© Goodheart-Willcox Co., Inc.. 7 The Newborn © Goodheart-Willcox Co., Inc. Key Terms neonate Apgar test Brazelton scale pediatrician anemia phenylketonuria.

© Goodheart-Willcox Co., Inc.


7The Newborn


Key Terms

• neonate• Apgar test• Brazelton scale• pediatrician• anemia• phenylketonuria

(PKU)• jaundice• intensive care

nursery (ICN)

• neonatal intensive care units (NICUs)

• neonatology• well-baby checkup• reflexes• rooting reflex• sudden infant

death syndrome (SIDS)

• colic


Objective

• Give examples of medical care and tests newborns receive at birth.


Medical Care and Testing

• Neonate is the medical term for a baby from birth to age one month

• Immediately after birth,– fluid is suctioned from nostrils and mouth– cord is clipped– baby is dried with warm towels


The Apgar Test

• Apgar test checks the baby’s chance of survival– pulse, breathing, muscle tone,

responsiveness, skin color– given one minute and five minutes

after delivery• five-minute score should be higher

– most healthy babies score 6 or 7 at 1 minute, then 8 to 10 at 5 minutes

continued


The Apgar Test

• After the Apgar test,– antibiotic drops are put into the eyes– thermometer is attached to the chest– most newborns receive a vitamin K

injection to help their blood clot– some newborns receive a penicillin

injection to fight possible strep infection– sample of cord blood is taken to know the

baby’s blood type and antibody status

continued


The Apgar Test

• Before baby leaves the delivery room,– footprints are made– name bands are

placed around wrists and ankles


Neonatal Behavioral Assessment Scale

• Brazelton scale helps identify problems as early as possible– interaction with environment– motor processes– control of physical state– response to stress


Other Screening Tests

• A pediatrician cares for infants and children until adulthood

• Screening programs vary for each state– up to 55 disorders– 29 are treatable

continued


Other Screening Tests

• All states check for– anemia– phenylketonuria (PKU)

• Parents can request tests not required by the state, but must pay for them

• Jaundice is checked using blood from a heel prick or by a painless monitor– treated by placing baby under bright lights


Care for Premature Babies

• Over 12% of babies born premature• Intensive care nursery (ICN)• Newborns who need intensive care live in

neonatal intensive care units (NICUs)– heated, completely enclosed beds

• Neonatology is a branch of medicine concerned with the care, development, and diseases of newborns


Circumcision

• Surgical removal of the foreskin of the penis

• 65% of newborn boys• Generally for religious or cultural

reasons


Well-Baby Checkup

• Well-baby checkup is a routine medical visit for new babies

continued


Well-Baby Checkup

• Medical personnel will– explore for signs of good health and

proper growth– examine baby– answer questions– make recommendations for care– ask for family health history– measure baby’s length, head, chest– weigh baby


Did You Know?

The vast majority of newborn deaths take place in developing countries where access to health care is low. Most of these newborns die at home, without skilled care that could greatly increase chances for survival.Learn more about this issue by visiting the World Health Organization Web site.


Objective

• Describe the characteristics of a newborn.


Physical Traits of a Newborn

• Size– weigh about 7 pounds and are about

20 inches long• boys slightly larger

– lose weight after birth, gain after about 10 days

– grow one inch and 1½ pounds during first month

– have little body fat

continued



• Body proportion– head ¼ of total length

• adults 1/8

– rounded chest– protruding stomach, narrow pelvis

and hips– legs drawn up and appear bowed– legs short when compared to arms– almost no neck

continued



• Face– broad, flat nose– tiny jaw and chin– facial features

help them suck

continued



• Cranium– fontanels

• soft spots that allow for compression during childbirth

• fill with bone by one to two years of age• membrane that covers fontanels may move

as baby breathes

– bones of skull are soft• may be elongated during childbirth

continued



• Skin– thin, dry, blotchy, visible blood vessels– skin on feet loose and wrinkled– wrists have deep creases– scalp skin loose– languno on ears, shoulders, back,

forehead, cheeks (especially premature babies)

– rash one to several days after birth

continued



• Skin– stork bites– Mongolian spots

• African, Asian, Mediterranean descent

– may be slightly jaundiced

continued



• Eyes– appear small– usually dull gray-blue until about

six months– tears are not produced until about

three months– may cross at times, begin to work

together at about six months

continued



• Mouth– puffy cheeks because of sucking pads

inside cheeks– short tongue, cannot extend past gums– lining of lips may peel– most are toothless


Reflexes

• Reflexes are automatic, unlearned behaviors

• Some triggered by outside stimuli• Clue to health of nervous system• Needed for survival• Some stay throughout life, others leave• Practice for voluntary movement

continued


Reflexes

• Rooting reflex• Palmar (grasping)• Plantar (grasping)• Babinski• Moro (startle)• Walking


Objective

• Identify a newborn’s physical, intellectual, and social-emotional needs.


