Newborn Physical Examiniation: Abnormal Findings and Plan of Action

Immediate Care of the Newborn:
Clear airway, dry and stimulate the baby, clamp and cut the cord, assess APGAR score, maintain neutral thermal environment, initiate breast feeding, ensure safety and security, document all findings. As soon as the head is born, wipe the mouth, nose and eyes, suction only indicated if meconium stained liquor or APGAR score below six (6).

Dry and Stimulate Baby
Dry the baby next to the mother’s abdomen so that he/she gets the warmth from her through heat conduction. Place the baby on the mother’s abdomen for skin to skin contact to promote bonding.

Clamp and Cut the Cord
Cut the cord immediately after initial drying/warming of a normal healthy infant. Cutting of the cord at this time facilitates putting the baby skin-to-skin with the mother and encourages immediate breastfeeding.

Tie the cord with 2 clean ties about 2 centimeters apart. The ties should be tightly knotted with more than one knot. Some people use three ties to be extra sure that they do not come off.  The extra tie should be on the part of the cord still attached to the baby.  Tie the first one (or two) ties about 2 cms or two finger breadths from the baby’s body.  Tie the next tie the same distance - 2 cms or two finger breadths, from the first. Cut the cord between these two ties. The attendant should check frequently that there is no bleeding from the cord in the first day after delivery, especially during the first few hours. If there is, another clean tie should be applied. Bleeding later on from the cord might indicate an infection and then assistance from a health professional should be sought.