The prenatal pediatric visit usually takes place during the third trimester of the pregnancy.
Maternal nutrition, the hazards of alcohol, cigarette smoking and other drugs to the unborn baby; and the dangers of passive smoking once the infant is home should be discussed. Maternal illnesses and medications should be reviewed.
Information about the benefits of breast feeding or information about infant formula is
The use of car seats, safety of cribs, and issues regarding
Neonatal Resuscitation
A pediatrician should be present for high-risk deliveries, and all equipment must be set up and checked before delivery.
The infant who fails to breath spontaneously at birth should be placed under a radiant warmer, dried, positioned to open the airway, mouth and nares suctioned, and gentle stimulation provided.
The mouth should be suctioned first to prevent aspiration in case the infant takes a deep gasp when the nose is suctioned. Prolonged or overly vigorous suctioning may lead to bradycardia
Parent-Newborn Interaction. Early interaction between the infant and parents in the delivery room should be established. Holding, eye-to-eye contact, and early breast feeding should be
Vitamin K is given to the infant by intramuscular injection to prevent hemorrhagic disease of the newborn.
Ocular prophylaxis against gonorrheal and chlamydial infection is administered after birth with
Umbilical cord blood syphilis serology is completed if there is no documented record of a negative third-trimester maternal test.
Umbilical cord care consists of local application of triple dye or bacitracin ointment.
Hepatitis B Prophylaxis. If the mother is hepatitis B surface antigen-positive, or if she has active hepatitis B, the infant should be given an IM injection of hepatitis B immune globulin and a course of three injections
Hypoglycemia
Hypoglycemia is common in premature infants, infants who are small for gestational age, infants of diabetic mothers, and infants who have
Anemia during the newborn period may be caused by hemolytic and congenital anemias, fetal-to-maternal hemorrhage, placental abruption, and occult hemorrhage (intraventricular, intrahepatic, adrenal, or
Bilirubin Metabolism
Hyperbilirubinemia occurs frequently in the normal newborn because of increased production and decreased elimination of this breakdown product of heme.
Initial workup for neonatal hyperbilirubinemia includes measurements of total and direct bilirubin levels, hematocrit, Coombs test, and testing of urine for reducing substances to
Sepsis must be considered in any newborn who develops respiratory distress, temperature instability, hypoglycemia, lethargy, poor feeding, or jaundice. When sepsis is suspected, cultures of blood, urine, and
Gastrointestinal Problems
Ninety-six percent of full-term newborns pass a meconium stool before 24 hours of age. A delayed or absent passage of meconium may be caused by meconium plug syndrome, Hirschsprung disease, meconium ileus (cystic fibrosis), imperforate anus, or the small left
Urinary Problems. Ninety nine percent of normal full-term infants will urinate by 24 hours. If urination has not occurred within 24 hours, renal ultrasonography should be done and an intravenous fluid challenge may