Newborn Exam
The Purpose of the Newborn Exam
The standard newborn exam has several purposes. It is performed to spot any medical problems that may develop and facilitate treatments as early as possible. It should be performed by a trained health care professional as many signs and symptoms of disorders in infants require specific knowledge to diagnose properly.
Health care professionals are specifically trained to become comfortable with steps of the newborn exam so that it becomes second nature when working around infants. The procedure has several steps. First, before any physical exam of the baby is done, the nurse or doctor will give the baby a look over. They will look at the baby’s color, activity levels, the baby’s size in accordance with age, and they will listen to the baby’s cry if possible. A healthy baby should be a normal pink color and display the normal body movements associated with newborns. The body should also have the proper posture, muscle tone and definition. The baby’s extremities, including the fingers, toes, nose, eyes and ears should all appear to be normal in appearance. Also, the baby’s cry should be described as strong to be considered normal.
After this portion of the exam is completed, the doctor or nurse will begin to perform the physical part of the exam. The first body part to receive this exam is the baby’s head. During the birthing process, marks and bruising may appear on the infant’s scalp. It is important for a trained profession to note the differences between normal markings on the baby’s head with serious problems associated with bruising, shape, fontanelles or edema. After examining the head, the nurse or doctor will then move to the neck and shoulder region. While infant’s necks are short, they should still show the proper range of motions and be free of obstructions or asymmetry.
Also the infant’s clavicles should be physically examined to rule out deformity or fractures. An infant’s eyes should be symmetrical and properly placed on the face. Some discharge from the eyes may be normal, but other forms of discharge may be problematic. The health care professional will also perform a red light reflex test using an ophthalmoscope. Further examination of the face should reveal normally shaped ears and a freely moving tongue. When the infant is crying the doctor or nurse should be able to clearly see the palate. The interior of the nose should be free from serious congestions or respiratory difficultly and the gums and lips should be of normal color and shape.
The next step of the newborn exam will involve an exam of the chest area to check for normal positioning and to assess the baby’s breathing. This portion of the exam will also require listening to the heart and lungs to gauge whether the rates and sounds are normal. A normal range for newborn infants should be 40-60 bpm for the respiratory rate and 120-160 bpm for the heart rate. Any abnormalities or murmurs should be noted. The spine of the infant should be checked to rule out any problems. This includes any skin lesions or masses that may signal spine problems.
The health care professional will then palpitate the infant’s abdomen to check for the proper locations of organs and will perform a check of the umbilical cord as well. They will check the baby’s genitalia for normal positioning and check for patency of the rectum. The extremities should be stable, move properly and be free from deformity. Skin color and condition should be checked as well, and some edema is normal in infants.
The next portion of the newborn exam will involve specific reflex tests to determine if the infant has normal neurological responses. The final procedure of the newborn exam is in the field of dysmorphology, or searching for congenital malformations. Performing a complete and proper infant exam is essential to determining problems in infants as early as possible.