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Physical Examinations IV

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The Comprehensive Infant Examination

Overview

Source: Heather Collette and Jaideep Talwalkar; Yale School of Medicine

The newborn exam is important in establishing a baby's baseline health status as they enter the world. Newborn providers have the unique opportunity to evaluate a patient for the very first time. They are also tasked with identifying congenital anomalies that require early intervention to promote a long and healthy life for the child. Many newborn anomalies, such as heart defects, are noted on prenatal ultrasound. However, some anomalies are not apparent until the baby is born. A systematic approach ensures a complete newborn exam so that anomalies are not missed. 

If the baby is stable after birth, it is recommended to wait to examine them until they have spent at least 1 hour of skin-to-skin time with their mother. This regulates the baby's heart rate and breathing, promotes bonding, and establishes breastfeeding.

Procedure

1. Preparation for the exam

  1. Before the exam, obtain permission from the parent to examine their child.
  2. Ensure that all the equipment is available and disinfected adequately before starting. A stethoscope and ophthalmoscope are usually needed. Consider using a neonatal or pediatric-sized stethoscope, if available.
  3. The exam will eventually take place on a safe, flat surface such as a warmer or bassinet — ensure that such a location is available.
  4. Make sure to have a clean baby

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