Characteristics of

neonate:
Average range of vital signs in
the neonate:
Temperature: 36-37.5 degree Celsius
Pulse ( heart rate) : 120-140 beats/minute
Respiration: 30-40 beats/minute
Blood pressure: In newborn it is difficult to
obtain ,however the average blood pressure
is 75/50 mm of Hg
measuremen range average
ts
weight 2.5-4 kg 3 kg

Head to heel 48-53 cm 50cm

length
Head to rump 31-35 cm 32 cm
length
Head 32-35cm 33cm
circumference
Chest 30-33cm 31cm
circumference
Continued,…..
Baby starts loosing weight soon after birth.
She/he looses about 10% of the birth weight
in the 1st week, largely due to loss of water.
After the 7th day of birth she/he starts
gaining weight and regains birth weight
approximately by 10th day.
General appearance:
Baby is pinkish red in color.
Vernix caseosa is present on the baby’s skin at birth.
It is thought to have protective functions and is
mostly absorbed within a few hours.

posture:
Flexion of the head and extremities which rest on
chest and abdomen.
 However, the extended attitude of the head in face
presentation or the legs in breech persists for few
days more.
 Skin:
At birth; bright red, puffy , smooth
2nd – 3rd day; pink, flaky, dry
Lanugo: present initially which is replaced by
vellus hair ( the soft, browny hair)
Vernix caseosa: present
Edema around eyes, face, legs, dorsa of hands, feet
and scrotum or labia.
Acrocyanosis :cyanosis of hands and feet
Cutis marmorata: transient, mottling when infant
is exposed to decreased temperature.
Lanugo:
Vellus hair:
Acrocyanosis:
Cutis marmorata:
 Head:
Anterior fontanel : diamond shaped, 2.5-4
cm
Posterior fontanel : triangular shaped, 0.5-1
cm
Fontanels should be flat, soft and firm
Moulding , bulging fontanel because of
crying or coughing, caput succedaneum,
cephalohematoma ( hematomata between
periosteum and skull bone)
Caput succedenum:
Cephalohematoma:
Eyes:
Eye Lids usually edematous
Eyes usually closed
Color: slate grey, black, brown
 Absence of tears
Corneal reflex in response to touch- present
Pupillary reflex in response to light- present
Blink reflex in response to light or touch-
present
 Ears:
Top of pinna on horizontal line with outer canthus
of eye
Pinna is symmetrical and flexible
Startle reflex elicited by a loud, sudden noise
Pinna is cartilagenous
Nose:
Patent nose
Nasal discharge- thin white mucous
Sneezing present
Mouth and throat:
Intact, high arched palate
Uvula in midline
Frenulum of tongue- present
Frenulum of upper lip- present
Sucking reflex : strong and co-ordinate
Rooting reflex: present
Gag reflex : present
Extrusion reflex: present
Absent or minimum salivation, vigorous cry
Highly arched palate:
Frenulum:
 Neck:
Short, thick, usually surrounded by skin folds
Tonic neck reflex- present

Chest:
Antero-posterior and lateral diameters equal
Slight sternal retractions evident during
inspiration.
Chest is of barrel shaped
Evident xiphoid process
Enlarged breast due to maternal hormone effect
(estrogen)
Lungs:
Respiration chiefly abdominal
Cough reflex absent at birth, present by 1-2 days
Bilateral equal bronchial breath sounds

