Newborn

Question 1

Normal in newborns

Answer 1

• Milia
  
  • distended sebaceous glands which appear as tiny white spots on baby’s face
• Epstein’s pearls
  
  • Small, white epithelial cysts on baby’s gums
• Mongolian spots
  
  • bluish-black macules appearing over the buttocks/thighs of darker-skinned newborns
• Erythema Toxicum Neonatorum
  
  • red papular rash on baby’s torso which is benign and disappears after a few days
• Hemangiomas
  
  • Benign tumor of capillaries
• Cephalohematoma
  
  • swelling caused by bleeding between the ostium and periosteum of the skull
  • does not cross suture lines
• Caput succedaneum (CS - “crosses sutures & caput symmetrical)
  
  • Edematous swelling on scalp caused by pressure during birth
  • May cross suture lines
  • Symmetrical
  • Usually disappears in a few days
• Hyperbilirubinemia
  
  • Normal, physiologic jaundice appears after 24 hours of age and disappears at about 1 week of age
• Vernix caseosa
  
  • whitish cheese-like substance which appears intermittently over the first 7-10 days
• Acrocyanosis
  
  • normal cyanosis of baby’s hands and feet which appear intermittently over the first 7-10 days
• Nevus/Nevi
  
  • Birthmark
  • Nevus flammeus - nonblanchable port wine stain
  • Telangiectatic nevi - blanchable pink “stork bites”

Question 2

Apgar scale

Answer 2

• Used to evaluate newborn
• Scored at 1 minutes and 5 minutes after birth
• Criteria (2 points per category)
  
  • Cardiac status (2 for >100, 1 for HR 1 - 100)
  • Respiratory effort (2 for vigorous crying, 1 for slow or irregular breathing)
  • Muscle tone (1 for extremities flexed)
  • Neuromuscular irritability (2 for crying, 1 for grimacing,
  • Color (2 for pink, 1 for blue extremities)

Question 3

Teaching

Answer 3

• Clean eyes with plain water, cotton balls
  
  • do not use cotton swabs
  • do not use same cotton ball for same eyes
• Unhealed umbilicus
  
  • Fold diaper down below the umbilicus
  • heals in 7-14 days
  • cleaned with 70% alcohol to promote drying
• Bathing
  
  • 100-105F
  • Begin with eyes (inner to outer)

Question 4

Breastfeeding

Answer 4

• Clean areola w/ plain water before and after feeding
• Breastfeed 20 minutes per side
  
  • burp after each side
• Milk can be refrigerated for 24 hours
• Milk can be frozen for 6 months
• Store milk in plastic bag
• Breast milk low in fluoride and iron
• Milk should come in postpartum day 3
• Breastfeed Q2-3 hours to establish good milk supply
• Avoid while breastfeeding
  
  • oral contraceptives
  • Estrogen

Question 5

Infant Milestones - Growth

Answer 5

• Closure of anterior fontanel - 18-24 months
• Birth weight
  
  • Should double in 6 months
  • Should triple in 1 year
• First teeth to erupt
  
  • lower central incisors
  • Should have all deciduous teeth by 24 months

Question 6

Infant vitals

Answer 6

• Respirations 30-60
• HR 110-160

Question 7

Infant Activity Milestones

Answer 7

• Follow object with its head - 2 months
• Roll over - 4-5 months
• First teeth - 4-6 months
• First afraid of strangers - 6-7 months
• Sit up unassisted - 6-8 months
• Crawl - 8-9 months
• Walk holding furniture - 10-11 months
• Pincer Grasp - 12-13 months
• Stand alone - 12-13 months
• Walk alone - 14-15 months