What is the newborn assessment?
The newborn assessment is an assessment that takes place usually in the first 48hrs following birth and is not to be confused with the initial immediate assessment that gives the apgar score.
If your baby is born premature or unwell the assessment may take place over several hours or days, accommodating your baby's specific needs. A follow up assessment is usually offered in the first week after birth.
How is the newborn assessment different from the check they do just after birth which gives the APGAR score?
The initial check or assessment of your baby assesses it in relation to your baby's movement, heart rate, colour, response and breathing. This assessment is attending at 1 minute, 5 minutes and 10 minutes often without you, the parents, noticing it is being done. The health care provider will look for any major health conditions and measure your baby’s overall health. This is not the newborn assessment.
Is there an ideal time in my baby’s daily routine to do this assessment?
The time of day is not important but ideally your baby will be restful, and recently fed. There is no specific preparations to make for the assessment to take place.
What questions might my health care provider ask during the assessment?
Your health care provider will ask questions correlating any past medical history you and your family share, how the baby has been acting, feeding etc. There will be questions relating to your baby's bowel actions and passing of urine. Sleeping and restful states and general questions of any observations that you have made as a parent that may concern you. Your health professional will already have an understanding of any pregnancy and birthing issues that may or may not affect the baby's presentation.
Will the assessment be painful or distressing for my baby?
Your baby should not feel any pain during the examination / assessment but may exhibit signs of irritation as the tests are performed and the baby is handled and positioned for accurate evaluation. A large portion of the assessment is observational but there are aspects of manipulation.
The assessment see's the health care provider assessing size, shape, colour and movement of all aspects of your baby's body. Your health care provider will explain the assessment as they perform the examination.
Your baby's skin, face, chest, arms, hands, hips, legs, feet, back, spine, genitals and anus will all be assessed.
When they examine the head and neck they focus on the soft spots of the head, moulding of the bones and plates of the skull as well as the proportional relationship with the neck.
The baby's abdomen is gently palpated to assess organs such as the liver, spleen and kidneys as well as looking at how the umbilicus (belly button) is healing.
The hips are assessed for any signs of displacement, the test involves feeling the movement of the legs and hips by bending the legs upwardly and outwardly. This can cause the baby to become upset. The heart rate can be felt in the groin and this will be palpated for this purpose.
The chest area will be examined and this will involve placing a stethoscope to listen to the heart and assessing the heart sounds for murmurs, regurgitations or abnormal heart rhythms. The lungs are also assessed for abnormal sound and to ensure a good passage of air through them.
The eyes are examined for their general appearance and will have a "red light reflex test" attended assessing for any abnormalities.
The baby's reflexes are tested also which include:
- Moro reflex (startle reflex)- your health care provider will startle your baby to see if their arms and legs move.
- Rooting reflex- your care provider will stroke your baby’s cheek to see if they turn their head.
- Suck reflex- your care provider will see if your baby sucks automatically when something touches the roof of their mouth
- Grasp reflex- your care provider will stroke your baby’s palm to see if he or she will grasp (grab) it. Your care provider will also stroke the back of your baby’s hand to see if it opens.
- Stepping/walking reflex- your care provider will hold your baby’s weight while getting their feet to touch a flat surface to see if your baby will attempt to walk.
The newborn assessment takes approximately about 15mins to attend but varies depending on individual circumstance.
What if something unusual is found during the newborn assessment?
If something unusual is found, your health care provider will speak with you about this during the assessment. If your baby needs treatment, your health care provider will discuss the options with you.
What other tests are done soon after birth?
Your health care provider will discuss other tests that may be offered to you soon after birth, including:
• The Neonatal Screening Test (NST or heel prick test)
• Healthy Hearing Test
Will my health care provider give me other information about my baby’s health and safety?
Your health care provider will also discuss:
• Your baby’s six-week health check
• Sudden Infant Death Syndrome (SIDS)
• The use of baby capsules and child car seats
• Things that can injure your baby at home
• Visiting your GP, community midwife and / or child health nurse after birth
• The use of your baby’s personal health record (“red book”)
• Your baby’s immunisations