Professional Documents
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4 Neonatal Evaluation and Care
4 Neonatal Evaluation and Care
Respiration - range 30
to 60 breaths per
minute
Common variations
Bilateral bronchial breath
sounds
Moist breath sounds may be
present shortly after birth
Babies in distress may be placed in an incubator for
relief and constant monitoring of vital signs.
We would expect to see well-flexed,
full range of motion, spontaneous
movement
No response to a pinch= a
score of 0 points.
A grimace or feeble cry = a
score of 1 point.
A lusty cry scores 2
points on the APGAR!
To “pinch” baby and encourage crying is in conflict with the Leboyer method of
childbirth. This method is used to minimize trauma to the infant during and after
delivery. The room is dimly lit and quiet, the baby’s head is not pulled. The
infant is massaged or given a warm water bath. This is all in direct contrast to
the outdated method of smacking baby’s bottom to encourage deep breaths!
Expected findings:
Skin reddish in color, smooth and puffy at birth
Common variations:
Mottling -
Generalized red
and white
discoloration of
skin of chilled
infants with fair
complexion
Jaundice is a yellow discoloring of the skin,
mucous membranes, and eyes, caused by too
much bilirubin (a breakdown product of
hemoglobin made by the liver) in the blood. High
levels of bilirubin circulating in the blood stream
dissolve in the subcutaneous fat (the layer of fat In newborns, jaundice
just beneath the skin), causing a yellowish often exists due to an
appearance of the skin and the whites of the eyes. immature liver.
As shown in the
The sucking reflex picture above, this
may have been reflex occurs when
present long any nipple-sized
before birth, as object is placed on
shown above in the baby’s lips.
this fetus.
1. 2.
Rooting reflex When you stroke the corner of your baby's mouth
and move your finger slowly toward his ear you will see his tongue,
mouth, and sometimes even his head follow the direction of your
hand. They also open their mouth. This reflex helps babies to locate
the nipple for feeding. This usually disappears by 3-4 months.
Also known as the Extensor Plantar
Reflex or Toe Sign
When you stroke the bottom of your baby's foot, the big toe flexes
toward the top of the foot, the other toes fan out, and the leg extends
outward. This usually disappears by 9 months to 2 years, when the
toes curl under and the leg is pulled back.
Children can exhibit poor peer relations, rage, poor eye contact, limited to no
remorse for destructive or assaultive behaviors, chronic lying, agitating, and
stealing; and preoccupation with morbid topics, destruction or cruelty to animals.
Postpartum depression (PPD) is quite common after
a baby's birth. It can range from mild "baby blues"
which affect between 50 and 80 percent of all
mothers, to psychosis. In general, over 10 percent of
mothers experience some level of postpartum
adjustment problems. When these problems begin to
interfere with a mother's ability to take care of her
baby and her daily tasks, it is time to seek
professional help. Depression is a very real mental
condition, not imagined or voluntary.
The postpartum period begins after the
delivery of the baby and ends when the
mother's body has returned as closely as
possible to its pre-pregnant state…a period of
six weeks to two years. It involves the
mother’s adjustment to physical, emotional,
and hormonal changes, as well as learning
how to care for a newborn and function in this
new family unit. She will need to rebuild her
strength, getting plenty of rest, good nutrition,
exercise, and help during the first few weeks.
The mammary gland of the breast, upon
receiving a hormonal signal after the
birth of the baby, begins making
secretions. This process is called
lactation.