The Newborn Infant
What vaccinations should infants receive at birth?
When should an infant receive the Hep B vaccines
Birth, 1-2 months, 6-18 months
What is the neonatal period of an infant's life?
the first 28 days
What is the postneonatal period?
When are newborns most responsive?
1-2 hours post feeding
When should you do an apgar score?
1 and 5 minutes after birth, Continue at 5 minute intervals until its greater than 7.
1 minute apgar score values
8-10 normal, 5-7 some nervous system depression, 0-4 severe depression requiring immediate resuscitation
5 minute apgar score values
8-10 normal, 0-7 high rish for CNS and other system damage
<37 wks preterm, 37-42=term, >42 postterm
<1,000 extrememly low, <1,500 very low, <2,500 low >2,500 normal
SGA small for gestational age
AGA appropriate gestational age
LGA large for gestational age
Most normal, full-term newborns
lie in a symmetric position, with the limbs semiflexed and the legs partially abducted at the hip
By 1 year old, an infants weight should have
tripled and height increase by 50%
By 1 year, infants should be
walking, saying 1-3 words, and imitating activities
Normal heart rates for birth-1 year
0-2mo: 140, 90-190
0-6mo: 130, 80-180
6-12mo: 115, 75-155
Birth-2 months: <60, 2-12 months <50
scattered vesicles on an erythematous base, disappears spontaneously within weeks
pinpoint vesicles scatered diffusely, disappear within 1 week
smooth, white raised areas on nose, chin and forehead, disappears on its own.
salmon patch (nevus simplex)
"stork bite" or "angel kiss", splotchy pink marks fade with age
cafe au lait spots
light-brown pigmented lesion, if more than 5 consider neurofibromatosis
bluish-black on the buttocks
4-6cm, closes between 4 and 26 months
1-2cm, closes by 2 months
Female genitalia is often protuberant and has a milky white discharge from
salmon, red scaly eruption
What is the most common cause of low birth weight in developing and developed countries?
What is given to prevent neonatal gonococcal and chlamydial eye disease?
What is vitamin K prophylaxis for?
To prevent hemorrhagic disease of the newborn
Name the components of the apgar score:
Heart rate, respiration, muscle tone, reflex irritability, color of body
choanal atresia (stenosis)
Respiratory distress, apnea, unable to breath through nose
Tracheoesophageal Fistula manifestations
Unable to place NG tube in stomach, aspiration pneumonia, salivation
May be noted in a healthy term infant a few days after birth.
Hair tufts over the LS spine
suggest a spine defect
soft, white, creamy layer covering the skin in preterm infants
epidermal inclusion cysts on the hard palate, normal
The Moro reflex
Sudden, slight dropping of the supported head should cause opening of the hands and extension and abduction of the arms and a cry.
turning of the head toward light tactile stimulation of the periorbital area (by 32 weeks)
Omphalocele is more commonly associated with ______ while gastrochesis is more associated with ___?
other malformations; intestinal necrosis
a diffuse, edematous, often dark swelling of the soft tissue of the scalp that extends across the midline and suture lines
subperiosteal hemorrhage that does not cross the suture lines surrounding the respective bones.
an adaptation to unfavorable uterine conditions that result in permanent alterations in metabolism, growth and development.
a fetal clinical condition of excessive fluid accumulation in the skin and one or more other body compartments.
What has reduced the incidence of hydrops fetalis?
Rho D Immunoglobulin
Bilirubin is produced by the
catabolism of hemoglobin in the reticuloendothelial system.
Jaundice on the first day of life
is always PATHOLOGIC.