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Assessments for Newborn BabiesEach newborn baby is carefully checked at birth for signs of problems or complications. The healthcare provider will do a complete physical exam that includes every body system. Throughout the hospital stay, doctors, nurses, and other healthcare providers continually look at the health of the baby. They are watching for signs of problems or illness. Assessments may include the below.
Apgar scoringThe Apgar score helps find breathing problems and other health issues. It is part of the special attention given to a baby in the first few minutes after birth. The baby is checked at 1 minute and 5 minutes after birth for heart and respiratory rates, muscle tone, reflexes, and color. A baby who needs help with any of these issues is getting constant attention during those first 5 to 10 minutes. In this case, the actual Apgar score is given after the immediate issues have been taken care of. Each area can have a score of 0, 1, or 2, with 10 points as the maximum. Most babies score 8 or 9, with 1 or 2 points taken off for blue hands and feet because of immature circulation. If a baby has a difficult time during delivery and needs extra help after birth, this will be shown in a lower Apgar score. Apgar scores of 6 or less usually mean a baby needed immediate attention and care.
Birth weightA baby's birth weight is an important marker of health. Full-term babies are born between 37 and 41 weeks of pregnancy. The average weight for full-term babies is about 7 pounds (3.2 kg). In general, very small babies and very large babies are at greater risk for problems. Babies are weighed every day in the nursery to look at growth, and the baby’s need for fluids and nutrition. Newborn babies may often lose 5% to 7% of their birth weight. This means that a baby weighing 7 pounds 3 ounces at birth might lose as much as 8 ounces in the first few days. Babies will usually gain this weight back within the first 2 weeks after birth. Premature and sick babies may not begin to gain weight right away. Most hospitals use the metric system for weighing babies. This chart will help you convert grams to pounds. Converting grams to pounds and ounces:1 lb. = 453.59237 grams; 1 oz. = 28.349523 grams; 1000 grams = 1 Kg.
MeasurementsThe hospital staff takes other measurements of each baby. These include:
The staff also checks these vital signs:
Physical examA complete physical exam is an important part of newborn care. The healthcare provider carefully checks each body system for health and normal function. The provider also looks for any signs of illness or birth defects. Physical exam of a newborn often includes:
Gestational assessmentThe healthcare provider will check how mature the baby is. This is an important part of care. This check helps figure out the best care for the baby if the dates of a pregnancy are uncertain. For example, a very small baby may actually be more mature than he or she appears by size, and may need different care than a premature baby needs. Healthcare providers often use an exam called the Dubowitz/Ballard Examination for Gestational Age. This exam can closely estimate a baby's gestational age. The exam looks at a baby's skin and other physical features, plus the baby’s movement and reflexes. The physical maturity part of the exam is done in the first 2 hours of birth. The movement and reflexes part of the exam is done within 24 hours after birth. The provider often uses the information from this exam to help with other maturity estimates. Physical maturityThe physical maturity part of the Dubowitz/Ballard exam looks at physical features that look different at different stages of a baby's gestational age. Babies who are physically mature usually have higher scores than premature babies. Points are given for each area of assessment. A low of -1 or -2 means that the baby is very immature. A score of 4 or 5 means that the baby is very mature (postmature). These are the areas looked at:
Maturity of nerves and musclesThe healthcare provider does 6 checks of the baby's nerves and muscles. A score is given to each area looked at. Typically, the more mature the baby is, the higher the score. These are the areas checked:
When the physical assessment score and the nerves and muscles score are added together, the healthcare provider can estimate the baby’s gestational age. Scores range from very low for immature babies to very high scores for mature and postmature babies. All of these exams are important ways to learn about your baby's well-being at birth. By finding any problems, your baby's doctor can plan the best possible care. What are the physiological changes in the newborn immediately after birth?Once the baby takes the first breath, a number of changes occur in the infant's lungs and circulatory system: Increased oxygen in the lungs causes a decrease in blood flow resistance to the lungs. Blood flow resistance of the baby's blood vessels also increases. Fluid drains or is absorbed from the respiratory system.
Which is the most critical physiologic change required of the newborn?The most essential adaptation to birth is the initiation of breathing, but the airspaces of the fetal lung are filled with fetal lung fluid.
What is the priority assessment immediately after an infant's birth?Apgar scoring
The Apgar score is assigned in the first few minutes after birth to help identify babies that have difficulty breathing or have a problem that needs further care. The baby is checked at one minute and five minutes after birth for heart and respiratory rates, muscle tone, reflexes, and color.
Which intervention has the highest priority when caring for a newborn at birth?With every newborn contact, respiratory evaluation is necessary because this is the highest priority in newborn care.
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