What does the initial physical examination of a newborn include?

A newborn's initial physical exam includes several important steps to assess your baby's health.

Doctors' attention is focused on the main points:

1. General physical examination. Check skin color, head shape, presence of any abnormalities.

2. Measurement of physical parameters:

• Weight. The normal weight of a newborn baby is usually around 2500-4000 grams. It is important to keep in mind that each case is different, and fluctuations within 10% can be considered normal.

• Growth. The normal height of a newborn is approximately between 48 and 53 cm.

  It is important to keep in mind that each case is different and fluctuations within 10% can be considered normal.

  It is important to keep in mind that each case is different and fluctuations within 10% can be considered normal.

  Head circumference. The head circumference varies from 32 to 38 cm. This value can also vary depending on heredity and other factors.

• Head circumference. The head circumference varies from 32 to 38 cm. This value can also vary depending on heredity and other factors.

1. Reflex testing. Testing basic reflexes such as sucking and grasping reflexes.

2. Respiratory and cardiovascular assessment: Listening to the heart and lungs, assessing respiratory rate.

3. Checking the senses. Examination of eyes, ears, nose and mouth.

4. Assessing the condition of the umbilical cord. Check for inflammation or abnormalities.

5. Assessment of neurological status. Check muscle tone and reaction to stimuli.

6. Immunization. Introduction of the first vaccines (e.g., for hepatitis B).

7. Advice for parents. Information on newborn development and care recommendations.

This examination helps identify potential problems and ensures timely intervention when necessary.

Initial examinations of the newborn are performed during the first hours and days of life.

Our clinics in Florianopoli have basic timelines for newborn exams:

1. Immediately after birth: The initial examination is done within 1-2 hours after delivery to assess the baby's general condition.

2. Within the first 24 hours: Re-examination where reflexes, respiratory and cardiovascular system are carefully checked.

3. Day 3-5 of life: Final checkup at the maternity hospital before discharge, including assessment of the umbilical cord and necessary immunizations.

4. At 1 month: An important routine checkup with the pediatrician where physical and neural development is checked again.

These checkups help parents understand how their baby is developing and allow them to identify possible problems in time.

What is the APGAR score?

In Florianopoli, Brazil, our clinics use the APGAR score, a system used to quickly determine the condition of a newborn immediately after birth. It helps doctors assess the need for emergency care. The assessment is done at 1 and 5 minutes after delivery.

APGAR Criteria.

The assessment is based on five criteria, each of which receives a score from 0 to 2, depending on the condition of the newborn:

1. A (Appearance) - Skin color

• 0 points - Livid or pale.

• 1 point - The body is pink, but the limbs are blue.

• 2 points - Completely pink.

1. P (Pulse) - Pulse

• 0 points - No pulse.

• 1 point - Less than 100 beats per minute.

• 2 points - More than 100 beats per minute.

1. G (Grimace response) - Reflex (response to a stimulus)

• 0 points - No response.

• 1 point - Weak response to irritation.

• 2 points - Vivid reaction, shouting.

1. A (Activity) - Muscle tone

• 0 points - Lack of tone.

• 1 point - Weak activity, movements.

• 2 points - Good activity, moving actively.

1. R (Respiration) - Respiration.

• 0 points - No breathing.

• 1 point - Weak, irregular breathing.

• 2 points - Good breathing, active cry.

1. Outcome Assessment:

• 7-10 points - The newborn is in good condition.

• 4-6 points - Moderate depression, observation required.

• 0-3 points - Severe depression, emergency treatment needed.

The APGAR assessment is a quick and easy way to evaluate a newborn's condition at a critical time. It helps to determine if additional care or medication support is needed.

What is included in a newborn's physical exam?

1. General blood test. This helps determine hemoglobin levels and identify possible anemia or infection.

2. Hypothyroidism test. Checking thyroid hormone levels to detect hypothyroidism.

3. Phenylketonuria (PKU) test. This test helps detect an inherited disease that can lead to mental retardation if left untreated.

