GROWTH AND DEVELOPMENT ASSESSMENT OF NEW-

BORN

Aim: -
After assessing the new born we will be able to understand and identify the specific physical
and neurological characteristics of new-born.

Objectives: -
At the end of this assessment we will able to –
 List down the purposes of new-born examination
 Know the steps of examination of new-born
 Understand various aspects of history related to new-born health status.
 Describe physical characteristics of normal new-born.
 Recognise neurological characteristics of normal new-born.
 Identify any deviations in terms of congenital defects and neonatal infections.
 Identify the health needs of new-born and mother
 Educate mother about breast feeding and care of new-born
Introduction: -
Monitoring of new-born is the keynote of their successful outcome. Accurate nursing
observation is a vital factor in the survival and future development of the new-born. The
initial physical examination should be performed as soon as after birth of new-born. All new-
born should be thoroughly examined in first 24-48 hrs of the age. Assessment of new-born is
a very important aspect to recognise and identify any deviations in terms of congenital
defects and infections.

Purposes of assessment: -
 Identify the physical and neurological characteristics of new-born.
 Identify and record evidence of common new-born problems and congenital
anomalies and provide basis for identification of needs and plan nursing care of new-
born.

I. Biodata of the baby and mother: -

Name of baby: -
Age: -
Sex: -
Date of birth: -
Birth weight: -
Present weight: -
Mother’s name: -
Address: -
Period of gestation: -
Date of delivery: -
Identification band applied: -
Type of delivery: -
Place of delivery: -
Any problem during birth: -
If yes explain: -
Antenatal history: -
Antenatal visits-
Immunization-

Characteristics Observation Remark

Mothers age
Height
Weight
Nutritional status

A socioeconomic
background

I. Assessment
a) Vital parameters
Parameters Normal range Observed in child Remark
Weight 2.5-3.8kg
Length 50cm
Head circumference 33-35.5cm
Chest circumference 31-33cm
Temperature 36.5-37.50C.
Heart rate 120-160 beats/min
Respiration 40.60breaths/min

b) General behaviour and observation

Observation Normal characteristics In child remark
Skin –
Colour Pink
Plethora Dark reddish to purple
Turgor Good – smooth and soft
Lanugos Fine hair seen on back shoulder
and chicks
Vernix caseosa Greasy grey white substances
 with cheese like consistency
Pallor It may be due to anaemia, birth
asphyxia or shock
Cyanosis Central
Peripheral
Acrocyanosis
Birth marks-
Port wine stain Permanent birthmarks that have
cosmetic implications.
Normal variation
Jaundice Yellowish discoloration/enteric,
bilirubin level >5mg/dl.
Mottling Red or blue lacy appearance of
the baby’s skin
Milia Small white spots on the infant’s
nose chin or cheeks. These are
due to sebaceous glands and
resolve in two to
three weeks.
Oedema Normally not present
Erythema toxicum nettle sting’ appearance,
erythema with white papules. It
often begins on the face and
spreads to the trunk and limbs
but the palms and soles are not
affected. They resolve
spontaneously.

Mongolian spot Bluish, often large, commonly

seen on the back buttocks, thighs
Infantile Initially blanching or red
haemangioma maculae of varying size

Head –
Anterior fontanelle Diamond shaped, flat soft and
firm
Posterior fontanel Triangular in shaped, 1-2 cm
wide, fontanel may budge when
new-born cries
Cephalo-hematoma Localise effusion (serum blood)
firmer to touch than oedematous
area, appears on 2nd or 3rd day,
resulting from a traumatic
delivery, it never extends the
suture lines
Caput succedaneum Localise oedema on the scalp
crossing the suture lines, may be
present at birth
Sutures It may override during vaginal
 delivery
Hair Silky separate strands
Eyes Eyes usually closed, lids
usually oedematous
sclera- white to bluish white
Iris· dark grey or brown, no
discharge, eyes clean and
healthy.

brisk closure of eyes

glabellar tap
cleft lip cleft palate
face
top of the pinna of ear is in a
Ears horizontal plane to the outer
location canthus.

Pinna firm, cartilage felt

along with edge.
cartilage Instant recoil

Nasal passage is patent

Nose
Clean oral cavity intact.
High arched palate uvula in
Oral cavity midline.
Cleanliness No precocious teeth, no
Epstein pearls and no oral
thrush.

Neck is short symmetrical,

no glands palpable full
range.
Neck

Breast tissue more than 10

mm diameter.
Areola raised May have
Chest gynaecomastia, may have
Breast nodule
milky white
discharge.
Abdomen
Bowl sound Are present

Initially it is white and

Umbilical cord
gelatinous later it dries and
shrivels. Two
arteries and vein

Genitalia
Female Labia majora well developed
and cover labia minora.
Urethral
meatus is located above the
vaginal opening. Whitish
mucoid
discharge or bloody
discharge. (pseudo
menstruation)

Testes descended in the scrotum.

Male Pendulous and deeply pigmented
urethra opening located at the tip
of glans.
Back
Spinal curve Spinal curved round.
Anus patent
Extremities
No. of fingers and 10 fingers of hands and toes
toes each
Deep creases over anterior
Sole creases 1/3rd to ½ of sole
New-born offer resistance to
Resistance to passive passive movements. Elbow
movements doesn’t cross the mid line of the
chest.

Joints are flexible.

Joint mobility

Reflexes
Rooting reflex touching or stroking the
cheek along the side of
mouth stimulates
the new-born to tum the
 head towards that side.

Sucking and swallowing

reflex is well developed
Sucking reflex
and coordinated.

When tongue is touched

Extrusion reflex or depressed new-born
respond by forcing it
outwards.

the arm and leg on the side

to which head is tuned
Tonic neck reflex
extend while the
opposite arm and leg are
flexed.

grasp fingers

Grasp reflex sudden extension and abduction

of extremities and fanning of
Moros reflex fingers followed by flexion and
adduction of extremities.

The toes flare open

Babinski’s reflex New-born make stepping

movement
Step or dance reflex
Bibliography
1. Mayoor K Chheda, practical aspects of paediatrics, CBS publishers and
distributors 7th edition.
2. O P Ghai, Essential paediatrics, CBS publishers and distributors, edition 9th
edition,2019.
3. Parul Datta, Pediatric Nursing, second edition, Jaypee.
4. Marlow’s, Text book of pediatric nursing, south asian edition, ELSEVIER
publisher.
5. Rimple Sharma’s Essentials of Pediatric Nursing, second edition