- August 15, 2018
- Posted by: Dr. Nnamdi Elenwoke
- Category: Health
The newborn baby’s first cry always brings a smile to everyone around him. But, to see if this baby is healthy, the doctor will perform a physical examination within 24 hours. After the immediate examination of the baby to show the Apgar score, a full body check-up is important.
Virginia Apgar (1909-1974) was an Anaesthesiologist that introduced the Apgar score in 1952 to check the health of a newborn baby. The Apgar test includes 5 factors: Appearance, Pulse, Grimace response, Activity and Respiration. It is usually given to a baby twice: once at 1 minute after birth, and again at 5 minutes after birth.
This examination starts with measurement of body weight, length and head circumference. Then the doctor examines the newborn’s skin, head and neck, heart and lungs, abdomen and genitals. And also the nervous system and reflexes to check all the body systems and organs. Doctors might do routine screening tests as well. To be clear with the presence of health issues that will not get detected in physical examination,
The doctor will examine the skin colour of the newborn baby. Which is may be reddish, but the fingers and toes may have a bluish tinge. This is due to the poor blood circulation during the first few hours. Yellow colour appearance of the skin within 24 hours requires further assessment.
Head and Neck
The head circumference is measured with a tape and the fontanelle and sutures are palpated. This Baby Infant Growth Chart Calculator is useful to check the development up to 2 years. The size of the fontanelle can be varying. The coronal suture can be overriding. While the saggital suture will be often separated.
Caput succedaneum (swelling, or edema of a newborn’s head) usually disappears on its own within several days. It appears as a lump or a bump on their head. Caused by the pressure from the dilated cervix or vaginal walls during the delivery.
Examination of the head, face (including palate) and neck of the newborn will reveal the presence of any birth defects. Or abnormalities that occurred during delivery. Anormal delivery, in which the head delivers first, might cause slight defects of the skull. This are usually reversible and will disappear within 7-14 days. Also, some swelling and bruising are typical. These problems are common with babies delivered through the birth canal (vaginal delivery). Not only skull defects but defects of the face might also occur.
Heart and Lungs
Heart rate, and skin color are checked to see if the newborn baby’s circulation and respiration are okay. Any heart murmurs during auscultation need further investigations. The normal heart rate of a newborn baby is 110-160 beats/ min while this could be reduced up to 85 beats/ min during sleep.
The chest wall movements are checked during respiration. The respiratory rate in newborns are faster than in adults. The rate is almost 30-60 breaths/ minute. Grunting, flaring nostrils and a poor cry may be problems in the lungs and heart issues.
Abdomen and Genitals
The doctor will examine the abdomen and position of internal organs. Such as the kidneys, liver, and spleen. Enlarged kidneys may be due to ablockage to the outflow of urine. While a distended stomach may state a problem with the bowels and other organs.
Examination of the genitals is necessary to identify the gender. And also to see the urinary and genital organs are defect free. The doctor will check whether the urethra is open and is in the proper location. It is necessary to see the descended testicles in males.
It is normal to have swollen labia in a baby girl for first few weeks. Also a blood discharge through the vagina is also possible and is not an anomaly.
Nerves, muscles, and bones
The newborn baby has certain reflexes. The doctor will check these reflexes of the baby to conclude his nervous system is healthy.
The limbs will be checked to see the muscular functions. While the bones will be checked to see if the baby has broken bones during the delivery.
Also, it is important to check the hip bones to see if there are any developmental defects. This will be done at the end as this procedure will make the baby uncomfortable.
A complete physical check-up reassures the health of your baby. It is necessary to do this in the first 24 hours after birth.