WHAT IS IT?
After birth, each child is carefully examined several times by a doctor. The first examination takes place shortly after birth in the delivery room. It is mainly checked whether the baby adapts well to life outside the womb. When the baby is about 1 day old, the first head-to-toe examination follows, performed by a pediatrician. When the baby is 7 days old, this head-to-toe examination is repeated. This can be done by the pediatrician if the mother is still in the hospital, or by the pediatrician or family doctor if the mother has already left the hospital. The parents (or one of them) are best present during the examination. The baby is always fully undressed so that the doctor can examine the entire body. To prevent cooling, the examination is done in a sufficiently warm room. The doctor will also ask questions about the course of the pregnancy and the birth to get a good idea of the overall health of the baby.
The birth is very intensive for a baby: the baby needs to recover for the first few minutes outside the belly. The Apgar test determines how well the baby adapts to life outside the womb. Approximately one minute after birth, respiration, skin color, muscle tension, heart rate and response to stimuli are checked. A score of 0, 1 or 2 is given on each of these parameters. 0 means absent, 2 optimal. A total score of 10 points is as a score of less than 4 means that there may be serious problems. Oxygen is then usually administered immediately. A score between 4 and 6 is frequent. The baby then responds well, but not yet optimally. The test is then repeated after 5 and 10 minutes. A score above 7 means that the baby responds normally. Shortly after birth, the weight, height and head circumference are also measured.
The baby will be fully and accurately checked during this examination.
The doctor carefully looks at baby’s skin. The following findings are common:
Lanugo: the baby is often covered with thin, downy hairs at birth. They are completely normal and are used to keep the baby warm. They disappear during the first days.
Skin lubricant: this is a greasy white layer on the skin of the newborn baby that is mainly present in the skin folds. Skin lubricant disappears automatically after a few days.
Jaundice: about 1 in 3 children develops jaundice during the first week of life. The skin can then turn slightly yellow. Jaundice usually disappears by itself. If the doctor suspects abnormal jaundice, some blood is collected. Sometimes phototherapy is necessary: the baby is then placed under a UV lamp.
Smudgy rash with sores: this is a harmless rash for babies with dry skin. It does not bother the baby, and the rash disappears automatically after a few days or weeks.
Strawberry stain (hemangioma): this is a large amount of small blood vessels located in or on the skin, visible as flat or slightly raised red spots. They may already be present at birth or occur in the first months after birth. Strawberry spots are harmless, and 95% eventually disappear spontaneously. Treatment is usually not necessary.
Nutritional status and fluid balance
Too small a baby with a low birth weight may indicate a growth disorder in the womb. The elasticity of the skin gives an indication of the moisture balance.
Findings caused during birth
Because the baby passes through the narrow birth canal during delivery, a number of harmless abnormalities can occur:
Birth swelling: this is a temporary swelling on the baby’s head, which consists of moisture and feels soft and elastic. Usually the swelling disappears automatically within 1 to 3 days after birth.
Blood shedding on the head: this is a temporary swelling on the baby’s head, which consists of blood between the skull and the bone of the skull.
Treatment is usually not necessary: the body cleans the blood itself over the course of a few weeks or months. Blood shedding on the whites of the eyes: the whites of the eye are colored bright red. The shedding of blood is not painful and will disappear automatically within 1 to 3 weeks.
Fracture of the collarbone: Sometimes the movement of the arm may be somewhat limited by a fracture of the collarbone, but this heals spontaneously within a few days to two weeks. Blood circulation The doctor checks whether the heart and blood circulation are functioning properly.
Skin color: the skin should be beautiful pink. A blue discoloration of the lips or tongue indicates a lack of oxygen. Pulse rate: with a healthy child the heart rate is 100-160 / min, but the heart rate of a crying child can increase to 200 / min.
Heart murmur: the doctor listens with the stethoscope to the baby’s heart. If heart murmur is audible, further examination of the heart must be done to determine whether or not there is a heart defect.
Lies pulses: the doctor checks whether the heartbeat can be felt in the femoral arteries of both groins. Respiratory system The doctor listens to the baby’s lungs with the stethoscope. A newborn baby normally breathes 40 to 60 times per minute. Breathing difficulties can be due to diseases of the lungs, but also of the heart, infections and metabolic disorders. Nervous system and senses The doctor will examine the different functions of the nervous system and the senses.
Skull: because the skull still needs to grow, the various bones have not yet completely grown together. With a newborn there are normally two fontanelles present: the large and the small fontanel. A fontanel is an opening between the skull bones. The size of the fontanelles is always checked. The front fontanelle grows completely close between the ages of 8 to 24 months. The posterior fontanel closes a little earlier, around the age of 2 to 6 months.
Movement: the doctor checks whether the baby moves the 4 limbs by itself the same amount. Reflexes: the doctor checks, among other things, the suction, gripping, shock and step reflexes.
Eyes: the doctor examines whether there are abnormalities of the eyes. He may also test the pupil reflex. Ears: the doctor checks whether there are abnormalities of the ears. A hearing test is later performed via Child and Family, when the baby is 2 to 4 weeks old.
The doctor checks the different parts of the digestive system.
Mouth: the doctor feels whether the palate is completely closed.
Belly: the doctor feels the stomach and listens with the stethoscope. The liver is often felt in a newborn, the spleen is normally not. If other masses are noticeable, the baby must be examined further. The doctor also checks the umbilical stump and checks whether it heals properly. An umbilical hernia occurs regularly in newborns, and usually recovers automatically after a few years.
Anus: the doctor always checks the vent opening and will ask if the baby has already made a bowel movement.
The genitals are also checked. With boys, the doctor feels whether both testes are present in the ball bag and whether the penis is normally formed. The length of the pubis to the top of the penis must be more than 2.8 cm. In girls, the doctor checks whether the labia and clit are large and small. White loss in babies is a normal phenomenon.
Skeleton and hips
The doctor assesses the proportions of the body and limbs.
Arms and hands: the doctor checks the number of fingers and looks at the position of the folds in the palm.
Legs and feet: the doctor checks the number of toes and checks whether the baby may have a club foot.
Hips: the doctor always checks the mobility of the hips and checks whether there is a difference in the length of both thighs. This may be due to an abnormal development of the hip. Sometimes an ultrasound is needed to rule out abnormalities.
The weight is checked daily for the first few days. It is normal for a newborn to lose 10% of his birth weight during the first 5 days. The baby is used to getting food continuously through the umbilical cord.
SCREENING BORN DEROGATIONS
Every newborn child in Flanders receives a blood test at the heel 72 hours after the birth. This blood test is usually done on maternity, at the midwife or the treating doctor. The blood sample is screened for a number of serious congenital disorders, so that early treatment can be started to prevent or limit health damage