Je

s
vi
a
M
vs

S2 Lec 3: The Normal Newborn by Dr. Alabastro September 6, 2010

Re
ai
M  As the score gets higher, the more mature the
n baby is
Re DEFINITIONS:
F.
co Live Birth
Ri
Birth Weight
fie  Weight immediately after birth
ul
Pa Gestational Age Neuromuscular Activity
vs  40 weeks: complete AOG
Vi  Not by months
ne
le Term
Ar  38 weeks of AOG
a
ň Preterm
Ni  Less than 38 weeks
g
an Post term
ad
D *Definition of Term, Preterm & Post term here are pediatric
er evaluation and is different from OB evaluation
h
ac Adequate for GA Physical Maturity
e
T Small for GA
ar
be Large for GA
co
Ri Factors Which Affect Mortality & Morbidity
ie 1. The neonate is compelled to make the
ck transition before he is ready.
Ni  Neonate: from 0-28 days old
ad  Infancy: first 2 years of life
Gl
Je 2. Adverse intrauterine influences: Hypoxia and
nz Malnutrition
Ay  Small for uterine age
h
at 3. Major congenital abnormality
K Classification of Newborn (Lubchenco)
o New Ballard Scoring
*Add the scores in neuromuscular activity & physical maturity
Jh 1. Neuromuscular Activity
h
a
 For assessment of infant’s posture, square
window, arm recoil, popliteal angle, scarf sign,
n
and heel to ear
e
Gi  As the number goes to the left, the more
o premature the baby is
Ed 2. Physical Maturity
e  Lanugo hair, skin, plantar surface, breast,
ll eye/ear, genitals (male and female)
ce
Jo Page 1 of 2
k
ar
M
h
ac
R

•
”
“G Peak of physiologic jaundice during 5th-
n 6th day of life
h • Jaundice should not be there after the
Jo 14th
n h. Gamma Globulin almost entirely IgG
Ia
a Requirements in the care of the Newborn
n
Ni 1. Immediate resuscitation
g
A 2. Establishment of respiration

3. Adequate nutrition
n
e
Bi 4. Normal Body temperature
• 36.5°C and below that is fatal for the
newborn
*Graph is slightly S curve • Not to consume too much oxygenation
*Above 90-97: large for gestational age
5. Avoidance of contact infection
*Below line: small for gestational age
6. Newborn screening
Physiology of the Newborn
Millennium Development Goals
a. Switch from placenta to lung as the organ of
gas exchange 1. Eradicate extreme poverty and hunger
b. Change from fetal to adult circulation 2. Achieve Primary education
• Parallel circulation to series 3. Promote gender equality and empower women
c. Nutritive Sucking at 34 weeks of gestation 4. Reduce child mortality
• No coordination in swallowing 5. Improve maternal health
d. First stools passed within 24 hours. 6. Combat HIV/AIDS, Malaria and other diseases
7. Ensure environmental sustainability
• No first pass of stool, might have an
8. Develop a global partnership and development
obstruction
• During the first days of life, stool is
Essential NB Care
blackish in color. After 4 days, normal
color of stool should be observed.
Immediate and thorough drying of the NB (30 sec to 1
• 1 month of black stool is abnormal.
minute warms and stimulates breathing)
e. Digestive enzymes adequate except for
amylase
Early skin to skin contact between mother and NB
• Cannot digest fats easily (delayed washing for 6 hours to prevent hypothermia,
f. Gastric capacity is 10-20ml infection and hypoglycaemia
g. Loss of heat by conduction, convection,
evaporation and radiation. Properly times cord clamping and cutting until cord
• More premature, more loss of heat pulsations stops (prevents anemia and brain
h. Extracellular compartment constitutes up to haemorrhage)
35% of bodyweight; loss of excess fluids in the
first few days Nonseparation of NB and a mother for early
• Physiologic Weight Loss: loss of weight breastfeeding.
starting from the third day of life.
• Weight loss should not be more than
10% of the total weight.
• Weight should not exceed 10 days.
• If weight loss exceeds 10% and
exceeds for 10 days, it is abnormal.
i. Kidney functions immature
j. Physiologic jaundice
• Happens during 2nd-3rd day of life

Page 2 of 2