Assessments for Newborn Babies

After birth, newborn babies are carefully checked for problems or complications. Throughout the hospital stay, physicians, nurses, and other care providers continually assess each infant for changes in health and signs of illness.

One of the first assessments is a baby’s Apgar score. At one minute and five minutes after birth, infants are checked for heart and respiratory rates, muscle tone, reflexes, and color. This helps identify babies that have difficulty breathing or have other problems that need further care.

Complete Physical Exam

Because birth weight is an important indicator of health, babies are weighed daily in the nursery. This indicates their growth, as well as their fluid and nutritional needs. Newborn babies may lose as much as 10 percent of their birth weight.

In addition, each newborn undergoes a complete physical examination. Care providers evaluate vital signs, including temperature, pulse, and breathing rate. They also check the infant’s general appearance from head to toe, looking at everything from soft spots on the skull to breathing patterns to skin rashes to limb movement. Your baby’s head circumference, abdominal circumference, and length will also be measured.

Your Baby’s Maturity

Maturity assessment is helpful in meeting a baby’s needs if the dates of a pregnancy are uncertain. For example, very small babies may actually be more mature than they appear by size and may need different care than premature babies.

An examination called the Dubowitz/Ballard Examination for Gestational Age is often used. This check evaluates a baby’s appearance, skin texture, motor function, and reflexes. The physical maturity component of the exam is conducted within the first two hours of birth. This looks at your baby’s skin, eyes, ears, chest, genitals, and feet, since these areas of the body look different at different stages of maturity.

Next, within 24 hours after delivery, the Dubowitz/Ballard Examination looks at six aspects of the baby’s neuromuscular system. These include:

• Posture

• How far the hands can be flexed toward the wrist

• How far the arms spring back to a flexed position

• How far the knees extend

• How far the elbows can be moved across the chest

• How close the feet can be moved to the ears

Additional Tests

After birth, all newborns receive eye drops or an antibiotic ointment in their eyes. This is required by law to protect the baby from an unknown gonorrhea infection in the mother.

Most babies also receive a vitamin K injection in the upper thigh. Vitamin K is an essential component of blood clotting. The injection helps prevent a serious problem called vitamin K deficiency bleeding.

Finally, nearly all babies will have a simple blood test to check for disorders that are not apparent immediately after delivery. Some of these disorders are genetic, metabolic, or blood- or hormone-related. Your newborn may also undergo a hearing test.

All of these examinations are important ways to learn about your baby’s well-being at birth. By identifying any problems, your baby’s physician can plan the best possible care.