Info

Premature

Term

Postmature

Level of intrauterine growth based on birth weight and gestational age of liveborn, single, white infants. Point A represents a premature infant, while point B indicates an infant of similar birth weight who is mature but small for gestational age; the growth curves are representative of the 10th and 90th percentiles for all of the newborns in the sampling. (Adapted from Sweet YA: Classification of the low-birth-weight infant. In Klaus MH, Fanaroff AA: Care of the High-Risk Neonate, 3rd ed. Philadelphia, WB Saunders, 1986. Reproduced with permission.)

Level of intrauterine growth based on birth weight and gestational age of liveborn, single, white infants. Point A represents a premature infant, while point B indicates an infant of similar birth weight who is mature but small for gestational age; the growth curves are representative of the 10th and 90th percentiles for all of the newborns in the sampling. (Adapted from Sweet YA: Classification of the low-birth-weight infant. In Klaus MH, Fanaroff AA: Care of the High-Risk Neonate, 3rd ed. Philadelphia, WB Saunders, 1986. Reproduced with permission.)

Examination Several Hours After Birth. During the first day of life, and optimally within 8 hours of birth, newborns should have a comprehen-

sive examination. Wait until 1 or 2 hours after a feeding, when the baby is most responsive, and ask the parents to remain in the room.

Observe the baby, first when lying undisturbed and then almost completely undressed if the baby is quiet. Observe the baby's color, size, body proportions, nutritional status, and posture, as well as respirations and movements of the head and extremities.

Most normal, full-term newborns lie in a symmetric position, with the limbs semiflexed and the legs partially abducted at the hip.

In breech babies, the legs and head are extended; the legs of a frank breech baby are abducted and externally rotated.

Normally there is spontaneous motor activity, with flexion and extension alternating between the arms and legs. The fingers are usually flexed in a tight fist, but may extend in slow, athetoid posturing movements. Brief tremors of the arms, legs, and body are commonly seen for a short time after birth during vigorous crying, and even at rest.

Throughout the examination, and particularly during auscultation and palpation, it is important to have the baby quiet to optimize your examination. Place the tip of your gloved finger in a crying baby's mouth to quiet the baby long enough to complete these portions of the examination. The order of the examination is unimportant.

Studies by Dr. T. Berry Brazelton and others have demonstrated the wide range of abilities in newborns. Demonstrating some of the abilities of new-borns during your comprehensive examination is both helpful for you and wonderful for the parents. Here are some of these newborn abilities:

By 4 days after birth, tremors occurring at rest signal central nervous system disease from a variety of possible causes, ranging from asphyxia to drug withdrawal. Asymmetric movements of the arms or legs at any time suggest the possibility of central or peripheral neurologic deficits, birth injury (such as a fractured clavicle or brachial plexus injury), or congenital anomalies.

Getting Back Into Shape After The Pregnancy

Getting Back Into Shape After The Pregnancy

Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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