Neonatal physical examination -A score (graphic)
A score is a standard evaluation method to check the baby's physical condition, and it is also the first examination that the baby receives after birth, usually immediately after birth.
Specific inspection details:
1, observe all parts of the body: carefully observe all parts of the baby's body from head to toe. Such as overall posture, tension, maturity of nervous system. If you find anything unusual, you must consult frequently so that you can get up early for treatment.
2, listen to the baby's heartbeat: if it is a newborn, because the heart has not fully healed, so be sure to listen to the baby's heartbeat often, so as to check whether you have heart disease. In addition to the number of breaths or breathing methods, in order to check the gastrointestinal condition, you should also touch your baby's abdomen with warm hands.
3, check the ear: if the ear is abnormal early, it can be cured early. Carefully check whether the ear hole is normal and whether the ear shape is normal. In addition to checking the inside and outside of the ear by hand, we should also observe the external shape with our eyes.
4. Blood test: collect a small amount of blood from the heel and stick it on the filter paper for inspection. You can diagnose whether you have congenital metabolic abnormalities through blood tests, usually two days after birth. At birth, the baby will carry the enzymes needed for new metabolism in the body. If these enzymes are lacking, it will easily lead to mental weakness or physical and mental disorders.
5, carefully observe the head wound: pay attention to observe whether the baby is injured when passing through the birth canal. The head is a very important part, so check it carefully. Start from the top of your head and slowly touch around your head, so that you can check for tumors or other abnormal symptoms.
6. Check the state of the hepatic portal: carefully check the state of the hepatic portal with your fingers. If you find something unusual, you should take immediate measures to deal with it. After the baby is born, it will be excreted immediately for metabolic reasons. All these checks are very important.
7. Check the leg state: separate the baby's legs by hand, and then check whether the posture of the legs is normal and whether the leg lengths are equal. If the femoral joint dislocates, the leg splitting posture will be unnatural and the legs will be unequal in length.
8. Examination of sexual organs: When leaving the hospital, disposable organs should be examined again. If it is a baby girl, check the healing of the outer labia and the inner labia. If it is a baby boy, check whether the scrotum on both sides is equal in size. If one scrotum reaches 2~3 times the size of the other, it may suffer from scrotal edema or hernia.
9, check the baby's mouth: check the baby's gums, tongue, mouth shape, and whether there are abnormal tumors. Babies' mouths can usually be examined with their fingers. If the base of the tongue is too close to the bottom of the mouth, surgery should be performed immediately.
Detection time: 1 minute, 5 minutes and 10 minutes after birth were evaluated respectively.
1, skin color. The whole body skin ruddy is 2 points; The hands and feet are slightly bluish purple, and the trunk red is1; The whole body is blue and purple, 0 points.
2. Heart rate. If the heartbeat is strong, 2 points will be deducted for more than 100 times per minute; The heartbeat is weaker than 100 beats/minute1; If you can't hear the heart sound, it is 0.
3. Reaction after stimulation. Crying response is 2 points faster: 65438+ expression pain 0 point; No response to stimulus is 0.
4. Muscle tension. If the baby's activity is normal and the muscle tension is normal, score 2 points: if the hands and feet are slightly bent and the muscle tension is low, score 1 point; If the baby is soft, give 0 points.
5. Take a deep breath. Breathing smoothly, crying is 2 points; Breathing is weak and irregular, and crying is as low as 1 min; No breathing is 0.
Tip: The score of A only provides medical reference for medical staff. Generally speaking, a score of 8- 10 is good; The neonatal score of 7 or below is mild asphyxia. Generally, newborns with mild asphyxia will get better soon after cleaning the respiratory tract and inhaling oxygen. The score below 3 with extremely low score is severe asphyxia.
42-day physical examination of newborn
When the baby is 42 days old, he will go to the hospital for a physical examination. The 42-day physical examination is of great significance to the newborn baby, because it is his first time to go to the hospital for physical examination after discharge, and it is also the beginning of monitoring his growth and development.
Weight: it is an important indicator to judge the baby's physical development and nutritional status. It is best to measure your weight when your baby defecates on an empty stomach, and try to take off your clothes, shoes and hats. The measured data should be subtracted from the weight of the clothes and diapers worn by the baby. .
Height: It is a main index of baby's bone development. People's height is influenced by many factors, such as heredity, endocrine, nutrition, disease, exercise, etc., so we must ensure that the baby's nutrition is comprehensive and balanced, get enough sleep, and maintain a certain amount of activity every day.
Head circumference: it reflects the baby's brain development and brain capacity, and is also an important indicator of the baby's physical development. The size of a baby's head circumference, like its weight and height, has a normal range. Contrary to what some people think, a baby with a big head must have a developed brain and be smarter than other babies. It is not normal for a baby's head circumference to grow too fast or too slow. For example, when a baby is born, the head circumference is smaller than normal, and then the head circumference grows slowly or even stops growing, so it is necessary to doubt whether there is the possibility of brain dysplasia or head deformity.
