Examination of the newborn baby

Examination of the newborn baby

اسلاید 1: Examination of the newborn baby

اسلاید 2: Examination at birthAimTo describe and carry out an examination of a baby soon after birthObjectivesTo screen for malformations To observe smooth transition to extra uterine lifeAn asses overall of baby’s conditionEN-Teaching Aids: ENC2

اسلاید 3: Examination of the newborn babyMinimum prerequisitesMother & baby togetherWarm room, fresh clean sheet/clothesThermometer Weighing scaleWatch with secondsStethoscope Eyes see what the mind knowsSkilled , knowledgeable health professional ! EN-Teaching Aids: ENC3

اسلاید 4: Principles of examinationAssessAsk, Check, RecordLook, Listen, FeelClassifyTreat or adviseEN-Teaching Aids: ENC4

اسلاید 5: Examination at birth: Assess Ask Antenatal details Antenatal visits – TT, Iron-folate supplementation, HIV/Syphilis screeningExposure to teratogens, infectionsPoly or oligohydramniosPostnatal details: Condition at birth; resuscitation, Single umbilical artery ,excessive drooling CheckWeigh the babyTemperatureRecord EN-Teaching Aids: ENC5

اسلاید 6: Assess: Look for EN-Teaching Aids: ENC6

اسلاید 7: Assess: Look for Quick screening for malformationsScreen from top to bottom, midline, and back examination Orifice examination Anal openingEN-Teaching Aids: ENC7

اسلاید 8: Assess: Look for Single umbilical artery Simian crease Dysmorphic features Excessive drooling of salivaEN-Teaching Aids: ENC8

اسلاید 9: Assess: Look for Look for abnormal swellingAbnormality of limbs & spineEyes, ears, umbilicus ObserveBreathing rate / pattern Color Heart rate Activity- feeding , movementsEN-Teaching Aids: ENC9

اسلاید 10: Assess: Listen for Grunting, Cry, Heart soundsEN-Teaching Aids: ENC10

اسلاید 11: Any abnormal swelling: Caput, cephalhematomaPalpable femoral pulsesDislocation of hipCapillary refill time ( CRT)Confirm the findings of inspectionPalpate the abdomenFeel for testes in male babyAssess: Feel forEN-Teaching Aids: ENC11

اسلاید 12: Weighing the babyPrepare the scale: cover the pan with a clean cloth/autoclaved paper; ensure the scale reads zero Preparing and weighing the babyRemove all clothingWait till the baby stops movingWeigh nakedRead and recordReturn the baby to the motherScale maintenanceCalibrate dailyClean the scale pan between each weighingEN-Teaching Aids: ENC12

اسلاید 13: TemperatureAt birth-warmth, keep the baby in skin to skin contact with the motherEN-Teaching Aids: ENC13

اسلاید 14: Temperature recording Hands and feet should be checked for warmth with the back of the hand to see if the baby is in cold stressTemperature measurementUse clean thermometerHold vertically in the axilla for 3 minuteRead and recordNormal 36.5ºC-37.5ºCEN-Teaching Aids: ENC14

اسلاید 15: Examination within 24 hoursObjective To describe and carry out an examination of a baby within 24 hours of birthAimTo ensure that malformations are detectedTo ensure establishment of breast feeding ; maintenance of temperature ;classify baby as normal or abnormal EN-Teaching Aids: ENC15

اسلاید 16: AssessAsk, Check, RecordLook, Listen, FeelClassifyTreat or adviseEN-Teaching Aids: ENC16Examination within 24 hours

اسلاید 17: Examination at 24 hrs: Assess Ask Breastfeeding Activity of the babyAny other problems*CheckWeigh the babyTemperature Record EN-Teaching Aids: ENC17Passage of meconium up to 24 hrs and urine up to 48 hrs of life is usually normal

اسلاید 18: ColorSkin Discharge from eyes, umbilicusCount respiratory rateChest retractions Abnormal swelling scalpAbnormality of limbs fingers , backWeightFor breast feeding Position Attachment Assess: Look for EN-Teaching Aids: ENC18

اسلاید 19: Grunt CryAuscultation of heartAssess: Listen for EN-Teaching Aids: ENC19

اسلاید 20: Femoral pulse CRTTemperature by touchDescent of testisDepth or extent of jaundice Feel for abdomen Confirm findings of inspectionAssess: Feel for EN-Teaching Aids: ENC20