4. Screening for other inherited diseases. May include diseases such as cystic fibrosis and other metabolic disorders.

5. Medical examinations. Checks for various congenital anomalies and other conditions that may require immediate intervention.

A newborn's first checkup is usually done within the first 48 hours after delivery, and then as part of regular pediatric checkups.

The doctor examines general health, development, digestion, and performs necessary screenings and immunizations.

Screening and vaccine interventions for the newborn play a key role in ensuring their health and well-being.

Screening and vaccine interventions mean:

Screening is a series of tests done right after birth to look for possible health problems or congenital diseases.

Screening is essential for early detection of diseases. It can significantly improve the chances of successful treatment and prevent serious complications. For example, screening for phenylketonuria* or galactosemia** (Phenylketonuria (PKU) and galactosemia are two inherited metabolic diseases that require special attention to diet and medical care) allows treatment to begin as soon as possible after birth.

1. * Phenylketonuria (PKU)

• Cause. This disease is due to a deficiency of the enzyme phenylalanine hydroxylase, which is responsible for converting the amino acid phenylalanine into tyrosine. As a result, phenylalanine builds up in the body and can cause serious brain damage.

• Symptoms. If left untreated, FCU can lead to mental retardation, seizures, hyperactivity, and other neurological problems.

• Diagnosis. In our clinics, FCU is usually diagnosed early in life with screening tests in newborns.

• Treatment. The main treatment includes a strict diet low in phenylalanine. Foods containing this amino acid (e.g., meat, fish, eggs, dairy products) should be excluded. There are special food substitutes for people with FCU.

Galactosemia**

• Cause. This disease is also associated with a deficiency of enzymes needed to metabolize galactose, which is found in many dairy products. The most common galactose disorder is associated with a deficiency of the enzyme galactose-1-phosphaturidyltransferase.

• Symptoms. If left untreated, galactosemia can cause damage to the liver, kidneys, brain, and eyes, as well as cause symptoms such as jaundice, vomiting, stunted growth, and cataracts.

• Diagnosis. Just like FCU, galactosemia is usually detected through newborn screening in our clinics.

• Treatment. Treatment consists of eliminating all sources of galactose from the diet, which includes avoiding dairy products and certain processed foods.

Both of these diseases are controllable with a specialized diet, and early detection and treatment is important to prevent serious health consequences.

Types of screenings

• Metabolic tests. Testing for certain hereditary diseases.

• Hearing Screening. Provides early detection of hearing problems, which is important for speech and communication development.

• Screening for infections. Screening for infections such as HIV or hepatitis.

Vaccination activities

Vaccination is the process of administering a vaccine to provide immunity to certain infectious diseases.

Vaccination protects your newborn from serious diseases such as measles, rubella, influenza and hepatitis. These diseases can have serious consequences, so prevention is important.

Usually, the first vaccination is given as early as at birth (e.g. hepatitis B vaccine). This is followed by other vaccines according to a set schedule, which may vary depending on the country and health guidelines.

Screening and immunizations are important steps in your newborn's care that help prevent illness and ensure your baby's health.

Parents should consult with the physician about necessary procedures and follow the recommended schedule.

It is recommended that postpartum women be monitored regularly by a physician for at least 6-8 weeks, postpartum, to ensure quality medical care and support during this important period.

What is a postnatal test?

A postnatal test (or postnatal examination) is the process of assessing the health of the newborn baby and the mother's condition after delivery. It includes different aspects that help make sure that both mom and baby are in good health after birth.

Main aspects of the postnatal test for the newborn baby

These tests are done for every newborn in our hospitals.

1. General Health Parameters:

• Assessment of weight, height and head circumference.

• Checking general physical activity and reflexes.

1. Disease screening. Tests to detect inherited diseases such as phenylketonuria (PKU) or hypothyroidism.

2. Screening for infections. Monitoring for infections that can be transmitted during childbirth.

3. Hearing and vision screening. Early detection of possible hearing or vision problems.

4. Postnatal screening for the mother:

• Physical recovery. Assessment of the uterus, stitches (if there were any), and the general health of the mother.

