🩺 NEWBORN ASSESSMENT PROCEDURE

1. Definition

• Newborn assessment is a systematic examination of a baby immediately after birth and during the neonatal period to evaluate adaptation to extrauterine life.

• It includes physical examination, vital signs, reflexes, and behavioral responses.

2. Purpose

• To assess general health status of the newborn

• To detect congenital abnormalities early

• To evaluate adaptation to extrauterine life

• To identify risk conditions requiring immediate care

• To establish baseline data for future comparison

3. Indications

• Immediately after birth (within first hour)

• Before discharge from hospital

• During routine postnatal visits

• In sick or high-risk newborns

• During home visit in community settings

4. Contraindications

⚠️ There are no absolute contraindications, but:

• Delay assessment in severely unstable newborn

• Avoid excessive handling in:

  • Respiratory distress

  • Premature babies (risk of hypothermia)

5. Articles / Equipment

🧰 Equipment:

• Stethoscope

• Thermometer

• Infant weighing scale

• Measuring tape

• Watch with second hand

🧴 Supplies:

• Clean gloves

• Warm cloth/towel

• Hand sanitizer

📋 Records:

• Newborn assessment chart

• APGAR score sheet

6. Patient Preparation (Newborn Preparation)

• Ensure warm environment (prevent hypothermia)

• Wash hands and maintain aseptic technique

• Place baby on warm, clean surface

• Ensure baby is calm (preferably after feeding)

• Explain procedure to mother

7. Procedure Steps

🔷 Initial Observation

• Check cry → strong/weak

• Observe color → pink (normal), cyanosis (abnormal)

• Note posture and activity

🔷 Vital Signs

• Temperature: 36.5–37.5°C

• Heart Rate: 120–160/min

• Respiratory Rate: 30–60/min

🔷 Anthropometric Measurements

• Weight: 2.5–4 kg (normal)

• Length: 48–52 cm

• Head circumference: 33–35 cm

• Chest circumference: 30–33 cm

🔷 Head to Toe Examination

👶 Head

• Check shape, fontanelles (anterior & posterior)

• Molding/caput (normal in birth)

👀 Eyes

• Symmetry, discharge, redness

👂 Ears

• Position and shape

👃 Nose

• Patency (check breathing)

👄 Mouth

• Check cleft lip/palate

🔷 Chest

• Symmetry of chest movement

• Breath sounds (clear/abnormal)

🔷 Heart

• Auscultate for heart sounds and murmurs

🔷 Abdomen

• Soft, no distension

• Umbilical cord: 3 vessels (2 arteries, 1 vein)

🔷 Genitalia

• Male: testes descended

• Female: normal structure

🔷 Limbs

• Check movement and deformities

• Count fingers and toes

🔷 Skin

• Color, birth marks, rashes

• Check for jaundice

🔷 Reflexes

• Moro reflex

• Rooting reflex

• Sucking reflex

• Grasp reflex

🔷 APGAR Scoring (at 1 & 5 minutes)

A + P + G + A + R

• Appearance, Pulse, Grimace, Activity, Respiration

• Score: 7–10 (normal), 4–6 (moderate), 0–3 (severe distress)

8. Post Procedure Care

• Keep baby warm and dry

• Return baby to mother (skin-to-skin contact)

• Encourage early breastfeeding

• Clean and arrange equipment

• Document findings properly

9. Complications (If Abnormalities Found)

• Respiratory distress

• Congenital anomalies

• Hypothermia

• Neonatal jaundice

• Infection signs

10. Health Education

• Importance of exclusive breastfeeding

• Maintain warmth (kangaroo care)

• Cord care (keep clean and dry)

• Recognize danger signs:

  • Poor feeding

  • Fever or cold body

  • Fast breathing

  • Yellow discoloration

• Advise regular follow-up

🎯 Viva Questions (Important)

Q1. What is normal heart rate of newborn?👉 120–160 beats/min

Q2. What is APGAR score used for?👉 To assess newborn’s condition immediately after birth

Q3. Name any two newborn reflexes.👉 Moro reflex, Rooting reflex