NEWBORN BABY: WHAT YOU NEED TO CHECK

Newborn baby: What you need to check by Dr. Nnamdi Elenwoke.

The newborn baby’s first cry always brings a smile to everyone around him. But, to see if this baby is really healthy, the doctor will perform a physical examination within 24 hours. After the immediate examination of the baby to indicate the Apgar score, a full body check-up is done.

Virginia Apgar (1909-1974) was an Anaesthesiologist that introduced the Apgar score in 1952 to quickly check the health of a newborn baby. The Apgar test includes 5 factors: Appearance, Pulse, Grimace response, Activity and Respiration. It is usually given to a baby twice: once at 1 minute after birth, and again at 5 minutes after birth.

This examination starts with the measurement of body weight, length and head circumference of the baby. Then the doctor examines the newborn's skin, head and neck, heart and lungs, abdomen and genitals and also the nervous system and reflexes in order to check all the body systems and organs. Moreover, to be clear with the presence of health issues that will not get detected in physical examination, the doctors might do routine screening tests as well.

Skin

The doctor will examine the skin colour of the newborn baby, which is maybe reddish, but the fingers and toes may have a bluish tinge due to the poor blood circulation during the first few hours. Yellow colour appearance of the skin within 24 hours requires further assessment.

Head and Neck

The head circumference is measured with a tape and the fontanelle and sutures are palpated. This Baby Infant Growth Chart Calculator is useful to check the development up to 2 years. The size of the fontanelle can be varying. While the saggital suture will be often separated, the coronal suture can be overriding.

[caption id="attachment_1637" align="alignright" width="300"] Caput succedaneum[/caption]

Caput succedaneum which refers to the swelling, or edema, of a newborn's, usually disappears on its own within several days. It appears as a lump or a bump on their head and is caused by the pressure from the dilated cervix or vaginal walls during the delivery.

Examination of the head, face (including palate) and neck of the newborn will reveal the presence of any birth defects or abnormalities that occurred during delivery. A normal delivery, in which the head delivers first, might cause slight reversible defects of the skull. But, this will disappear within 7-14 days. Also, some swelling and bruising are typical. These problems are common when the baby is delivered through the birth canal (vaginal delivery). Not only skull defects but defects of the face  might also occur.

Heart and Lungs

Auscultation, heart rate, and skin color are checked to see if the newborn baby’s circulation and respiration are up to the norm. Any heart murmurs during auscultation require further investigations. The normal heart rate of a newborn baby is 110-160 beats/ min while this could be reduced up to 85 beats/ min during sleep.

The chest wall movements will be seen during respiration and respiratory rate in newborns are rapid than in adults. The rate is almost 30-60 breaths/ minute. Grunting, flaring nostrils and a poor cry can indicate problems in the respiratory and cardiovascular systems. During this phase of the check-up, any presences of basic birth defects of the heart and lungs are cleared out.

The normal heart rate of a newborn baby is 110-160 beats/ min while this could be reduced up to 85 beats/ min during sleep. The chest wall movements will be seen during respiration and respiratory rate in newborns are rapid than in adults. The rate is almost 30-60 breaths/ minute.

Abdomen and Genitals

The doctor will examine the abdomen and its size, shape, and position of internal organs, such as the kidneys, liver, and spleen. Enlarged kidneys may indicate a blockage to the outflow of urine while a distended stomach may indicate a problem with the bowels and other organs.

Examination of the genitals is necessary to identify the gender and also to see the urinary and genital organs are defect free. The doctor will check whether the urethra is open and is in the proper location. It is necessary to see of the testicles are descended in a boy.

It is normal to have swollen labia in a baby girl for first few weeks and also a blood discharge through the vagina is also possible and is not an anomaly.

Anus should be checked to make sure the opening is normally placed and not sealed shut.

Nerves, muscles, and bones

The newborn baby has certain reflexes and the doctor will check these reflexes of the baby to conclude his nervous system is healthy.

The limbs will be checked to see the muscular functions and so also the bones will be checked to see if the baby has bones broken during the delivery.

Also, it is important to check the hip bones to see if there are any developmental defects. This will be performed at the end as this procedure will make the baby uncomfortable.

A complete physical check-up reassures the health of your baby and is therefore necessary to perform in the first 24 hours after birth.

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