• Emotional well-being. Checking for postpartum depression and supporting psychological health.

• Feeding. Advice on breastfeeding and newborn care.

• Discussing contraception and family planning. Coverage of issues related to postnatal recovery and the next pregnancy.

A postnatal test helps identify potential problems early on and provides support for mom and baby at critical times after birth. It is an important step for the health and well-being of both.

What is a screening test after birth?

A screening test after birth, or neonatal screening, is a series of tests we perform on a newborn during the first few days of life to identify potential diseases or conditions that may require treatment.

Goals of the screening test:

1. Early detection of diseases. Some conditions are not immediately apparent, but can become serious if left untreated.

2. Prevention of complications. Prompt detection allows treatment to begin and prevents possible long-term health consequences.

3. Basic aspects of the screening test:

• Tests for genetic diseases. Usually includes tests for conditions such as phenylketonuria (PKU), hypothyroidism, cystic fibrosis, and other inherited diseases.

• Hearing Screening. Tests a newborn's hearing to look for possible disorders. This is important for speech and communication development.

• Screening for cardiovascular disease. Uses pulse oximetry to check oxygen levels in the blood to help detect heart defects.

• General observation. The doctor examines the newborn for visible abnormalities or problems.

1. Process. Screening is usually done in the first 24-48 hours after birth, but some tests may be repeated a few weeks later. Usually includes blood tests (a set of blood drops from the heel), hearing tests, and pulse oximetry.

Screening helps doctors and parents identify problems early, which can make a big difference in a child's health and development. Early intervention often leads to better outcomes.

What is a physical examination of a premature baby?

A premature infant physical examination is a specialized assessment of the health of a baby born before the 37th week of pregnancy. The main aspects of this examination include:

1. General Examination. Assessment of appearance, skin condition, color, muscle tone and other visible signs.

2. Measuring height and weight. Assessing height, weight and head circumference to determine developmental level.

3. Assessment of respiratory function. Check respiratory rate and depth, spasms or signs of respiratory failure.

4. Cardiovascular system check. Listening to the heart, assessing heart rate and the presence of possible abnormalities.

5. Assessment of reflexes. Testing of basic reflexes (sucking, grasping and others).

6. Checking the senses. Examination of eyes, ears, nose and mouth for abnormalities.

7. Neurological Assessment. Checking muscle tone and responses to stimuli to make sure the nervous system is developing properly.

8. Monitoring of possible complications. Risks associated with premature babies, such as infectious diseases, respiratory and other system problems, are taken into account.

9. Feeding support. Assessment of breastfeeding ability or need for specialized formula.

10. Advice for parents: Information on how to care for a premature baby and what to expect as the baby grows and develops.

Regular check-ups are important for early detection and correction of possible developmental problems.

What are the key indicators of the neonatal intensive care unit?

Our neonatal intensive care units (NICUs) focus on monitoring and maintaining the stability of critically ill infants.

We take into account seven key indicators that are evaluated:

1. Oxygen Saturation. The oxygen level in the blood is an important indicator for assessing respiratory function. Normal values are 90% or higher.

2. Respiratory rate. The rate of breathing movements per minute measures how efficiently the baby is breathing. In newborns, this is usually between 30 and 60 times per minute.

3. Pulse (heart rate). It is measured to make sure the heart is working efficiently. Normal values for newborns are between 120 and 160 beats per minute.

4. Blood Pressure. Monitoring blood pressure helps to assess cardiovascular health. Target values can vary, but typically for preterm infants it can be 39-75 / 16-45 mmHg.

5. Body temperature. Maintaining a normal temperature (about 36.5-37.5 °C) is critical, especially for premature infants.

6. Blood glucose. Blood sugar levels are monitored because hypoglycemia or hyperglycemia can be dangerous for newborns.

7. Electrolytes and acid-base balance. Monitoring levels of sodium, potassium, calcium and other electrolytes, as well as acid-base status, is very important for metabolism and overall health.

These indicators help medical staff to identify problems in a timely manner and take the necessary steps to maintain the health of premature and critically ill newborn patients.