by: Jonas Marvin M.

Anaque RM, RN
BREASTFEEDING
3 Es
Early within 30 mins after birth
Exclusive- up to 6 months
Extended 2 years and beyond
Breastfeeding should be initiated at once about 30 minutes
after normal delivery
And about 3 - 4 hours after delivery by caesarian section
FEEDING CUES includes
baby turns towards the breast and searches for the
nipple,
licking movements,
flexing arms,
clenching fists,
tensing body and kicking legs.
Crying is the last sign of hunger

TAURINE and linoleic acid: for brain development

and increases Inteligence
newborn baby needs 120kcal/kg/day: 180 cc most
milks/kg/day
First nutrient receive by the baby is CARBOHYDRATES
Cereals, vegetables, fruits and juices, meat and fish and
egg
avoid honey (botulism risk)
No egg white until 12 months (risk of allergy)
Pureed meats, fish, poultry,
egg yolk
introduce 1new foods per week (easier to identify
adverse reactions)
and allow a few days between

COLIC
rule of 3s: unexplained paroxysms of irritability and crying
for > 3 hours/day
and > 3 days/week for > 3 weeks in an otherwise healthy,
well-fed baby
timing: onset 10 days to 3 months of age; peak 6-8 weeks
child cries, pulls up legs and
health benefits of breastfeeding are
Key
Behavioural
Sub-Messages
passes gas soon after feeding
lower risk of diarrhea,
Message
management
pneumonia, and chronic
parental relief, rest and
illnesses.
reassurance
Watch out for
Oxytocin also calms and relax the
Identify the signs and
hold baby, soother, car ride,
signs and
mothers emotion it controls the
symptoms of diarrhea.
music, vacuum, check diaper
symptoms of
emotional response of a mother A. Passage of watery stools at
ALWAYS BURP the baby
diarrhea.
Milk ejection Reflex
least 3 times a day.
if breast feeding, elimination
Prolactin Milk Producing
B. Excessive thirst.
of cows milk protein from
hormone
C. Sunken eyeballs or fontanel.
mother's diet (effective in very
Acinii/ alveolar cell- milk
small percentage of cases)
producing cells
Seek medical
Know the location of the
Lactiferous tubules milk storage
advice.
nearest health facility/personnel
Physiological benefits
Tubig Kubeta Oresol
where you can avail of medical
Breastfeeding promotes
Combat of Cholera
services.
uterine involution,
decreases risk of

Bring the patient to the

postpartum hemorrhage
hospital if the signs and symptoms
and increases period of
are present
Dry mouth, sunken
postpartum anovulation
or depressed
(having periods without
Follow the four
The four rules in the
fontanels
ovulating).
rules for the
treatment
of
diarrhea.

The eyes stop making

Mothers can also practice
treatment of
A.
Increase
fluid
intake.
tears
natural child spacing
diarrhea.
Hydration

Sweating may stop

since breastfeeding delays

Weakness
B.
Continue
breastfeeding.
ovulation. This is called

Decreased urine
C.
Take
zinc
supplement.
Lactation Amenorrhea
output
D. Refer to health
Method (LAM). A

Increased thirst
lactating woman has at
professional immediately
Dry mouth and
least 98% protection from
if child does not improve.
swollen tongue
pregnancy for six (6)

Dizziness
months when she remains without her period
(ammenorrheic) and fully or nearly fully breastfeeds.
BRAT Diet (for severe dehydration)
Breastfeeding also decreases the risk of
B- Banana
breast cancer,ovarian cancer and hip and bone
R- Rice
fractures.
A- Apple
Breastfeeding also makes it easier for night feeds.
T- Toasted Bread

by: Jonas Marvin M. Anaque RM, RN

Plan A- home management

Plan B RHU ORS (1 glass of water, 4 tsp of sugar, a pinch
of salt)
Plan C IVF
Developmental milestone
One month--midline vision
2 mos- -first social smile
No head control
Closing of posterior fontanel
Eyes begin to follow
Responds to familiar voices by moving the whole
body
Coos two sounds (1st vowel sounds)
3mos

Can bring objects to mouth at will

Head held erect and steady
Laugh aloud
Smile in mothers presence

4 mos. STEP reflexes disappears

(Stepping, Tonic neck, Extrusion, Palmar Grasp)
Head rotation
Head control (head lags disappears)
Reach toys near to him
5 mos. Rolls FAYB (Front to Back)
Takes object presented to him
ROLL OVER
Mirror image
6 mos - Doubles birth weight
Rolls from back to abdomen
Eruption of first tooth (lower central incisors)
Sits with support
Can pull to sitting to standing
Drinks from a cup
Syllable Oh Oh begins
7 mos - Grasp toys with hands
Hand to hand coordination
Fear of strangers begin
8 mos.- Sits alone
(sits without support)
Stranger anxiety at peaks
9 mos Says first word Dada
Then mama
CRAWL
Responds to parent anger
Elevate himself to sitting position
Can hold bottle with good hand to mouth
coordination
Disappearance of fear of strangers

