The first four weeks of an infant’s life are considered as the neonatal period. The period is associated with several complex physiologic changes, and the infant requires continuous and effective care.

The care of a newborn involves evaluation for the need of resuscitation, a thorough physical examination, administration of prophylactic medications and vaccinations, adequate feedings, safe sleep, hygiene, and other key aspects of baby’s wellbeing.

Initial examination involves the assessment of growth parameters and behavior at the time of birth. In case of a normal spontaneous vaginal delivery or a Cesarean section with no associated complications, the examination can be deferred until one hour of age after skin to skin contact between the mother and the baby is established and breastfeeding is started. The baby is examined by a pediatrician or nurse practitioner in the first 24 hours of life. A team assesses and attends to any resuscitation efforts needed by the newborn at the time of birth. The Apgar score at 1 and 5 minutes of life helps assess the need for resuscitation.

Auscultate the heart for rhythm and the presence of any murmurs. Auscultate lung fields to check for adventitious sounds and air entry. Assess the abdomen for asymmetry or malformations, and auscultate to determine peristalsis and palpate to check for any masses or organomegaly.

Evaluate the umbilical stump for normal vessels and hernias. Palpate the femoral pulses for intensity and symmetry. Check the hips with the help of Ortolani and Barlow maneuvers to assess for the presence of clicks. Extremities must be assessed for symmetry, pulses, range of motion and any deformities. In the back, assess the centralization of the spine and check for the presence of sacral dimples or hair tuff.

Examine the skin for color, macules, spots, birthmarks or any signs of trauma that may have occurred at the time of birth or may have been caused by medical equipment. Assess neurologic development by eliciting reflexes and assessing tone. Observe the responses of the newborn to light and touch.

Until the umbilical stump falls, the newborn should be bathed with a sponge to keep the cord dry. Diaper care is essential, skin cleansing should be with soft nonwoven alcohol- and fragrance-free wipes, water, and emollient cleansers.

Hyperbilirubinemia is a common finding in newborns and most infants have some visible jaundice in the first week following birth. Jaundice during the first 24 hours of life calls for investigation. Keep the umbilical cord exposed to air. If covered, keep it loosely covered with a clean cloth.

Routine newborn care is integral to assist babies in the transition period after birth.

Reference

1. Perez BP, Mendez MD. Routine Newborn Care. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539900/