Newborn Exam
last authored:
last reviewed:
Introduction
Always wash your hands!
Use an infant stethoscope and clean with alcohol
Hand babies gently but conifdently; slower movements are less likely to startle the infant.
Have everything ready; including opthalmoscope
Change diapers as necessary
Start listening to the baby if it is quiet first
If eyes are open check red reflex
Keep baby warm
Learn to sooth baby as necessary
always use a glove when inserting finger into a baby's mouth; don't let the baby think your scent is
be systematic; you are less likely to omit parts of the examination
Parents are anxious and interested; explain what's happening
Review abnormal findings before speaking with staff
Examine every baby you can, including each delivery you're at
observe baby for colour, activity, posture and behaviour
start from head to tail
listen to heart and lungs
- same areas as adult
examine baby's head for marks, bruising, shape, fontanelles, and sutures
look for dysmorphic features, including low-set ears
ear abnormalities and cartilage (if skin tags or pre-auricular pit, could be a marker for kidney malformation)
check nares for patency: when baby is not crying, occlude one and observe respirations
mouth, including palate (natal teeth can be present)
neck for masses, sinuses
palpate clavicles
open hands, observe creases and grasp reflex
arm recoil: possibly Moreau (one of the most important tests, showing neurologic function); if not, drop baby test
- avoid in first 30 minutes due to epinephrine and using up glucose
assess breast tissue
examine abdomen: light palpation, then deeper
check for femoral pulses: suprapubic folds
check hips (Barlow-Ordoloney maneuvers)
check femur length
examine feet
Babinski and plantar grasp
turn baby over
palpate spinous processes
check anus and sacral areas
examine genitalia
hold finger over canal to avoid pushing testes upwards
measure head circumference (measure 3x) and take biggest measurement
length: mark
Barlow-Ordoloney
To assess for developmental dysplasia of the hip, previously known as congenital hip dysplasia.
This should be screened for in every child.
Keep fingers over greater trochanter to feel for a hip click.
Barlow = back
Ordoloney = out
Resources and References
 |