10 mos - Pincer grasp

Peak a boo
Pull self to stand
Respond to own name
Brings hand together
Vocalizes one or two sounds
11 mos - Stands with support
12 mos - Stands alone
Walks with help
Triples body weight
Can say two words
Eats with fingers
1-3 years old weight monthly
Anterior fontanel starts to close
15 mos - Walks well alone
Throws toys
Creep stairs
Hand to eye coordination
18 monhs- Uses spoon and fork
Jumps and plays
Can climb upstairs
Bowel training starts
2 years - Open door knobs
Bladder training
2 words per talk
50 vocabulary words
tower of 6 cubes
3years - Routine BP taking
Can draw Circle
Can now ride tricycle
Tiptoe
can remove t- shirt alone (undress self)
900 vocabulary word
4 years - Draws square
4 word per talk
1500 vocabulary words
uses scissors
5 years old - Draws Triangle
Rides bicycle
Tie the shoe laces
Count using fingers
prints name
1.
2.

Certain hazards present different ages.

Chokingfrom mechanical obstruction is the leading
cause of death (by suffocation) for infants younger
than 1 year of age
for toddlers, there are more burns, poisoning, and
drowning

by: Jonas Marvin M. Anaque RM, RN

3.
4.

for preschoolers, more playground equipment

accidents, choking, poisoning, and drowning;.
adolescents, more automobile accidents, drowning,
fires, and firearm accidents

PLAYS APPROPRIATE FOR AGE:

Infants: Solitary Play- self is the interest of activities.
Toddlers: Parallel Play- plays alongside, but NOT with another.
Preschool: Associative Play- plays in random without group
goal
School Age: Cooperative Play- Organized with rules and
leadership
Adolescents: Competitive Play- with win-lose type of rules

CIRCUMCISION
elective procedure
- prevention of phimosis
- watch out for signs of Bleeding and hemorrhage

E. Babinskis reflex
Trigger: A gentle stroke on the sole of the foot (from
heel to toe)
Response: Foot turns in and toes flare up
Duration: Six to 24 months
Reason: Perhaps an attempt to protect against falling

Dentition
primary dentition (20 teeth)
first tooth at 6 months (5-9) (lower incisor), then 1 per
month until 20 teeth
6-8 central teeth by 1 year
secondary dentition (32 teeth)
first adult tooth is 1st molar at 6 years
2nd molars at 12 years, 3rd molars at 18 years

The initial weight loss for a healthy neonate is 5% to

10% of birth weight. Physiologic weight loss
REFLEXES OF THE NEWBORN
A. Root reflex
Trigger: A gentle stroke on the newborns cheek
Response: Baby turns toward the touch, with mouth
open
Duration: Until baby is three to four months old
(sometimes, babies continue doing this in their sleep
past four months old)
Reason: Helps baby find food
B. Suck reflex
Trigger: Something, such as a nipple (breast or
bottle) or parents finger, touching roof of babys
mouth
Response: Baby sucks on nipple
Duration: Three to four months
Reason: Helps baby eat
C. Galant reflex
infant is held in ventral suspension and one side of
the back is stroked along paravertebral line
reflex consists of lateral curvature of the trunk
toward the stimulated side
disappears by 2-3 months

D. Moro reflex (also called startle

reflex)
Trigger: Loud noise (even babys own cry!), sudden
movement, or sensation of falling
Response: Baby cries and extends legs, arms, and
fingers, arches back, then retracts arms and legs
reflex consists of abduction and extension of the
arms, opening of the hands, followed by flexion and
adduction of arms
Duration: Until baby is four to six months old
Reason: Babys first attempts to protect himself from
harm
If baby startles himself awake: Try swaddling him to
make him feel more secure

