normal newborn or assessment of normal newborn definition of a normal newborn characteristics of a normal newborn care of a normal newborn anthropometric assessment of a normal newborn terminologies used to describe the abormalities in the newborn nursing care to be provided to the newborn seminar on newborn ppt on normal newborn examination of newborn care of nweborn given at birth cord clamping and ligate the cord

1. SHRUTIKA RAJENDRA
DHONGADE
4TH YR

2. WHAT IS NORMAL
NEWBORN ???

3. Definition :
 A healthy infant born at term (between 38
weeks and 42 weeks) should have an average
birth weight 3.5 kg (usually between 2.5 kg-
4.5kg), cries immediately following birth,
establishes independent rhythmic respiration and
quickly adapts to the changed environment is
normal newborn.

4. Immediate physiological changes in
newborn
During the process of birth, the baby
has to face many physiological and environmental
changes which produce stress in newborn. The
neonate needs to adjust to its extrauterine life
to maintain normal physiological activities.

5.  1.Respiratory changes
 2.Circulatory changes
 3.Neurologic system
 4.Digestive system
 5.Renal system
 6.Integumentary system
 7.Endocrine system
 8.Musculoskeletal system
 9.Blood

6. Physical features of newborn
A.General examination:
1.Posture – generalized flexion is seen
2.Activity- alert and active
3.Cry – cries when hungry or wet
4.Colour – body and extrimities pink
5.Vital signs –
temperature- 35.5-37.5 degree c
heart rate – 120-40b/min
respiratory rate – 40-60breaths/min

7. B.Anthropometric assessment :
1.Weight : 2.5-3 kg
2.length : 45-50 cm (head to feet)
3.Head circumference : 33-35 cm (fig.1)
4.Chest circumference : 31-33cm (fig.2)
Fig.1 Fig .2

8. C.Head to toe examination:
1.Skin : soft,smooth and puffy.
Covered with vernix caseosa
2.Head : skull bone not completely fused
3.Face: Examine newborns face for any asymmetry or malformation.
4.Eyes : distance between inner canthus of both the eyes 2cm
5.Ears : ear cartilage well formed
6. Nose : examine for its shape and nasal bridge

9. 7.Mouth : examined while child is crying or yawning
observe for cleft lip and cleft palate.
8.Neck : palpated for any lymphadenopathy or any
abnormal mass. Fig.1
9.Chest : barreal shaped , engorged having witch’s milk
10.Abdomen : palpation feels soft,
auscultation for presence of bowel sound
Fig.1 Lymphamdenopathy
(swelling of lymph nodes)
Fig.2 Barreal shaped chest

10. 11.Feet and hands : look for creases
examine the range of motion
12. Genitalia : full term female –labia majora covers the
labia minora and clitoris
full term male – large pendulous scrotum
penis should be inspected for
location of urethral opening
13.Back and spine : inspect spine for any mass,
opening,any truft of hair or protruding sac

11. D.Neurological assessment
1. Muscle tone:
-posture
-passive tone
-active tone
2.Joint mobility : flexible and relaxed
3.Certain automatic reflexes:
-moro’s reflex
-pupillary reflex
-blinking
-grasp rooting
-suckling reflex
4.Body movements :
moves extrimities actively
1. normal
muscle tone
Body movements

12. Character <36 weeks 37-38 weeks >39 weeks
Sole creases 1–2 Transverse creases on
anterior 1/3rd of sole
Multiple creases on
anterior 2/3rd of sole
Entire sole covered with
creases
Breast nodule 2 mm 4 mm 7 mm
Scalp hair Fine, Wooly, Fuzzy Fine, Wooly, Fuzzy Coarse, Silky
Ear lobe Coarse, Silky Moderate amount of
cartilage
Stif ear lobe, thick
cartilage
Testes and scrotum Testes partially
descended, scrotum small
and few rugae
- Testes fully descended,
scrotum normal size,
prominent rugae
Assessment of gestational age at
birth.

13. IMMEDIATE CARE OF THE NEWBORN
CARE AT BIRTH:
Soon after the delivery of the baby, it should
be placed on a tray covered with clean dry linen
with the head slightly downward (15°).
The tray is placed between the legs of the
mother and should be at a lower level than the uterus to
facilitate gravitation of blood from the placenta to the infant.
Apgar rating at 1 minute and at 5 minutes is to be recorded.

14. Clamping and ligature of the cord:
The cord is clamped by two Kocher’s
forceps, and is cut in between the clamps leaving
about 1” or 5 cm from the abdomen of baby.
Squeezing the cord with fingers prior to appling
ligatures or plastic cord clamps prevents
accidental inclusion of embryonic remnants .

15. CARE IN NURSERY:
All healthy new-borns are kept in the delivery
room with their mother to promote immediate breastfeeding
and early bonding.
Indications for admission of the new-born in the nursery are:
-Prematurity
-Respiratory distress
-Presence of pallor or cyanosis
-Need for O2 therapy.

16. Routine Nursery Care
Infant’s weight, front-occipital circumference (FOC) and length are
recorded
The new-born must be kept under a neutral thermal condition.
DAILY OBSERVATION AND CARE Rooming-in:
Soon after birth, if mother is fit, baby is kept in a cot by the
bedside of mother.
This establishes mother-child relationship. Mother also
learns the art of baby care.

17. • Baby bath:
Routine bath is delayed until the baby is able to
maintain the body temperature.
The water for baby bath should be at body
temperature (> 97.5°F)
Umbilical cord care:
It is kept exposed to air and allowed to dry to
promote early detachment.
Umbilical
cord
healing

18. Routine medications:
A single intramuscular dose of 0.5–1 mg of vitamin K1
(phytonadione)
is given to all new-borns within 6 hours of birth.
Eyes are kept clean with cotton wool soaked with sterile
normal saline as a prophylaxis against ophthalmia
neonatorum.

19. Immunization and vaccines:
Hepatitis B vaccine is given at birth.
Feedings:
The frequency, duration and volume of each feed is
important for new-born’s growth and development.
The infant should be put to breast as soon as
possible after delivery in the delivery room.
Usually it is 8–12 times per day.

20. Follow-up:
During follow-up, the new-born is assessed for weight,
hydration, infection and for any new problem.
Parental education and immunization schedule are
discussed.

21. LET’S TEST OUR KNOWLEDGE
1.At birth skin is covered by white cheesy substance called ?
a)Vemix ceosa b)vernic caseosa
c)vernix caseosa d)vernix casosa
2.White plaques adhering to oral mucosa and tongue indicate
which infection ?
a)Candidiasis b)candida albicans
c)Cellulitis d)carbuncles
3.In physiological changes in digestive system the amount of saliva
is increased in ?
a) 2 hours b) 2 days
c) 2 weeks d)2 months
4) Depressed frontanel is the sign of –
a) Dehydration b)diarrheoa
c) Mental retardation d) none of the above

22. Thank you so much………