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Assessing the health of a newborn is very important for detecting any problems in their earliest, most treatable stages.  

Measurements


A baby's birth weight is an important indicator of health. The average weight for full-term babies (born between 37 and 41 weeks gestation) is about 7 lbs (3.2 kg). In general, small babies and very large babies are m ore likely to have problems. Newborn babies may lose as much as 10% of their birth weight . This means that a baby weighing 7 pounds 3 ounces at birth might lose as much as 10 ounces in the first few days. Your newborn will be weighed in the hospital at all check-ups. In most cases, metric units are used to record babies' weight. 

Converting grams to pounds and ounces:

1lb.=453.59237 grams; 1 oz.=28.349523 grams; 1000 grams=1 kg.

​​​What other measurements are taken of the newborn?

Like weight, length and head circumference help your baby's health care provider get an idea of his or her overall health. They may also be measured using metric units, centimeters (cm) instead of inches (in). To convert inches to centimeters: 1 in = 2.54 cm.

  • Head circumference; the distance around the baby's head
    • The average newborn's head measures 13 3/4 inches (35 cm)
    • Generally, a newborn's head is about half the baby's body length in cm plus 10 cm.  So a baby that is 18 inches long would be 45.7 cm (18 x 2.54).  His or her head would be about 32.9 cm or a little under 13 inches.
  • Length ; the measurement from the top of the head to the heel of one foot
    • The average newborn is about 50 cm or 19 3/4 inches long. 


Physical Examination


A complete physical exam is an important part of newborn care. Each body system is carefully examined for signs of health and normal function. The doctor also looks for any signs of illness or birth defects. Physical exam of a newborn often includes assessment of the following:

  • Vital Signs
    • Temperature; able to maintain stable body temperatures of 97.0 degrees Fahrenheit to 98.6 degrees Fahrenheit in normal room environments
    • Heartbeat; normally 120 to 160 beats per minute.  It may be much slower when an infant sleeps
    • Breathing rate; normally 40 to 60 breaths per minute
  • General appearance; physical activity, muscle tone, posture, and level of consciousness or whether or not an infant is awake and alert. 
  • Skin; color, texture, nails, presence of rashes
  • Head and Neck:
    • Appearance, shape, presence of molding (shaping of the head from passage through the birth canal)
    • Fontanel (the open "soft spots" between the bones of the baby's skull)
    • Clavicles (bones across the upper chest)
  • Face; eyes, ears, nose, cheeks.  The presence of red reflex in the eyes.
  • Mouth; roof of the mouth (palate), tongue, throat
  • Lungs; breath sounds, breathing pattern
  • Heart sounds and femoral (in the groin) pulses
  • Abdomen; presence of masses or hernias
  • Genitals and anus; open passage for urine and stool and normally formed male and female genitals
  • Nerves; reflexes (for example, the Moro or startle reflex), cranial nerves ( for example, eye movement), abnormal ( or lack of) movements
  • Arms and legs; movement and development


Gestational Assessment


Gestational age assessment means figuring out the number of weeks of your pregnancy. A full-term pregnancy is usually 40 weeks. It is important to assess if gestational age is uncertain or if your baby is smaller or larger than expected.

The new Ballard score is commonly used to determine gestational age.

  • 6 physical (body development) and 6 neuromuscular (nerve and muscle development) signs of maturity are each given a score ranging from -1 to 5. 
  • The scores are added together to determine the gestational age of the baby.  The total score may range from -10 to 50.
  • Premature babies have low scores.  Babies born late have high scores.

​​​How is physical maturity measured?

The physical assessment includes an exam of the following physical characteristics:

  • Skin texture; skin may be sticky, smooth or peeling
  • Lanugo; this is the soft downy hair on a baby's body.  It is absent in premature babies, it is present in full-term babies, but not in babies born late.
  • Plantar creases; these are the creases on the soles of the feet ranging from absent to covering the entire foot.
  • Breast; the thickness and size of the breast tissue and areola (the darkened area around each nipple) are assessed.
  • Eyes and ears; whether or not eyelids are fused or open, and the amount of cartilage and stiffness of the ear tissue are noted.
  • Genitals, male; the presence of testes and appearance of the scrotum, from smooth to wrinkled is verified.
  • Genitals, female; the appearance and size of the clitoris and the labia are noted.

​​​How is neuromuscular maturity assessed? 

The neuromuscular assessment includes an exam of the following:

  • Posture; how the baby holds his or her arms and legs.
  • Square window; how far the baby's hands can be flexed toward the wrist.
  • Arm recoil; how well the baby's arms "spring back" to a flexed position
  • Popliteal angle; how well the baby's knees bend and straighten
  • Scarf sign; how far the elbows can be moved across the baby's chest
  • Heel to ear; how close the baby's feet can be moved to the ears

Gestational age assessment is an important way to learn about your baby's well-being at birth. By identifying any problems, your baby's health care provider can plan the best possible care.



Newborn Warning Signs


Your newborn baby is going through many changes in getting used to life in the outside world. Almost always this adjustment goes well, however there are certain warning signs you should watch for. Some general warning signs with newborns include:

  • Not urinating (It may be hard to tell, especially with disposable diapers)
  • No bowel movement for 48 hours
  • A rectal temperature over 100.4 degrees Fahrenheit or less than 97.5 degrees Fahrenheit
  • Breathing fast (over 60 breaths per minute), or a bluish skin coloring that does not go away.  Newborns normally have irregular respirations, so you  need to count for a full minute.  There should be no pauses longer than about ten seconds between breaths.
  • Retractions, or pulling in or the ribs when taking a breath
  • Wheezing, grunting or whistling sounds while breathing
  • Odor, drainage, or bleeding from the umbilical cord
  • Worsening jaundice or yellowing of the skin on the chest, arms, or legs, or whites of the eyes
  • Crying or irritability which does not improve with cuddling and comfort
  • A sleepy baby who cannon be awakened enough to nurse or bottle feed
  • Signs of sickness, cough, diarrhea, pale skin color
  • Poor appetite or weak sucking ability

Every child is different, so trust your knowledge of your child and call your child's physician if you see signs that are worrisome to you.