Wk 9.1 - Basic Newborn Care

Question 1

Components of Newborn Assessment

Answer 1

Includes:
1) weight
2) head circumference
3) length
4) reflexes
4) other routine newborn findings (e.g., caput: soft, swollen area on a newborn’s scalp caused by pressure during labor and delivery)

Question 2

Normal vs Concerning Newborn Breathing

Answer 2

Normal Breathing
→ shallow rapid breaths
→slow deep breaths
→ apnea < 10 seconds

Abnormal/Irregular Breathing:
→ apnea > 10 seconds
→ intercostal or sternal retractions
→ tracheal tug
→prolonged grunting
→nasal flaring

Question 3

Normal vs Concerning Newborn Colour

Answer 3

Normal:
1) acrocyanosis of hands/feet (~24 hrs)
→bluish discoloration of a newborn’s hands and feet caused by normal circulatory adjustment after birth
2) mild jaundice (~24 hrs)
3) red rash with crying

Abnormal
- central cyanosis (blue lips/tongue), which signals impaired oxygenation

Question 4

Normal vs Concerning Newborn Temperature

Answer 4

Normal:
- axillary temperature = 36.5–37.5°C. If >37.5°C, remove layers and reassess in 30 min; if <36.5°C
→ Central temperature is better indicator than peripheral (cold feet and hands = normal)

Abnormal (Seek care for temperature >38°C):
>37.5°C
→remove layers
→ reassess in 30 min

<36.5°C
→use skin-to-skin with blanket
→ reassess in 30 mins

Question 5

Key Newborn Care Teaching Topics

Answer 5

1) Weighing & output
→What is expected weight loss?
→Normal pees and poos?

2) Sleep and activity
→How much sleep?
→ feeding cues?

3) Bathing and cord care
→How to bath?

4) Infant feeding & Input
→How much should they get? →How often?

5) Other learning
→Car seats safety?

Question 6

9 Components of a Safe Newborn Sleep Environment

Answer 6

1) Place baby on their back

2) No smoking around baby

3) Baby sleeps alone in a crib

4) Crib free of toys/loose bedding

5) Crib next to adults bed for 1st 6 months

6) Firm mattress with a tight sheet

7) crib meets safety regulations

8) keep face uncovered

9) Baby in light clothing; avoid overheating

Question 7

What is SIDS and who is at risk?

Answer 7

SIDS is the sudden death of an infant under 1 year during sleep.

Biological risks:
→ male sex
→low birth weight
→ prematurity

Modifiable risks:
→ prone sleeping position
→ tobacco exposure in prenatal or postnatal period

Question 8

What is positional plagiocephaly?

Answer 8

A flat spot on a baby’s head caused by lying in one position too long

Preventable
→ with tummy time
→ regularly alternating the baby’s head position (lying on both sides)

Question 9

Risks of Bed-Sharing With a Newborn

Answer 9

1) risk of suffocation, overheating, and entrapment
→heavy blankets, or an adult’s body can accidentally block a baby’s nose or mouth

2) LBW or preterm infants
→ these babies have even more fragile airways and weaker muscle tone, making it harder for them to move their head away if their airway becomes blocked.

3) Exposure to smoking, alcohol or drugs
→Any substance that makes an adult sleep more deeply increases the chance they won’t notice a baby moving

4) Soft surfaces
→create deep crevices where a baby can roll and become trapped

5) non-supine (not on back) sleep
→baby on their stomach or side increases risk of SIDS bc airway can become obstructed more easily.

6) Pillows or blankets
→ can block airway

Question 10

Normal newborn sleep behaviour?

Answer 10

~ 16 hours a day
→ Unpredictable
→ Frequent waking
→Should not go longer than 4 to 6 hours in a 24-hour period (must meet minimum feeding)

Question 11

INPUT: Newborn Feeding Tips

Answer 11

Newborns feed:
→every 2–4 hours
→about 8–12 times a day
→feeds lasting ~20 minutes

→ skin-to-skin supports latching
→spit-up is common
→early and repeated latching makes increases milk supply

Question 12

OUTPUT: Pee Teaching Tips

Answer 12

Wet Diapers (Pees)
Day 1 = 1 wet diaper (Clear)
Day 2 = 2 wet diapers
Day 3 = 3 wet diapers
Day 4 = 4 wet diapers
Day 5 and beyond = 6 or more (Clear – Pale Yellow)

Seek care if:
→< 6 wet diapers after day 5 or any other minimum not met
→ Smelly/foul urine
→ S&S of dehydration:
- Concentrated urine, dry mouth and lips, sunken fontanelles, skin turgor
→ Poor feeding, difficult to rouse

Question 13

OUTPUT: What Poo Should Look Like

Answer 13

Soiled Diapers (Poos)
Day 1 & 2
→At least 1(black/green meconium poo →green)
Day 3 & 4
→At least 3 (green  yellow/brown)

Day 5 and beyond
→At least 3 (yellow, soft and seedy)

Question 14

OUTPUT: Other Findings

Answer 14

Urate crystals in newborn diapers?
→Brick-red or orange “stains” caused by concentrated urine in the first days of life
→common and normal as long as wet diaper counts improve.

Pseudomenstruation?
→A small amount of vaginal discharge or spotting in newborn females due to withdrawal of maternal hormones
→normal and resolves on its own.

Question 15

Normal Newborn Weight Loss

Answer 15

After 48 Hrs of Life
→ 7% weight loss is expected; →≥10% = red flag (can indicate that baby is not getting enough milk)

Nurse Role - assess:
→ feeding
→output
→milk intake
→ stool transition (from meconium to mature stool)

Question 16

When and how to give a newborn their first bath

Answer 16

→1st bath: on day 2–3 of life

→daily baths aren’t needed because they dry out skin

→Use a small tub, mild soap

→ It’s okay if the cord gets wet.

Step 1: Wash face/head first and dry with a hat

Step 2: wash and dry the body

Question 17

What do you do about the umbilical cord?

Answer 17

Normal healing
→takes up to 14 days
→ small amounts of blood or goopy discharge and a mild smell

Seek Care if:
→ the skin around the base becomes red
→ the odor is strong enough to “clear the room”