Care of Born Child on Delivery - The newborn infant

The newborn infant:

A healthy infant born at term (between 38-42 weeks.) should have an average birth weight of 2500 to 3000 gms.

1.     it cries immediately following birth.

2.     It establishes independent respiration.

3.     It quickly adapts to changed environment.

The newborn is otherwise called as the neonate (between 0-28 days). After 28 days to one year, it is called as an infant.

Immediate neonatal assessment:

Provided the baby is seen to be making some respiratory effort, a quick assessment of its general condition is made which includes the following factors:

1.     Heart rate.

2.     Respiratory rate.

3.     Muscle tone.

4.     Reflex response to stimulus.

5.     Colour.

The scoring system is called as the Apgar scoring system. Apgar score, is recognized and used universally of the above five signs. The heart rate and respiratory effort are the most important.

Apgar score is assessed at 1 minute and 5 minutes after birth. The maximum score is 10. Medical assistance should be sought if the score is less than 7.

The normal infant in good condition at birth achieves an Apgar score of 7-10.

A score below 7 indicates a degree of asphyxia, which necessitates some form of resuscitation.

Physical features of a newborn at birth. Weight:

The weight is variable from country to country but usually exceeds 2500 gm. In India, the weight varies between 2.7 to 3.1 kg.

Length:

Usually, length is between 50-52 cm.

Posture:

The newborn assumes the attitude of its intrauterine existence-extremities flexed and fists clenched.

Skin:

Initially slightly blue, but soon become pink. Vernix caseosa may be present.

Head:

Head is larger in relation to the rest of the body.

Face:

The face is comparatively smaller in relation to the head. The eyes remain closed most of the times. Pupils react to light. The cheeks are full due to brown fat.

Neck and trunk:

The neck is short the circumference of the chest is slightly less than that of the head.

Genitalia:

In the males, the testes are in the scrotum, the rugae cover the scrotum. In females, labia minora and clitoris are covered by labia majora.

Temperature:

The body temperature may fall to as low as 97⁰F because the newborn is very thermolabile due to immature hypothalamus.

Urine:

1.     Small amount of urine is passed.

2.     A neonate passes urine 6 to 8 times a day

Stool:

The first stools passed are called as the meconium (sticky, dark coloured) may be passed soon after birth.