Chest circumference: evaluate the development of baby's chest, including the development of lungs and chest, as well as the development of chest and back muscles and subcutaneous fat. The size of the baby's chest circumference is related to physical exercise and nutrition. Therefore, new mothers should often give their babies passive exercise and exercise their bones and muscles. For example, breast enlargement can promote the development of baby's chest muscles and promote the development of chest and lungs.
Evaluation of developmental intelligence: to know whether the baby's intellectual development is at a normal level. Doctors will use some methods to measure the baby's intellectual development. If in doubt, they will further evaluate the baby's intellectual development through neuropsychological tests. For infants with mental retardation, corresponding intervention measures can be taken in time for early rehabilitation.
For the baby's growth and development, it should be dynamically monitored. Therefore, after 42 days of physical examination, it is necessary to give the baby a regular physical examination, systematically understand the physical growth and dynamic changes of the baby at all ages, so as to find the abnormal growth in time and make some diseases with inconspicuous symptoms get early detection, early diagnosis, early intervention and early treatment.
What are the full-moon physical examinations for newborns (28-day examination)
Measuring height and weight is an important index to understand growth and development. Full-term newborns are 47 ~ 53 cm tall and weigh more than 2550 grams, with an average of about 3000 grams.
Head: Observe the size and shape of the skull, touch the baby's scalp, and feel the size of the suture, the tension of the fontanel and the presence or absence of hematoma.
Place the red ball about 30 cm away from the eyes, move the red ball horizontally, and observe whether the baby's eyes can catch up with the red ball.
The auricles of full-term newborns are well developed and straight.
Neck: whether there is torticollis, whether it can move freely, and touch both sides symmetrically with your fingers from the inside out to feel whether there is a clavicle fracture.
Chest: Observe whether the two sides of the chest are symmetrical, whether there is swelling, whether the breathing movements are coordinated, and the frequency should be 30 ~ 45 beats/min, and whether there is dyspnea. Listen to the breathing in the lungs with a stethoscope.
Abdomen: first look for gastric peristalsis and intestinal type, and then gently touch it with your hand to feel whether there is abdominal distension and mass. There is no omphalocele in umbilical region and no swelling and exudation in stump.
Hip: whether the skin is smooth, pay attention to whether there is spina bifida.
Genital and anus: pay attention to whether there is deformity and whether the testicles of the baby boy descend to the scrotum.
Limbs: whether there are multiple fingers or fingers (toes) and thighs can be flat, so as to know whether there is congenital dislocation of hip joint.
Examination of newborns after eating for 48 hours.
After the newborn eats for 48 hours, draw a small amount of blood from the heel and drop it on a special filter paper. After drying in the shade, sealed bags are sent to the screening center for examination, and congenital hypothyroidism, G-6-PD deficiency, phenylketonuria, hypercystinuria and galactosemia can be detected.
Preparation before neonatal physical examination
1. Make sure the hospital has a good physical examination. Generally, the baby's first physical examination is in the maternity hospital or the regional maternal and child health hospital, and she will go to the community hospital every time after the physical examination. Therefore, when leaving the hospital, my mother should consult the doctor about the specific location of the 42-day physical examination, so as not to worry later.
2. Make an appointment by telephone Before you go through the physical examination for your baby, you should first check the specific working hours of the physical examination hospital. Because some health centers don't work every day. You can call and ask when they usually give the baby a physical examination. Then go according to the time they say, and try to avoid going to the hospital during rush hour. In fact, the first physical examination does not have to be in 42 days, and sometimes special circumstances can be postponed for a few days.
3. Bring all the documents. It's the first time to take a baby for a physical examination, you need to bring documents: household registration book, baby birth certificate, parents' ID card, baby medical record book, etc. Some places also need to bring vaccination records. It is best for a mother to record the detailed health status of her baby at home at any time. The younger the baby is, the more detailed the record should be. For example, the baby's appetite, stool condition, diarrhea and so on. It is convenient for doctors to answer questions.
4. If the baby is in a good mood, the baby will be in a bad mood. Mothers should not choose to go to the hospital when the baby is upset or hungry, lest the baby can't cooperate with the doctor well because of irritability. Generally, it is cooler in the morning, and the baby's spirit is better. This time you have a choice.
Remarks:
The night before the physical examination, the mother had better give the baby a warm bath and put on clean clothes or underwear. It is best to wear loose clothes for physical examination, which is convenient to put on and take off. It is best not to wear jumpsuits, which will bring trouble to doctors. You can wear pants and a vest.
Prepare the questions you need to ask the doctor in advance. Through the physical examination, the doctor will give the baby a general evaluation. At this time, mothers must not miss the opportunity to ask professionals about parenting. For example: Is the baby developing normally? "What problems need to be paid attention to in the normal parenting process?" And so on, and make records.