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Initial Evaluation of the Normal Newborn

By

Deborah M. Consolini

, MD, Thomas Jefferson University Hospital

Reviewed/Revised Sep 2023
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Topic Resources

Hand washing is critical for all personnel who provide newborn care to prevent transmission of infection.

Immediately at delivery, the neonate’s respiratory effort, heart rate, color, tone, and reflex irritability should be assessed; all are key components of the Apgar score assigned at 1 minute and at 5 minutes after birth (see table Apgar Score Apgar Score Apgar Score ). Apgar scores between 7 and 10 indicate that the neonate is making a smooth transition to extrauterine life; scores < 7 at 5 minutes (particularly if sustained beyond 10 minutes) are linked to higher neonatal morbidity and mortality rates in population studies (1 References Hand washing is critical for all personnel who provide newborn care to prevent transmission of infection. Immediately at delivery, the neonate’s respiratory effort, heart rate, color, tone,... read more ). Many normal neonates have cyanosis 1 minute after birth that clears by 5 minutes. Cyanosis (and, in particular, central cyanosis) that does not clear may indicate congenital cardiopulmonary anomalies Overview of Congenital Cardiovascular Anomalies Congenital heart disease is the most common congenital anomaly, occurring in almost 1% of live births ( 1). Among birth defects, congenital heart disease is the leading cause of infant mortality... read more Overview of Congenital Cardiovascular Anomalies or central nervous system (CNS) depression.

Table

Apgar Score

Score*

Criteria

Mnemonic

0

1

2

Color

Appearance

All blue, pale

Pink body, blue extremities

All pink

Heart rate

Pulse

Absent

< 100 beats/minute

> 100 beats/minute

Reflex response to nasal catheter/tactile stimulation

Grimace

None

Grimace

Sneeze, cough

Muscle tone

Activity

Limp

Some flexion of extremities

Active

Respiration

Respiration

Absent

Irregular, slow

Good, crying

* A total score of 7–10 at 5 minutes is considered normal; 4–6, intermediate; and 0–3, low.

Preventive interventions include administration of the following:

Subsequently, the neonate is bathed, wrapped, and brought to the family. The head should be covered with a cap to prevent heat loss. Keeping the newborn in the same room as the mother and early breastfeeding should be encouraged so the family can get to know the infant and can receive guidance from staff members during the hospital stay. Breastfeeding Breastfeeding (See also Nutrition in Infants.) Breast milk is the nutrition of choice for young infants. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for a minimum of 6 months... read more is more likely to be successful when the family is given frequent and adequate support. (See also Care of the Normal Newborn Care of the Normal Newborn While in the hospital, new parents should be taught how to feed, bathe, and dress their newborn and become familiar with the newborn's activities, cues, and sounds. Before hospital discharge... read more .)

References

Drugs Mentioned In This Article

Drug Name Select Trade
A/T/S, Akne-mycin, E.E.S., Emcin Clear , EMGEL, E-Mycin, ERYC, Erycette, Eryderm , Erygel, Erymax, EryPed, Ery-Tab, Erythra Derm , Erythrocin, Erythrocin Lactobionate, Erythrocin Stearate, Ilosone, Ilotycin, My-E, PCE, PCE Dispertab , Romycin, Staticin, T-Stat
Emtet-500, Panmycin, Sumycin
No brand name available
AquaMEPHYTON, Mephyton
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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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