F. Walking (or stepping) reflex

Trigger: Holding baby upright with his feet on a flat
surface
Response: Baby lifts one foot, then the other, as if
walking
Duration: About two months
Reason: May prepare baby developmentally for
walking several months from now
G. Tonic neck reflex
Trigger: Lying on his back with head turned to one
side
Response: The arm on that side extends, while the
opposite arm bends at the elbow (a fencing
position)
Duration: About six months (sometimes not present
until two months of age)
Reason: May prepare baby developmentally for
voluntary reaching later
H. Grasp (or palmar grasp) reflex
Trigger: Pressing a finger or other object, such as a
rattle, into babys palm
Response: Baby makes a fist and tries to grab finger
Duration: Three to four months
Reason: May prepare baby developmentally for
voluntary grasping later
Fun fact: Babys grip can be strong enough to
support his entire body weight
Pyloric Stenosis
clinical features
non-bilious projectile vomiting that occurs after feeding
usually starts at 2-6 weeks of age
infant hungry and alert, will re-feed
gastric peristalsis goes from left upper quadrant (LUQ) to
epigastrium

by: Jonas Marvin M. Anaque RM, RN

 olive sign: olive-shaped mass at margin of right rectus

abdominis muscle

usual site: ileocecal junction

clinical features
classic triad
1. abdominal pain
2. palpable sausage-shaped mass: upper to mid abdomen
3. red currant jelly stools (only in 10-15% of patients)

Gastroesophageal Reflux Disease

extremely common in infancy: thriving baby requires no
investigation
management
conservative: thickened feeds, elevate bed to 45 degrees
medical: short-term enteral feeding to enhance weight gain
drugs: ranitidine, omeprazole: to decrease gastric acidity,
ACUTE DIARRHEA
Etiology
viral infection
most common Rotavirus
slight fever, malaise, vomiting, vague abdominal pain
resolves in 3-7 days
bacterial infection Salmonella, Campylobacter, Shigella,
pathogenic E. coli,
more severe abdominal pain, high fever, bloody diarrhea
allergic: food
Management
prevention and treatment of dehydration is most
important
replacement of fluid deficit + maintenance + ongoing
losses
antibiotic therapy when indicated oral rehydration
therapy with frequent small volumes of pediatric oral
rehydration solutions (e.g. Pedialyte)
IV may be required for severe dehydration
early refeeding advisable
antidiarrheal medications not indicated
Celiac Disease
also known as gluten-sensitive enteropathy
defect at the mucosal level
toxic or immunologic reaction to gluten in BROW
(Barley, Rye, Oats, Wheat)
Alternative foods: RICE and CORN
Hirschsprungs Disease
also known as congenital aganglionic megacolon
rectosigmoid in 75% of cases
associated with Down Syndrome (DS)
clinical features
severity depends on length of colon involved
no meconium within first 24 hours
palpable stool on abdominal exam with empty rectum on
digital rectal exam (DRE)
intermittent diarrhea, BM only with rectal stimulation
constipation, abdominal distention, vomiting
failure to thrive (FTT)
RIBBON LIKE STOOL
Intussusception
telescoping of segment of bowel into distal segment
> ischemia and necrosis

DOWN SYNDROME (DS)

most common abnormality of autosomal
chromosomes
trisomy 21
Clinical Features
very wide range of severity
low IQ, developmental delay, short stature, obesity
shorter life expectancy
HEENT: flat occiput, 3rd fontanelle, microcephaly, small
midface, small mandible and maxillae, upslanting
palpebral fissures, epicanthal folds, speckled iris (Brushfield
spots), refractive errors and strabismus, furrowed
prominent tongue, high arched palate, ear anomalies, frequent
AOM, hearing problems
CVS: congenital cardiac defects (50%), particularly septal
defects (AVSD)
MENINGITIS
signs of meningismus
Brudzinskis sign: reflex flexion of hips and knees upon
flexion of the neck
Kernigs sign: reflex contraction and pain in hamstrings
upon extension of leg that is flexed at the hip
opisthotonos: spasm in which head and heels are bent
backward and body bowed forward
nuchal rigidity
RESPIRATORY DISTRESS SYNDROME (RDS)
also known as hyaline membrane disease
most common cause of respiratory distress in the pre-term
infant

manifesttachypnea, tachycardia, chest wall

retractions (recession), expiratory grunting, nasal
flaring and cyanosis during breathing efforts.
Prevention
steroid therapy (e.g. Celestone/bethamethasone) for mothers
prior to delivery of premature infants
monitor lecithin:sphingomyelin (L/S) ratio (2:1)
A. A cleft lip is a physical split or separation of the two
sides of the upper lip and appears as a narrow
opening or gap in the skin of the upper lip. This
separation often extends beyond the base of the nose
and includes the bones of the upper jaw and/or upper
gum.
B. A cleft palate is a split or opening in the roof of the
mouth. A cleft palate can involve the hard palate (the
bony front portion of the roof of the mouth), and/or

by: Jonas Marvin M. Anaque RM, RN

the soft palate (the soft back portion of the roof of the
mouth).
Spina bifida (Latin: "split spine") a developmental congenital
disorder caused by the incomplete closing of
the embryonic neural tube.
most common location of the malformations is
the lumbar and sacral areas.
Myelomeningocele is the most significant and
common form, and this leads to disability in most
affected individuals.
RA 9288 - Newborn Screening (NBS) is a simple procedure
to find out if your baby has a congenital metabolic disorder
that may lead to mental retardation or even death if left
untreated.

