Care of the Newborn

Jennifer J. Buescher and Harold Bland

Chapter contents

Preconception and Intrapartum Health

402

Audiology Screening

410

Preconception Counseling

402

Signs and Symptoms of Concern

410

Transition from Fetus to Newborn

403

General Observation

410

Circulatory Changes

404

Vital Signs

411

Neonatal Resuscitation

404

Respiratory Symptoms

412

The Apgar Score

406

Other Signs and Symptoms that Should Raise Concern

412

Resuscitation of the Infant Born through Meconium-Stained Amniotic Fluid

406

Differential Diagnosis of Concerning Signs and Symptoms

413

Initial Newborn Evaluation

406

Common Problems Encountered in the Term Newborn

415

General Appearance

407

Hypoglycemia

415

Skin

407

Infant of a Diabetic Mother

415

Neurologic Examination and Newborn Reflexes

407

Jaundice

416

Head, Face, and Neck

408

Birth Trauma

416

Eyes

408

Parental Education and Anticipatory Guidance before

Chest and Lungs

408

Discharge

418

Heart

408

Feeding and Elimination Habits

418

Abdomen

408

Safety at Home

418

Genitalia and Anus

408

Circumcision

419

Muscles, Skeleton, and Hips

409

Preventing and Recognizing Illness

419

Postnatal Assessment of Gestational Age

410

Whether present at the delivery or taking care of a new infant in the newborn nursery, the family physician plays an important part in newborn care during the early days of life. At the moment of birth, the newborn infant undergoes many changes and is vulnerable in the new environment. This chapter discusses these physiologic changes as well as the basics of neonatal resuscitation. The initial examination, common benign findings in the newborn period, developmental dysplasia of the hip, and audi-ology screening are described. Signs and symptoms of concern and common problems in the newborn period, including group B streptococcal infection and hyperbilirubinemia, are discussed, as well as infant safety, parent education, hospital follow-up, and care after discharge from the neonatal intensive care unit.

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