Newborn Check

Question 1

Things ask parents?

Answer 1

Labour - how long since delivery, type of delivery, problems in labour, medications in labour

Mother - any temperatures, overall health in pregnancy, history of congenital hip problems

Baby - term? weight, feeding, urine (12 hours), meconium (48 hours), breathing

Question 2

Things to look for in general inspection?

Answer 2

Cry - feeble, pitch

Colour - cyanosis, pallor, jaundice, rashes/petechiae

Birth trauma - caput succedaneum, subconjunctival haemorrhages, cephalohaematoma, forceps marks

Dysmorphic features - dysmorphia, cleft lip, small tongue/jaw (Pierre-Robin syndrome)

Posture, tone, movements - hemiparesis, opisthotonos, hypertonicity, myoclonus

Question 3

Parts of top to toe examination?

Answer 3

Cranium
Face
Eyes
Shoulder
Arms
Chest
Abdomen
Femoral pulses
Genitalia
Hips
Legs
Back

REFLEXES

Question 4

Cranium?

Answer 4

Cephalhaematoma
Cranium deformities
Fontanelles and sutures

Question 5

Face?

Answer 5

Dysmorphic features
Cleft lip
Ears
Roof of mouth (marfans, cleft)
Presence of suck reflex

Question 6

Eyes?

Answer 6

Red reflex

Question 7

Shoulders

Answer 7

Check aligned, feel clavicles

Question 8

Chest?

Answer 8

Resp rate
Cap refill
Signs of respiratory distress
Auscultate chest and heart sounds

Question 9

Abdomen?

Answer 9

Distension (obstruction)
Scaphoid abdomen (diaphragmatic hernia)
Umbilical stump (comment on appearance)
Palpate for masses, organomegaly and ballot kidneys

Question 10

Arms?

Answer 10

Extend
Palmar creases
Polydactyly/Syndactyly

Question 11

Femoral pulses?

Answer 11

FEEL THEM
Coarctation

midway between the anterior superior iliac spine and the symphysis pubis

Question 12

Genitalia?

Answer 12

Boy - feel testes, check descended, check for hypo/epispadias, foreskin

Girls - check vulval susion, cysts/tags, check anus patent

Question 13

Hips?

Answer 13

Knees flex in palms and abduct, thumbs over medial aspect of knees, fingers over lateral aspects.

Ortolanis - checks if hips already dislocated - push anteriorly (towards you)

Barlows - checks if hip can be dislocated - push posteriorly (towards floor) - can feel clunk if dislocated

Question 14

Legs?

Answer 14

Extend
Check same length
Femoral creases (downs)
Check feet for talipes (club foot) and calcaneovalgus (abudcted forefoot and dorsiflexed ankle)
ROM at ankles
Look for polydactyly/syndactyly

Question 15

Back?

Answer 15

Inspect for…

Lipomas
Tufts of hair
Port wine stains
Mongolian blue spot

Palpate for…

Spinal abnormalities
Natal cleft

Question 16

Reflexes?

Answer 16

Grasp - put finger in baby’s palm, they will grasp it

Moro - hold baby sitting on bottom with hand supporting top of back, neck and head. Drop upper body backwards towards bed with hand still below them before catching –> arms should abduct, aduct and will cry

Question 17

End pieces?

Answer 17

Thank parents and redress baby

Measure head circumference, length and weigh baby.

Fully document in notes and in child’s red book.