Questions to ask before?
Antenatal - any abnormalities on antenatal scans or screening and complications?
Delivery - mode, gestation, complications? - were they breech?
Risk factors for infection - history of Group B strep, intrapartum sepsis
FH - of any congenital heart defects, hip problems, congenital cataracts or eye problems
Weight of the baby? How feeding?
Approach to examination
General inspection Head Eyes and ears Mouth Neck Shoulders, arm and hands Heart and chest Abdomen Genitalia and anus Hips, legs and feet
General inspection and examination
Colour - jaundice, cyanosis
Moro reflex (do with tone)
Inspect and feel fontanelles
Inspect for any swellings - do these cross suture lines?
Measure head circumference
Inspect the features of the face - any abnormal?
Assess rooting reflex
Eyes and ears
- Look for red reflex in both eyes
- Assess whether they are normally set
- Assess patency
Look for cyanosis
Look for cleft lip/palate
Shoulders, arm and hands
shoulder - assess for clavicle fracture
Arm - any erb’s palsy? Brachial pulse
Hands - 10 fingers, single palmar crease? webbed fingers?
Heart and chest
- Feel apex beat
- Auscultate the heart for rate and any murmurs
- Count RR
- Signs of respiratory distress
- Auscultate the chest?
- Listen for abnormal breathing sounds e.g. grunting, stridor
Palpate for masses - any hernias?
Check umbilical stump (2 arteries and a vein, any infection?)
Genitalia and anus
Ask consent again
Male - check for hypospadias, testes descended
Female - ensure labia aren’t fused
Palpate for any inguinal hernias and palpate femoral pulse
Anus - check patency
Hips, legs and feet
Hips - Barlow’s and Ortolani’s tests
Legs - femoral pulse if not done already, any malformations (valgus, varus)
- Also can check stepping reflex
- Sandal gap?
- 10 toes?
- Talipes? (club foot)