What are the 5 main components of NIPE?
Eyes, mouth, heart, genitalia and hips
After you enter the room, introduce yourself and offer congratulations, how would you explain the nipe procedure and its limitations? (6)
- top to toe examination of the baby focussing on essential components
- optional
- repeated by the GP 6-8 weeks
- screening not diagnostic
- snapshot in time
- problems may still arise
What are 6 things you must do after explaining the procedure and before you begin?
- confirm the baby’s identification (name DOB CHI)
- confirm with mum any significant history identified from notes
- observe her interaction with the baby
- ask how baby is feeding
- confirm stool and urine output
- observe baby’s general condition
What should be assessed throughout in the Skin?
Colour (cyanosis and jaundice)
Integrity
Birthmarks
Rashes
Trauma
What are you assessing in the head and face?
Overall symmetry
Size
Shape
Suture lines
Fontanelles
Injury / trauma
Head circumference (32-27cm)
How long can the fontanelles be palpable for ?
Anterior - up to 18 months (known as the soft spot)
Posterior - closed by 6 weeks
What are 2 conditions to watch out for when examining the head shape?
Caput
Cephalobemhematoma
What are you checking the eyes for?
- Normal structures present (iris, pupils, sclera)
- Shape (congenital eyelid abnormalities, epicanthic folds)
- Position
- Clarity - conjunctivitis, subconjuctival haemorrhage
- Fundal reflexes
What are the key components of fundal reflex?
Colour, brightness and presence of reflex
Orange red - magnolia
What are the associated features of fetal alcohol syndrome?
- microcephaly
- smooth philtrum
- underdeveloped jaw
Ears
Size
Shape
Structure (any tags or pits?)
Hearing test
Nose
Patency - occlude one nostril at a time
Symmetry and position
Philtrum
Mouth
Rooting reflex
Visual inspection - hard/soft palate to uvula
Tongue
Gums
Digital inspection of hard/soft palate to the uvula
Gag reflex
Suck reflex
Jaw and chin
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