Newborn Exam Checklist

 Knock on patient’s door, announce that we are from pediatrics, and ask if we can enter
(be aware that some mom’s may be soundly sleeping or may not be ready for us to enter
room)
 Introduce self and preceptor, including respective roles
 Confirm correct patient/mom/family names
 Congratulate mom/dad (ask if baby has name)

 Ask how mom/dad are doing with infant so far

 Ask if they have a primary care physician for their child

 Ask mom/dad if they have any specific concerns or questions

 Ask if they have any other children (ages, health status, etc.)

 Ask general questions about the pregnancy and delivery (student should indicate what
they know from reading chart, and parent(s) can clarify and add information, be wary
about discussing mom’s personal information or abnormal results in front of other family
members)

 Ask general questions about patient (student should indicate what they know from
reading chart, and parent(s) can clarify and add information)
1. Feeding (how often, how long, is latch ok, remember early feeds are small and
inconsistent and that’s ok)

2. Stooling/Voiding (how many)

3. Sleeping

4. Activity

5. Other concerns if present (jaundice, low glucose, maternal chorio, other maternal
complications, infant breathing issues, etc.)

6. Review family history (focusing on infant/childhood conditions) as well as social history

(who lives at home, pets, smoke exposure)

 Examine baby with preceptor (explain the different exam components along the way in
basic language)

 Skin (face/throughout)
 I do not see any rashes, birthmarks or dry skin
 Anicteric
 Chest: asymm of rib cage
 4 spots on heart
 2 spots on lungs
 1 bowel sounds
 I do not hear any murmurs, I heard S1 and S2
 Lungs are clear bilaterally, no retractions
  Head: palpate anterior fontanelle, coronal/sag/lambdoid sutures, posterior fontanelle,
and shape of head from back
 Fontanelles are open and soft, I do not see any swelling or molding
 Tone:
 Appropriately flexed at rest
 LIFT UP BY ARMS (observe head lag” appropriate tone of neck)
 SET BACK DOWN (observe moro intact)
 Rotate head to each side
 Ears:
 Normally set, no skin tags or lesions
 SCM palpate
 Eyes: red reflex (whenever eyes open)
 Red reflex intact bilaterally
 Nose:
 Symmetric, no difficulty breathing
 Mouth/palate: feel palate, stroke cheek
 Sucking & rooting reflex +
 Palate intact
 Palpate clavicles
 No clavicular crepitus
 Abdomen: inspect & palpate
 3 vessels in UC (2 a, 1 v)
 No hepatosplenomegaly, kidney enlargement
 No masses
 Skin: arms & hands
 Normal palmar creases, 5 digits present
 No dry skin/rash/lesions
 Grasp reflex +
OPEN DIAPER
 Pulses
o Femoral (symmetric, 2+)
o Brachial and femoral simultaneously (no delay)
 Genitalia
o M: testes descended bilaterally, raphe midline
o F: normal female genitalia
REPLACE DIAPER
 Hips
o Barlow (posterior pressure)
o Ortolani (thumb on medial knee, index over opposite greater trochanter; abduct
hip and push upward w/ index and toward bed)
o No clunking noted
FLIP (hold w/ left hand, exam w/ right)
 Spine:
o Run finger down midline
 No scoliosis noted
o Run finger down each side (2 separate strokes)
  galant reflex + (legs swing towards stroked side)
 Sacral dimple?
 Patent anus
SET BABY DOWN
 Feet:
o Tactile stimulation of foot to awaken
 Baby can be stimulated and is alert
 5 digits
 Plantar & grasp reflexes +

 Review plan and any screening tests to be done (or give results if done).

 Discuss Hep B vaccine, circumcision plans, anticipated dc home, etc.

 Ask mom/dad if they have any additional concerns or questions

 Thank mom/dad and say goodbye