Heel prick method used to obtain specimen

Newborn screening is ideally done immediately after
24 hours from birth.
The blood sample for NBS may be collected by any
of the following: physician, nurse/midwife, medical
technologist or trained nurse/midwife
Results can be claimed from the health facility where
NBS was availed. Normal NBS Results are available
by 7 - 14 working days from the time samples are
received at the NSC.

A NEGATIVE SCREEN MEANS THAT THE NBS

RESULT IS NORMAL.
A positive screen means that the newborn must be
brought back to his/her health practitioner for further
testing.

The disorders tested for newborn screening are:

(1) Congenital Hypothyroidism (CH)
(2) Congenital Adrenal Hyperplasia (CAH)
(3) Galactosemia (GAL)
(4) Phenylketonuria (PKU)
(5) Glucose-6-Phosphate-Dehydrogenase Deficiency (G6PD
Def.)
(6) Maple Syrup Urine Disease (MSUD)

BULLETS:
o

Pseudomenstruation - vaginal opening is

visible and a mucoid discharge, which might
be bloody secondary to estrogen withdrawal

In a neonate, the symptoms of heroin withdrawal

may begin several hours to 4 days after birth.
In a neonate, the symptoms of methadone
withdrawal may begin 7 days to several weeks after
birth.
In a neonate, the cardinal signs of narcotic
withdrawal include coarse, flapping tremors;

sleepiness; restlessness; prolonged, persistent,

high-pitched cry; and irritability.
In a premature neonate, signs of respiratory
distress include nostril flaring, substernal
retractions, and inspiratory grunting.
Respiratory distress syndrome (hyaline membrane
disease) develops in premature infants because their
pulmonary alveoli lack surfactant.Normal ratio of
surfactants L/S is 2:1
Whenever an infant is being put down to sleep, the
parent or caregiver should position the infant on the
back.(supine) (Remember back to sleep.)
Clinical signs of a dehydrated infant include
lethargy, irritability, dry skin decreased tearing,
decreased urinary output, and increased pulse.
A serving size of a food is usually 1 tablespoon for
each year of age.
The characteristic of fifth disease (erythema
infectiosum) is erythema on the face, primarily the
cheeks, giving a slapped face appearance.
Signs that a child with cystic fibrosis is responding to
pancreatic enzymes are the absence of steatorrhea,
improved appetite, and absence of abdominal pain.
Roseola appears as discrete rose-pink macules that
first appear on the trunk and that fade when pressure
is applied.
Circumcision wouldnt be performed on a male
child with hypospadias because the foreskin may be
needed during surgical reconstruction.
Blood pressure in the arms and legs is essentially
the same in infants.
When bottle-feeding a newborn with a cleft palate,
hold the infants head in an upright position.
Because of circulating maternal antibodies that will
decrease the immune response, the measles, mumps,
and rubella (MMR) vaccine shouldnt be given until
the infant has reached 1 year of age.
Before feeding an infant any fluid that has been
warmed, test a drop of the liquid on your own skin
to prevent burning the infant.
A newborn typically wets 6 to 10 diapers per day.
The most adequate diet for an infant in the first 6
months of life is breast milk.
An infant can usually chew food by 7 months, hold
spoon by 9 month, and drink fluid from a cup by 1
year of age.
Kohlbergs stages of moral development; Eriksons
eight stages of development; and Piagets phases of
cognitive development.
In an infant, a bulging fontanel is the most significant
sign of increasing intracranial pressure.
Cows milk shouldnt be given to infants younger
than age 1 because it has a low linoleic acid
content and its protein CASSEIN is difficult for
infants to digest.
If jaundice is suspected in a neonate, the
nurse/midwife should examine the infant under