Meeting the Newborn’s Physical Needs

• Feeding• Clothing and

dressing• Diapering• Bathing• Sleeping• Exercising• Scheduling


Feeding

• Newborns grow quickly, nutrient needs are important

• Breast- or formula-feeding– American Academy of Pediatrics

recommends breast-feeding for first year


Breast-Feeding

• Advice for mother– eat a balanced diet– drink at least eight

8-ounce glasses of fluid per day

continued


Breast-Feeding

– may need supplementary vitamin D, iron, and fluoride for baby

– certain foods may upset baby’s stomach– prescription and/or over-the-counter

drugs can affect baby– rest and avoid stress– consult with a doctor, nurse, or lactation

consultant if needed– use breast-feeding time to bond


Formula-Feeding

• Parents choosing to formula-feed– consult with

doctor regarding formula to use

– report digestive problems or rashes to baby’s doctor

continued


Formula-Feeding

– if formula is mixed with water, ensure that water is safe

– avoid making formula at home• Food and Drug Administration oversees

commercially-prepared formulas

– feed newborns the correct amount, such as two to 2½ ounces per pound of body weight every 24 hours

continued


Formula-Feeding

– keep utensils, bottles, and nipples completely clean

– keep ready-made formula refrigerated– check nipples for clogs or tears– throw away all unfinished formula– cuddle while feeding to enhance bonding– avoid propping the bottle


Burping the Baby

• To burp a newborn, – place baby in a sitting position with a hand

on the collarbone and under the chin

continued


Burping the Baby

– lay baby face down across lap with baby’s face toward adult’s knees

– lightly pat baby’s back once in position (pat below the ribs for two or three minutes unless baby burps sooner)

– burp baby before, midway, and after feeding


Clothing and Dressing

• Should be comfortable, easy to put on and take off, appropriate for weather

• Must be flame-retardant– indicated on manufacturer’s tag

• American Academy of Pediatrics recommends no blankets for first year

• Interact with baby as dressing and undressing to enhance bonding


Diapering

• Cloth or disposable diapers– both have

advantages and disadvantages

• cost• convenience


What Do You Think?

• There are often complaints about the impact of disposable diapers on the environment.

• Cloth diapers are often seen as an alternative that is more environmentally friendly; however, they must be laundered, often in harsh chemicals.

• What are your thoughts on this issue?


Bathing

• Sponge baths recommended until the navel completely heals– up to three

weeks after birth

• Keep cord stump dry and never pull on it


Sleeping

• Average 17 hours per day– as many as 23 hours and as few as 11

hours

• Light sleepers– seven or eight naps– wheeze, gurgle, suck while sleeping

• Firm mattress needed• Avoid toys and pillows in bed

continued


Sleeping

• Place baby on back• Clean pacifier

recommended– sudden infant death

syndrome (SIDS), baby dies without warning while sleeping


Exercising

• Important for muscle development, coordination, and relaxation

• May become a daily, lifelong habit• Way to have fun with babies and

develop a warm relationship


Scheduling

• Feeding and sleeping should be done on the newborn’s schedule– nurse newborns about every two hours– arouse sleeping newborns every three

or four hours for feedings

• Most babies begin to develop eating-sleeping patterns in a few weeks


Meeting the Newborn’s Intellectual Needs

• Parents are child’s first teachers• Babies respond to human speech

– 12 to 24 hours after birth can move arms and legs rhythmically to human speech

– show preference for parent’s voice over a stranger’s voice

• Imitation of others is common

continued



• Parents should stimulate babies– stimulation comes

from closeness to caregivers

• Newborns learn through their senses– enjoy looking at and

listening to

continued



• Newborns visual preferences include– designs and patterns that are bold,

horizontal, spiral– objects that move– circular-shaped objects– faces


Meeting the Newborn’s Social-Emotional Needs

• Babies learn best when alert

continued


Meeting the Newborn’s Social-Emotional Needs

• Some babies cry one-sixth to one-fourth of the day

• Colic is a condition in which the baby has intense abdominal pain

• Attempts to soothe are important– newborns cannot be “spoiled” by attention– babies may not stop crying, but will benefit

from soothing attention of adults


Objective

• Explain how parents of newborns can meet their own needs.


Meeting the Parents’ Needs

• Rest• Organize tasks• Take care of new business

– birth certificate, social security card

• Spend time with other adults


What Would You Do?

• Parents today have been called “helicopters” because of their tendency to hover around their children, hindering independence.

How would you encourage parents to make a life for themselves outside of their role as caregivers of children?


• anemia. Condition that occurs when the level of healthy red blood cells, which carry oxygen to all parts of the body, becomes too low.

• Apgar test. Test that checks the baby’s chance of survival.

Glossary of Key Terms


• Brazelton scale. Test used to determine whether a baby has problems interacting with the environment, handling motor processes, controlling his or her physical state, or responding to stress.

• colic. Condition in which a baby has intense abdominal pain and cries inconsolably.



• intensive care nursery (ICN). Special nursery that can provide immediate intensive care just after birth for babies who need it.

• jaundice. Liver condition that can make the skin, tissues, and body fluids look yellow.



• neonatal intensive care units (NICUs). Heated, completely enclosed beds for newborns who need intensive care.

• neonate. Medical term used to describe the baby from birth to one month of age.

• neonatology. Branch of medicine concerned with the care, development, and diseases of newborns.



• pediatrician. Doctor who cares for infants and children until adulthood (age 21 or 22) when physical growth is complete.

• phenylketonuria (PKU). Disease that can cause mental retardation if left untreated by diet.

• reflexes. Automatic, unlearned behaviors.



• rooting reflex. Reflex that helps babies search for food by turning the head and moving the mouth in response to a touch on the cheeks or mouth.

• sudden infant death syndrome (SIDS). Syndrome in which a baby dies without warning in his or her sleep.



• well-baby checkup. Routine medical visit in which the doctor examines a baby for signs of good health and proper growth.


© Goodheart-Willcox Co., Inc.. 7 The Newborn © Goodheart-Willcox Co., Inc. Key Terms neonate Apgar test Brazelton scale pediatrician anemia phenylketonuria.

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