Neonate and Infant Exam - NNU session

Question 1

Neonate vs infant exam

Answer 1

• Neonate - within 72hrs of life (if more than 34 weeks) - can be delayed if unwell
• Infant - repeated at 6-8 weeks in GP surgery

Question 2

What is important to examine at time of birth?

Answer 2

• Cord examine - check is triple

Question 3

Important not to miss on back of baby

Answer 3

• Spina bifida
• Imperforate anus

Question 4

Reasons for neonatal exam

Answer 4

• Provides a baseline
• Identify problems eg infections, poor feeding, congenital abnormalities

Question 5

What conditions worsen after feeding newborn?

Answer 5

• Pyloric stenosis
• Tracheo-oesophageal fistula
• Metabolic problem

Question 6

What if mum does not consent for NIPE?

Answer 6

• If mum says no - explain why, document and escalate
• If still saying no after this, GP will be informed for a 6 week check. If still refuse at 3 months inform social services - child in need

Question 7

Exam order

Answer 7

• Opportunistic - eg when quiet, listen to chest

Question 8

When do fontanelles close?

Answer 8

Posterior fontanelle closes at 2 months
Anterior closes 8-18 months

Question 9

Caput vs cephalohaematoma

Answer 9

• Cephalohaematoma will not cross saggital suture line
• Caput is pitting when depressed

Question 10

Hydrocephalus sign

Answer 10

Sunset sign - eyes driven downwards