Healthy term infant Flashcards
What are the term parameters?
Term after 37 weeks Post term after 41 week Preterm 32-36 weeks Very preterm 28-32 weeks Extremely preterm 23-28 week
What are the normal weights for babies?
2.5-4.0kg
Over 4.0kg - LGA
Under 3.5 kg - SGA
What is the daily weight gain in the 3rd trim?
24 g
What is the main function of the 3rd trim?
Weight gain
Transfer of ions and vitamins from placenta
Describe the conditions to the baby in labour?
Hypoxic during contractions
Foetal Hb helps to release O2
Prolonged labour results in reduced foetal reserves
Increased cortisol and adrenaline enhances adaptation
What is the immediate perinatal adaptation?
First breath/ cry
Alveolar expansion
Change from foetal to newborn circulation
Decreased pulmonary arterial pressure
Increased PaO2
Apgar score
Early/ immediate skin to skin and suckling
What does the apgar score take into consideration?
HR RR Responsiveness Tone Colour
What is a normal apgar?
> 8
What is important for establishment of breastfeeding?
Skin to skin
Do babies tend to be alert after delivery?
Yes; very alert
Where can haemorrhagic disease of the newborn bleed into?
GI
Lung
CNS
What is given to newborns to prevent haemorrhagic disease of the newborn?
Vitamin K IM
What infections are babies at risk for due to vertical transmission?
Hep B; immediate vaccination or immunoglobulin Hep C HIV Syphilis TB GAS
What vaccinations are given to newborn babies?
Maternal pertussis and influenza
Routine vaccine schedule
Hep B at birth?
BCG first month?
What screening tests are performed on babies?
Newborn exam
Universal hearing screening
Hip; clinical and USS
Heel prick; CF, hypothyroidism, haemoglobinopathies, metabolic disease (incl. PKU)
What will the CF heel prick test for?
Immunoreactive trypsin
When is a newborn examination carried out?
Immediately after delivery
Formally around 24 hours
What is assessed for in the head new born examination?
OFC; head circumference Overlapping sutures Fontanelles Ventouse/ forceps marks Moulding Cephalohaematoma Caput succedaneum
What is the difference between cephalohematoma and caput?
Cephalohematoma; between periosteum and epicranial aponeurosis. Limited to suture lines
Caput; swelling in outer layer of skin
What is assessed in the eyes of newborn exam?
Size Red reflex Conjunctival haemorrhage Squints Iris abnormality
What is the commonest reason for an absent red reflex?
Cataracts; MUST be fixed to prevent cortical blindness
What is assessed in the ears of newborn exam?
Position External auditory canal Tags/ pits Folding FMHx of hearing loss
What is assessed in the mouth of a newborn exam?
Shape Philtrum (FAS) Tongue tie Palate Neonatal teeth Ebstein's pearls Sucking/ rooting (neuro)
What are signs of resp distress in a newborn baby?
Chest shape Nasal flaring Grunting Tachypnoea (>60) In-drawing Breath sounds
What encompasses the cardio exam in newborn exam?
Colour/ sats Pulses; femoral Apex Thrills/ heaves Heart sounds
What encompasses the abdo exam of neonates?
Moves with resp Distention Hernia Umbilicus (infection) Bile stained vomitus Passage of meconium Anus; can be a fistula to vagina or bladder
What encompasses the Gu exam of neonates?
Normal passage of urine
Normal genitalia
Undescended testes
Hypospadius
What encompasses the MSK exam of neonates?
Movement and posture
Limbs and digits
Spine
Hip exam
What encompasses the neurological exam of neonates?
Alert/ responsiveness Cry Tone Posture Movement Primitive reflexes
What are the primitive reflexes?
Sucking Rooting Moro ATNR Stepping Grasp
What kinds of skin lesions affects babies?
Mongolian blue spot
Strawberry naevus
Port wine stain
