
spinal nerves T8 through T10, is
usually present at birth, but may not be
observable until it is stronger at about
the 10th day of life.
BACK
- Spine appears flat in the lumbar and
sacral areas; curves appear only after the
child’s is able to sit a walk
Spina Bifida Occulta or Dermal Sinus –
pinpoint opening, dimpling or sinus tract in
the skin
- NB typically assumes its position in utero
EXTREMITI
ES
- Arms and legs appear short, hands are
plump
- Fingernails are soft and smooth,
sometimes extend over the fingertips
Achondroplastic Dwarfism - common form of
dwarfism that causes shorter limbs. In
babies, some potential signs include a head
that is large compared to the body, a
prominent forehead, and increased space
between the middle and ring fingers.
Simian Crease - characterized by the
presence of a single crease that runs the
breadth of the hand and is formed from the
fusion of the two palmar creases
BARLOW’S SIGN &
ORTOLANI SIGN
• Ortolani Sign - A "clunk" of the
femur head striking the shallow
acetabulum can be heard.
• Barlow's Sign - If the femur can be
felt to actually slip in and out of the
socket.