NEED TO FINISH Neonates: Newborn Exam

Question 1

What is the Newborn Infant Physical Examination (NIPE)?

Answer 1

1) To screen for congenital abnormalities that will benefit from early intervention

2) To make referrals for further tests or treatment as appropriate

3) To provide reassurance to the parents

Question 2

When is the newborn exam performed?

Answer 2

1) Within 72 hours of birth (by trained midwife or paediatric doctor)

2) Repeated 6-8 weeks later by GP

Question 3

What initial questions may you ask the mother in a newborn exam?

Answer 3

1) Pregnancy details: date/time and type of delivery/complications/high-risk antenatal screening results

2) Breech presentation: if breech at 36 weeks gestation or delivery (if earlier), the baby will need to have an ultrasound scan of their hips as there is an increased risk of developmental dysplasia of the hip.

3) Risk factors for neonatal infection

4) Abnormalities noted on antenatal scans

5) FH: first-degree relatives with hearing problems/hip dislocation/childhood heart problems/congenital cataracts/renal problems

6) Has the baby passed meconium?

7) Is the baby feeding ok?

8) Is there a family history of congenital heart, eye or hips problems?

Question 4

Steps of the newborn exam?

Answer 4

1) History

2) Weight

3) General inspection

4) Tone

5) Head:
- measure circumference
- shape
- palpate anterior fontanelle

6) Skin:
- colour

7) Face

8) Eyes
- abnormalities
- fundal reflex

9) Ears

10) Mouth & palate

11) Neck & clavicles

12) Upper limbs

13) Chest

14) Abdomen

15) Genitalia

16) Lower limbs

17) Back & spine

18) Anus

19) Reflexes