Heart:
Apex 4th -5th intercostals space, lateral to left sterna
border
S2 becomes slightly sharper and higher in pitch
than S1.
Abdomen:
Cylinder in shape
Liver- palpable 2-3 cm below right costal
margin
Spleen- tip palpable at end of 1st week of age
Umbilical cord- bluish, white at birth with
two arteries and one vein
Equal bilateral femoral pulses
Breasts and genitalia:
Both boys and girls have a nodule of breast
tissue around the nipple
In boys: the testicles are descended into the
scrotum which has plentiful rugae
The urethral meatus opens at the tip of the
Penis.
In girls born at terms, the labia majora
normally cover the minora
Labia and clitoris usually edematous patent
anal opening
 Extremities:
Ten fingers and toes
Full range of motion
Nails beds pink, with transient cyanosis
immediately after birth
Creases on anterior two third of sole, sloe
usually flat
Symmetry of extremities
Equal muscle tone bilaterally, especially
resistance to opposing flexion
Equal bilateral pulses
Neuromuscular system:
Extremities usually maintain some degree of
flexion
Extension of an extremities followed by previous
position of flexion
Head lag while sitting, but momentary ability to
hold head erect.
Able to turn head from side to side when prone
Able to hold head in horizontal line with back
when held prone.
Moro reflex present.
Special senses:
A neonate responds to various sensations with
evidence of pleasure or general discomfort.
Sense of vision:
Difficult to know exactly what a neonate sees.
The pupils react to light. Bright lights appear to be
unpleasant to the infant
The eyes can focus on close objects
Figures having the characteristics of the human
face are particular interest
Hearing :
It occurs after the 1st cry
The infant normally makes some response
to sound from birth and there is evidence
that ordinary sounds are heard well before
the 10th day
They respond to sound with eye movement,
cessation of activity, startle reaction or
crying
Taste:
It is fairly well developed. Sweet fluids are
accepted, whereas sour or bitter ones are resisted.
Smell:
The only evidence of smell is that many newborn
infants appear to smell breast milk and search for
the nipple.
Individual variation is found among infants in
their apparent ability to smell.
Sense of touch
Most highly developed
It is most acute on the lips, tongue, ears and
forehead
They withdraw from painful stimuli such as
extreme pressure.
Gross and fine motor development
Gross motor:
Posture of generalized flexion
In prone position leg is drawn up, can turn one
side
Head lags behind when pulled to sit
Fine motor:
hands are clinched and grasp reflexes are very
strong
Language and social behavior:
Able to make throaty voice and express
Discomfort by crying.
Neonatal Reflexes :
Eyes:
1. Blinking or corneal reflex:
Stimuli: Sudden appearance of a bright light or
approach of an object toward cornea
Response: infant blinks
Disappears : persists throughout life
Pathology if abnormal: neurological damage
Blinking reflex:
2.pupillary
Stimuli: bright light toward pupil
Response : pupil constrict
Disappears: persists throughout life
Pathology if abnormal: neurological damage
Nose:
Sneeze:
Stimuli: irritation or obstruction in nasal passages
Response: sneezing
Disappears: persists throughout life
Pathology if abnormal: neurological damage
Mouth and throat:
1.Cough:
Stimuli: irritation of laryngeal or trachea- bronchial
tree mucous membranes
Response: coughing
Disappears: persists throughout life
Pathology if abnormal: neurological damage
2.extrusion:
Stimuli: depressing or touching the tongue
Response: tongue is forced outward
Disappears: 4 months
Extrusion reflex:
3. gag
Stimuli: food, suction or passing a tube stimulating
the posterior pharynx
Response: gagging
Disappears: persists throughout life
Pathology if abnormal: neurological damage
4. Rooting :
Stimuli: stroke or touch cheek
Response: head turns toward stimuli
Disappears: approximately 4 months
Pathology if abnormal: central neurological system
disease
Rooting reflex:
 Sucking:
Stimuli: object touching lips or placed in mouth
Response: sucking
Disappears: 7 months
Pathology if abnormal: prematurity
Sucking reflex:
 Extremities:
1.Babinski:
Stimuli: lateral aspect of the sole is stroked from heel
upward and across ball of foot
Response: hyperextension of the toes
Disappears: 1 year
Pathology if abnormal: central palsy
2. Palmar grasp:
Stimulate the palm
Response: object is grasped
Disappears: 4 months
Pathology if abnormal: frontal lobe lesion
Babinski reflex:
Palmar grasp:
3.Plantar grasp:
Stimuli: place the finger at the base of the newborn’s
toes
Response: toes will curl downward
Disappears: 8 months
Pathology if abnormal: cerebral palsy, obstructive
CNS lesion
Plantar grasp:
4. Dance or step:
Stimuli: newborn is held upright, one foot is allowed
to touch a flat surface
Response: alternate stepping movements
Disappears : 4 months
Pathology if abnormal: cerebral palsy
Moro reflex:
Stimuli: sudden changes in position
Response: arm extended, head moves back, fingers
spread apart with thumb and fore finger forming a
“C” followed by arm being brought back to center
with hands clenched, spine and lower extremities
extended.
Disappears: 3-4 months
Pathology if abnormal: neurological damage
Moro reflex:
Tonic reflex:
Stimuli: head turned to one side when supine
Response: arm and leg extend on the side head is
turned toward; arm and leg flexed on opposite side
Disappears: 3-4 months
pathology if abnormal: neurological damage
Tonic reflex:
Refrences:
Datta.P(2014).Pediatric nursing.Japyee
brothers medical publishers pvt ltd. 1st
edition.Pg no:66-69
Ghai.O.P, Paul.V.K, bagga.A.(2009).
Essential pediatrics.CBS publishers and
distributors pvt.ltd. 7th edition. Pg no:96-102
Gupta.P. Essential pediatric nursing. CBS
publishers and distributors pvt.ltd. 2nd
edition.Pg no: 19-40
Continued……
Thakur.S.L.(2006) Advanced child health
nursing. Ultimate marketing pvt ltd. 1st
edition. Pg no: 29-46
Uprety.k.(2018)Essential of child health
nursing. Akshav publication pvt ltd. 1st
edition.Pg no:47-68
http://www.cmnrp.ca/uploads/documents/
Newborn_Adaptation_Assessment_2013_FI
NAL.pdf