FIRST EXAMINATION OF THE BABY

 

FIRST EXAMINATION OF THE BABY

 

This is a routine procedure done after third stage of labour in labour ward but is also done in the nursery as part of admission procedure. The aims are;

· To rule out congenital abnormalities

· To rule out birth injuries

· To assess maturity of the baby

Head    

ü measure the head circumference (average is 35 cm

ü Check for the moulding of the foetal skull

ü Width of the fontannelles and sutures, bilging of fontanel and wide sutures may indicate hydrocephalus

ü Depression on the skull may imply a fracture

ü Injuries e.g caput succadenium and cephalohaematoma

Eyes   

ü absence of eyebrows

ü Conjuctivalhaemorrage / bleeding

ü Any discharge and squint

Nose

ü Check for any deformities e.g.Well formed septum

ü Bleeding from the nose

ü Check for nasal flaring which is a sign of respiratory distress

ü Check for blocked nostrils

 

Mouth

ü Bleeding from the mouth

ü Check for tongue tie

ü Abnormalities e.g cleft palate or cleft lip

ü Frothing of the mouth

Ears

ü Bleeding from the ears

ü Leakage of CSF through the ears

ü Shape of the lobes to rule out malformations

ü Extra lobe of the ears

 

Neck

ü Check out for abnormalities e.g. congenital goiter

ü Check for meningocele

Chest

ü Shape of the chest for symmetry

ü Chest movement during respiration

ü Take apex beat

ü  Check  breast for swelling and discharge

Abdomen

ü Check for skin colour and presence of rashes

ü Check whether the cord is well ligated

ü Bleeding from the umbilical cord

ü Abdominal abnormalities e.g. hernia

Genitalia

ü For males check for the testis to rule out undescended testis

ü Female check for vaginal discharge, labia should be well formed size of a clitoris

Hip joint

ü Rule out congenital hip dislocation

Limbs

ü Check if arms and hands are moving freely

ü Rule out dislocation, fractures and Erb’s paralysis

ü Check for equality of the arms and to rule out abnormalities

ü Fingers for webbed and extra digits

ü Legs for equality, abnormalities and movement

ü Rule out tallipes and club foot

Back

ü Abnormalities of the backe.g.spina bifida, myelomeningocele

ü Check for skin colour and septic spots

Anus

ü While taking rectal temperature, check for imperforate anus

ü Bruises on the skin or rashes

Check for the following reflexes:

· Sucking reflexes – full term infant sucks the small finger

· Moro reflex – tested by gently lifting the baby up by its fingers from a flat surface and suddenly releasing it. It will respond byspreading its hands then move them together as though hugging.

· Rooting reflex – the baby turns in search of the nipple

· Grasping reflex – it will grasp your finger if you put it in its palm.

· Stepping reflex – when held on a flat surface in standing position, it makes stepping movement.