Newborn assessment

• Timing of newborn assessments

  1. At delivery: assess need for resuscitation measures; the stable newborn can stay with parents

  2. Upon admission to nursery or mother/baby unit: estimate the gestational age and the newborn's adaptation to life outside the uterus

  3. Prior to discharge: complete physical exam to detect problems or readiness for routine care at home including nutritional status/ability to breast or bottle feed
• Estimation of Gestational Age


  • Physical Characteristics
  • Neuromuscular Characteristics
• Newborn Reflexes

  • Rooting (rub cheek baby should turn head and open mouth)
  • Sucking
  • Palmar Grasping ( place finger in babies hands)
  • Moro (loud noise reflex)
  • Tonic neck
  • Stepping
• SGA / AGA / LGA

  • Small for gestational age (SGA)
  • Appropriate for gestational age (AGA)
  • Large for gestational age (LGA)
• Newborn Vital Signs: Normal Values

  • Heart rate=110-160 bpm
  • Resp. rate=30-60/minute
  • BP=50/30-70/45 mmHg
  • Axillary temp=36.5-37.2 C (97.7-99 F)
• Newborn Measurements: Normal Ranges

  • Weight=2500-4000 grams (5lb 8oz-8lb13oz)
  • Length=48-52 centimeters (18-22 inches)
  • Head circumference=32-37 centimeters (12.6-14.6 inches)
  • Chest circumference about 2 cm smaller than head circumference
• Newborn: Normal Gastrointestinal Pattern


  1. A term baby is ready to digest fats, carbs, and proteins at birth

  2. After the baby is born, he/she should pass meconium within 24 to 48 hours of life. If infant does not pass stool, alert the doctor/NP

  3. Meconium is tarry, sticky, black or dark green and odorless during the first few days of life

  4. After the GI tract develops normal flora, the infant stool will have odor

  5. A breast-fed baby's stool is seedy, yellow mustard gold and soft to liquid; stools more frequently

  6. A formula-fed infant's stool is pale yellow, formed and firmer
• Newborn: Normal Urinary Pattern

  1. A newborn should urinate within the first 24 hours of life

  2. Sterile, odorless, Straw colored, Cloudy appearance

  3. Typically voids 2-6 times a day initially, increasing to 5-25 times per 24 hours
• Newborn Characteristics


  • skin
  • head
  • mouth/nose
  • extremities
  • jaundice
  • caput
  • flaring nostrils
  • flexed and symmetric
  • lanugo
  • fontanelles
  • cleft palate
  • polydactyly
  • milia
  • cephalo-hematoma
  • coordinated suck/swallow
  • talipes equinovarus
• Newborn Behaviors

  • habituation - can baby shut out repetitive stimuli?
  • orientation to visual and auditory stimuli - does baby respond to parents' voice and face?
  • motor activity - motor tone in response to being handled?
  • self-quieting - can baby calm himself with sucking or swaddling?
  • cuddliness or social behaviors - does baby enjoy being held, does he smile?
• Head variations

  • Caput: crosses the suture line and is present at birth, NORMAL finding
  • Cephalohematoma: does not cross the suture line in first seven days of life, ABNORMAL finding
  • molding: overriding of cranial birth
• LGA

  • large for gestational age
  • Risk factors - diabetics, multipare, males, erythroblastosis fetalis, beckwith-weidman syndrome, transportation of great vessels
  • complications- birth trauma, hypoglycemia, polycythemia, hyperviscosity
• Estimation of gestational age chart

  • physical characteristics
  • Neuromuscular characteristics