The Full Term Infant

Question 1

What is considered full term in an infant?

Answer 1

37-42 weeks

Question 2

What is the average daily weight gain of a term baby?

Answer 2

24g

Question 3

What is considered normal weight loss for a baby after birth?

Answer 3

Loss of up to 10% birth weight

Question 4

What will be the features of a preterm infant in comparison to a pre-term?

Answer 4

Preterm baby will be - thinner, less muscle tone, pinker due to less subcutaneous fat

Question 5

What factors may make labour more difficult?

Answer 5

Hypoxic environment during contractions
Prolonged labour reduces foetal reserves - baby may become acidotic
Placental insufficiency
Growth restriction or excess

Question 6

What adaptations does a baby make when it is born?

Answer 6

First Breath
Alveolar expansion
Change from foetal to newborn circulation
Decreased pulmonary arterial circulation
Increased PaO2

Question 7

What is the apgar score?

Answer 7

This is a score that gives us an idea of how well a baby is doing after birth.
It is out of 10 and accounts for -
HR; RR; Responsiveness; Tone; Colour
Normal > 8

Question 8

What is the impact of skin to skin contact after birth?

Answer 8

Establishes breast feeding
Keeps baby warm
Allows bonding between mum and baby

Question 9

What is haemorrhagic disease of the newborn?

Answer 9

This is when baby doesn’t have enough vitamin K and develops a coagulopathy - there is then potential for GI; pulmonary or CNS bleed.
Therefore all babies born in scotland are given IM vitamin K supplement

Question 10

What are possible infections based on maternal history?

Answer 10

Hepatitis B
Hepatitis C
HIV
Syphilis
TB
Group B Streptococcus

Question 11

What is included in the newborn screening test?

Answer 11

Universal hearing screening
Hip screening
Cystic Fibrosis
Haemoglobinopathies
Metabolic diseases - PKU etc.

Question 12

What are possible examination finding on the babies head?

Answer 12

Incorrect head circumference
Overlapping sutures
Fontanelles
Ventouse/Forcep marks
Moulding of the head
Cephalhaematoma
Caput succedaneum

Question 13

What are fontanelles?

Answer 13

Soft spots on the baby’s skull where the bony plates have not yet come together

Question 14

What is a cephalhaematoma?

Answer 14

When the small blood vessels rupture between the baby’s scalp and skull. This is usually caused by trauma e.g. forceps

Question 15

What is caput seccedaneum?

Answer 15

This is a lump on the baby’s scalp caused by pressure

Question 16

What is the difference between caput succedaneum and cephalhaematoma?

Answer 16

They are both swellings on the scalp however a cephalhaematoma is caused by blood and a caput succedaneum is caused by pressure on the scalp

Question 17

What are we looking for when we examine the eyes?

Answer 17

Size
Red reflex - cataracts; tumours?
Conjunctival Haemorrhage
Squints
Iris abnormality e.g. collaboma

Question 18

What is a collaboma?

Answer 18

This is a gap in the structures of the eye

Question 19

What are we looking for when we examine the ears?

Answer 19

Position
External auditory canal
Tags/pits
Folding

Question 20

What are we looking for when we examine the mouth?

Answer 20

Shape
Philtrum
Tongue tie
Cleft palate
Neonatal teeth
Ebdteins pearls
Appropriate sucking/rooting reflex

Question 21

What is philtrum?

Answer 21

This is the groove between the upper lip and nose. In conditions such as foetal alcohol syndrome this may be absent

Question 22

What are ebsteins pearls?

Answer 22

Small, harmless cysts in the newborns mouth that contains white cells

Question 23

What are we looking for when we asses the face?

Answer 23

Facial Palsy

Dysmorphia e.g. down’s syndrome

Question 24

What do we look for when we asses respiration?

Answer 24

Chest shape
Nasal flaring
Grunting
Tachypnoea
In-drawing
Breath sounds

Question 25

What do we look for when we asses cardiology?

Answer 25

``` Colour/Saturation - think CHD? Pulses - femoral Apex beat Any thrills/heaves? Present heart sounds ```

Question 26

What do we look for when we asses the abdomen?

Answer 26

``` Moves with respiration? Distention Hernia Normal umbilicus Bile stained vomiting Passage of meconium Anus ```

Question 27

What do we asses when we examine the genitourinary system?

Answer 27

Normal passage of urine Normal genetalia Undescended testes - is they are undescended we assume ambiguious genetalia Hypospadius

Question 28

What is hypodspadius?

Answer 28

A birth defect in boys in which the opening of the urethra is not located at the tip of the penis.

Question 29

What do we asses in the musculoskeletal system?

Answer 29

Movement and posture Limbs and digits Spine - spina bifida? Hip examination

Question 30

What do we asses as part of a neurological examination?

Answer 30

``` Alertness and responsiveness Crying? Muscle tone posture Movement Primitive reflexes ```

Question 31

What are the primitive reflexes in newborn babies?

Answer 31

Sucking Rooting Moro - drops the baby's head back and it is startled Asymmetrical tonic reflex - turning the baby's head to one side causes extension of the arm and leg on this side

Question 32

What do we look for upon examination of the skin?

Answer 32

Normal erythema Mongolian blue spots Cavernous haemangioma Port wine stain

Question 33

What is a cavernous haemangioma?

Answer 33

An abnormal tangle of tightly packed, thin-walled capillaries that are prone to bleeding.