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Normal Newborn Care

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.

The use of car seats, safety of cribs.

Delivery

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

Early Routine Care of the Newborn

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.

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.

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.

Common Neonatal Problems

Hypoglycemia

Hypoglycemia is common in premature infants, infants who are small for gestational age, infants of diabetic mothers, and infants.

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).