اسلاید 21: RecordEN-Teaching Aids: ENC21

اسلاید 22: Examination at dischargeAim To ensure that baby is normal on exclusive breast feeds ObjectiveTo screen that heart is normal To ensure baby has no significant jaundice or danger signs Tell about follow up and danger signsEN-Teaching Aids: ENC22

اسلاید 23: Discharge from eyes , umbilicusBreathing difficultyBreast feeding- exclusivity and adequacyJaundice Assess: Look forListen forAuscultation of heartEN-Teaching Aids: ENC23

اسلاید 24: Temperature by touchDepth or extent of jaundice Confirm findings of inspection, if anyAssess: Feel for EN-Teaching Aids: ENC24

اسلاید 25: Danger signsEN-Teaching Aids: ENC25Not feeding wellLess active than beforeFast breathing (>60/ min)Moderate or severe chest in-drawingGruntingConvulsionsFloppy or stiffTemperature >37.50C or <35.50C Umbilicus draining pus or umbilical redness extending to skin.>10 skin pustulesBleeding from umbil. Stump

اسلاید 26: Examination on follow-upAimTo ensure that baby is growing well on exclusive breast feeds & give immunization as per national policyObjective To record the anthropometry weight , head circumference To ensure baby has no malformations like – cardiac murmurs EN-Teaching Aids: ENC26

اسلاید 27: Normal: feeding behaviourPositioningHead in line with bodyWell supportedAbdomen touches the mother abdomenTurned to the motherAttachmentMouth wide openLower lip evertedLittle areola visibleChin touches mother breastAssessment of feeding adequacyEN-Teaching Aids: ENC27

اسلاید 28: It is NORMAL for a babyTo pass urine six or more times a day after day 2To pass six to eight watery stools (small volume) in 24 hrsFemale baby may have some vaginal bleeding for a few days during the first week after birth. It is not a sign of a problem.Loses weight and regains by 7-10 daysEN-Teaching Aids: ENC28

اسلاید 29: Normal breathing30 to 60 breaths per minuteNo chest in-drawing, no grunting on breathing outWhen assessing breathing:Count number of breaths for a full minuteBabies may breathe irregularly for short periods of timeSmall babies (<2.5 kg or born before 37 wks gestation) may: Have some mild chest in-drawingPeriodically stop breathing for a few secondsEN-Teaching Aids: ENC29

اسلاید 30: RETRACTIONSEN-Teaching Aids: ENC30

اسلاید 31: Caput succedaneum vs. cephalohematomaNormal vs. Abnormal EN-Teaching Aids: ENC31

اسلاید 32: The umbilicus: Which one is normal?Normal vs. Abnormal EN-Teaching Aids: ENC32

اسلاید 33: UmbilicusEN-Teaching Aids: ENC33

اسلاید 34: Skin conditions: Which baby will you treat?Normal vs. Abnormal EN-Teaching Aids: ENC34

اسلاید 35: Skin pustulesLocate ? EN-Teaching Aids: ENC35

اسلاید 36: Skin A baby may have PUSTULES MORE than 10 are a DANGER SIGNRefer this baby urgentlyLess than 10 are a local skin infectionTreat them immediatelyEN-Teaching Aids: ENC36

اسلاید 37: PostureThe normal resting posture of a term newborn baby:loosely clenched fistsflexed arms, hips, and knees Small babies (less than 2.5 kg at birth or born before 37 weeks gestation)the limbs may be extended Babies born in the breech position may have fully flexed hips and knees; the feet the mouth; and legs may even reach near the mouth. EN-Teaching Aids: ENC37

اسلاید 38: The normal resting posture of a baby born breech EN-Teaching Aids: ENC38

اسلاید 39: ABNORMAL position of arm and handEN-Teaching Aids: ENC39

اسلاید 40: Color of the babyNormal vs. Abnormal EN-Teaching Aids: ENC40

اسلاید 41: Color of the babyNormal vs. Abnormal EN-Teaching Aids: ENC41

اسلاید 42: Case scenario 1Baby of Archana was born to a Primigravida mother at term, baby is now 20 hours of age noticed to have yellowness of face and trunk.What is the problem?What action you will take? EN-Teaching Aids: ENC42

اسلاید 43: Case scenario 2Baby of Radhika was born with weight of 1.5kg. Baby weighs 1.3 kg today on day 2. What are your concerns?What action you will take? EN-Teaching Aids: ENC43

اسلاید 44: Conclusion All newborn babies must be examined at Birth24 hrsBefore discharge and Follow-up A systematic approach consisting of ‘Ask, Check, Look, Listen, Feel’ should be followed at each assessment