(1)
Department of Family Medicine, University of California, Riverside, Riverside, CA, USA
Key Points
1.
The newborn examination forms the basis for all subsequent management. It is therefore comprehensive in nature.
2.
The newborn evaluation includes a review of prenatal and peripartum history, as well as newborn nursery course and physical examination.
Background
The initial newborn examination occurs immediately postpartum and will be repeated each day of the newborn’s hospital stay. This examination forms the basis for all subsequent management by providing an assessment of development and congenital abnormalities, if any. This examination is therefore comprehensive in nature.
The Examination
History
The newborn history consists primarily of a review of the prenatal and delivery course, including complications, if any. Particular attention should be made of the family history of congenital abnormalities, maternal medical conditions, and prenatal exposures including infection, medications, tobacco, alcohol, and illicit drugs.
Physical Examination
As noted, the newborn physical examination will serves as the baseline comparator for all subsequent examinations. It should, therefore, be comprehensive, detailed, and guided by an understanding of the most common areas of abnormality.
Vital Signs
Vital signs include temperature, pulse, respiratory rate, length, weight, and head circumference. Temperature can be checked in a variety of locations and the specific location should be noted along with the reading. Pulse and respiratory rate are both measured most accurately with the infant resting quietly, preferably in a parent’s arms or lap. Length is often most easily measured by marking the disposable paper on the exam table. A mark can be made at the crown of the head. The infant’s legs can be fully extended and a mark is made at his or her heel. The infant is then removed and the distance between the two marks is recorded. The additional weight of clothing and diapers can be significant for infants, so weight should be measured with the infant fully disrobed. Head circumference is measured as the circumference from the brow (above the eyebrows) to the temple (above the ears) and around the occiput (roughly equivalent to the position of a hat band).
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