Newborn & Six-Week Baby Check

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Introduction

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History

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General Observation

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Normal newborn rate: 40-60 breaths/min. Look for signs of respiratory distress: nasal flaring, grunting, chest retractions.
asymmetry or abnormal posturing

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Measurements

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Rapid increase may indicate hydrocephalus

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Head and Neck Examination

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Bulging fontanelle may indicate increased intracranial pressure
- Use ophthalmoscope at 30cm. Look for symmetrical, red-orange reflection. White reflex requires urgent referral
Low-set ears associated with chromosomal abnormalities
Check for cleft palate, high arched palate, and tongue-tie. Tongue-tie: restricted tongue movement due to short frenulum.

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Cardiovascular and Respiratory System

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Normal newborn HR: 120-160 bpm
Weak/absent femoral pulses may indicate coarctation of aorta
Both should be ≥95% and within 3% of each other

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Abdominal Examination

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Liver edge may be palpable 1-2cm below costal margin

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Genitourinary Examination

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Check for hypospadias and chordee
Clitoral hypertrophy may indicate congenital adrenal hyperplasia

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Musculoskeletal Examination

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Sacral dimples >2.5cm from anus or >5mm wide require further investigation
- Positive if hip dislocates
- Positive if clunk felt as hip relocates

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Neurodevelopmental Assessment

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- Suddenly lower infant's head while supporting body
- Stroke cheek near corner of mouth
- Place clean finger in infant's mouth
- Place finger in infant's palm
- Stroke sole of foot from heel to toe
Should smile responsively, fix and follow to midline, lift head briefly when prone