Initial Newborn Care and Assessment

ABCs and Temperature
■ Baby should be pink and have a loud, vigorous cry.
■ Suction the nose and mouth to clear excess secretions, mucus.
■ Stimulate breathing with vigorous rubbing and drying.
■ Dry baby and maintain warmth (wrap in blankets, warmer, etc.).

APGAR and Vital Signs (see APGAR Score)
■ Assess and document APGAR at 1 and 5 minutes after delivery. Note: Some hospitals also require a 10-minute APGAR score.
■ Assess and record vital signs (see normal ranges below).

Preterm	RR: 50–70	HR: 140–180	SBP: 40–60	T: 36.8_–37.5 C
Newborn	RR: 30–60	HR: 120–160	SBP: 60–90	T: 36.8_–37.5 C

Identification

■ Place ID bands on baby and mother.

■ Record baby’s footprints in chart.

Measurements

■ Weight: Normal is 6–10 lb.

■ Length: Normal is 18–22 inches.

■ Head circumference: Normal is 33–35 cm.

■ Chest circumference: Normal is 30–33 cm.

Physical Assessment

Note: Perform a regular, head-to-toe assessment, similar to an adult, but note the following areas specific to newborn assessment.

■ Appearance: Baby should be pink, have a loud, vigorous cry, and be well-flexed with full ROM and spontaneous movements.

■ Fontanels: Anterior is diamond-shaped about 4 cm at widest point; posterior is triangular 1 cm or less at widest point.

■ Molding: Skull may be odd-shaped with overlapping cranial bones.

■ Mouth: Inspect the mouth for cleft lip and/or cleft palate.

■ Heart Murmur: Soft murmur considered normal in first few days.

■ Breathing: Abdominal breathing is normal in newborns.

■ Umbilical Cord: Should have 1 vein and 2 arteries. It should be clamped, may or may not be pulsating, and no sign of bleeding.

■ Extremities: Legs and arms equal length to each other and all fingers and toes accounted for.

■ Male Genitalia: Testes palpable in scrotum or inguinal canal.

■ Female Genitalia: Large labia minora and vaginal discharge of blood or mucus is considered normal.