1. Immediate Newborn Assessment 👶
APGAR Score (1 min and 5 min)
| Sign | 0 | 1 | 2 |
|---|---|---|---|
| Appearance (color) | Blue/pale | Pink body, blue extremities | Completely pink |
| Pulse | Absent | <100 | ≥100 |
| Grimace (reflex) | No response | Grimace | Cry, cough |
| Activity (tone) | Limp | Some flexion | Active |
| Respiration | Absent | Slow, irregular | Good, crying |
Score: 7-10 = Normal, 4-6 = Moderate depression, 0-3 = Severe depression
Essential Newborn Care (EINC)
- Immediate drying: With dry cloth, remove wet cloth
- Skin-to-skin contact: Immediately after birth
- Delayed cord clamping: 1-3 minutes after birth
- Early breastfeeding: Within first hour
2. Normal Newborn Vital Signs 💓
Heart Rate
Normal: 120-160 bpm
During crying: Up to 180 bpm
Respiratory Rate
Normal: 30-60 breaths/min
Abdominal breathing is normal
Temperature
Axillary: 36.5-37.5°C
Prevent hypothermia! Skin-to-skin
Weight
Average: 2,500-4,000 grams
LBW: <2,500g | VLBW: <1,500g
3. Breastfeeding 🤱
Benefits of Breastfeeding
- Baby: Complete nutrition, antibodies (IgA), bonding, reduces infections
- Mother: Uterine involution, weight loss, bonding, delays ovulation
- Colostrum: First milk (yellow), rich in antibodies and protein
Proper Latch (Attachment)
- Mouth wide open
- Lower lip turned outward (flanged)
- Chin touching breast
- More areola visible above than below
- Slow, deep sucks with audible swallowing
Common Breastfeeding Problems
- Engorgement: Warm compress before feeding, cold after
- Cracked nipples: Correct latch, apply breast milk
- Mastitis: Continue breastfeeding, antibiotics if needed
4. Common Newborn Conditions 🩺
Physiologic Jaundice
- Appears after 24 hours of life
- Peaks at 3-5 days, resolves by 2 weeks
- Frequent breastfeeding helps
Pathologic Jaundice (Red Flags)
- Appears within first 24 hours
- Bilirubin rises rapidly
- May need phototherapy or exchange transfusion
Umbilical Cord Care
- Keep dry and clean (dry cord care)
- Falls off in 7-14 days
- Signs of infection: Redness, foul odor, discharge
Normal Variations
- Milia (white spots on nose)
- Mongolian spots (blue-gray on buttocks)
- Erythema toxicum (red blotches)
💡 Board Exam Tips - Infant Care
- ✓ APGAR: Appearance, Pulse, Grimace, Activity, Respiration
- ✓ Jaundice within 24 hrs = Pathologic (needs immediate workup)
- ✓ Exclusive breastfeeding for first 6 months (WHO recommendation)