by: Jonas Marvin M. Anaque RM, RN

natural window light. If natural light is unavailable,

the nurse/midwife should examine the infant under a
white light.
Vitamin K is administered to neonates to prevent
hemorrhagic disorders because a neonates intestine
cant synthesize vitamin K.
Fetal alcohol syndrome presents in the first 24
hours after birth and produces lethargy, seizures,
poor sucking reflex, abdominal distention, and
respiratory difficulty.
In a premature neonate, signs of respiratory
distress include nostril flaring, substernal
retractions, and inspiratory grunting.
Respiratory distress syndrome (hyaline membrane
disease) develops in premature infants because their
pulmonary alveoli lack surfactant.Normal ratio of
surfactants L/S is 2:1
Whenever an infant is being put down to sleep, the
parent or caregiver should position the infant on the
back.(supine) (Remember back to sleep.)
The percentage of water in a neonates body is
about 78% to 80%.
To perform nasotracheal suctioning in an infant,
the nurse/midwife positions the infant with his
neck slightly hyperextended in a sniffing
position, with his chin up and his head tilted back
slightly. Suction for no more than 10 seconds
After birth, the neonates umbilical cord is tied 1
(2.5 cm) from the abdominal wall with a cotton
cord, plastic clamp,
A premature neonate is one born after 20 wks and
before the end of the 37th week of gestation.
Stress, dehydration, and fatigue may reduce a
breast-feeding mothers milk supply.
When both breasts are used for breast-feeding, the
infant usually doesnt empty the second breast.
Therefore, the second breast should be used first at
the next feeding.
A low-birth-weight neonate weighs 2,500 g (5 lb 8
oz) or less at birth. SGA-MICROSOMIC INFANT
A very-low-birth-weight neonate weighs 1,500 g (3
lb 5 oz)
When teaching parents to provide umbilical cord
care, the nurse/midwife should teach them to clean
the umbilical area with a cotton ball saturated with
alcohol 50 to 70% after every diaper change to
prevent infection and promote drying.
Teenage mothers are more likely to have lowbirth-weight neonates because they seek prenatal
care late in pregnancy (as a result of denial) and are
more likely than older mothers to have nutritional
deficiencies.
Cutis marmorata is mottling or purple
discoloration of the skin. Its a transient vasomotor
response that occurs primarily in the arms and legs
of infants who are exposed to cold.

Ortolanis sign (an audible click or palpable jerk

that occurs with thigh abduction) confirms
congenital hip dislocation in a neonate
The first immunization for a neonate is the BCG
and hepatitis B vaccine, which is administered in
the nursing shortly after birth.
Infants with Down syndrome typically have
marked hypotonia, floppiness, slanted eyes, excess
skin on the back of the neck, flattened bridge of
the nose, flat facial features, spadelike hands,
short and broad feet, small male genitalia, absence
of Moros reflex, and a simian crease on the hands.
BECAUSE IT IS A NEUROMUSCULAR
DISORDER
The circumference of a neonates head is normally
2 to 3 cm greater than the circumference of the
chest.
Head is 33-35 cm, chest and abdomen is 31 to 33
and normal NB length is the same with the
umbilical cord which is 45 to 55 cm
During the first hour after birth (the period of
reactivity), the neonate is alert and awake.
The specific gravity of a neonates urine is 1.003 to
1.030. A lower specific gravity suggests
overhydration; a higher one suggests dehydration.
The neonatal period extends from birth to day 28.
Its also called the first 4 weeks or first month of
life.
A woman who is breast-feeding should rub a mild
emollient cream or a few drops of breast milk (or
colostrum) on the nipples after each feeding. She
should let the breasts air-dry to prevent them
from cracking.
Breast-feeding mothers should increase their fluid
intake to 2 to 3 qt (2,500 to 3,000 ml) daily.
After feeding an infant with a cleft lip or palate, the
nurse/midwife should rinse the infants mouth with
sterile water.
The nurse/midwife instills erythromycin in a
neonates eyes primarily to prevent
blindnesscaused by gonorrhea or chlamydia.
Human immunodeficiency virus (HIV) has been
cultured in breast milk and can be transmitted by an
HIV-positive mother who breast-feeds her infant.NO
BREASTFEEDING POLICY
Preterm neonates or neonates who cant maintain a
skin temperature of at least 97.6 F (36.4 C) should
receive care in an incubator (Isolette) or a radiant
warmer. In a radiant warmer, a heat-sensitive probe
taped to the neonates skin activates the heater unit
automatically to maintain the desired temperature.
Colostrum, the precursor of milk, is the first
secretion from the breasts after delivery.Contains
IGA
Neonates who are delivered by cesarean birth
have a higher incidence of respiratory distress
syndrome.

by: Jonas Marvin M. Anaque RM, RN

When providing phototherapy to a neonate, the

nurse/midwife should cover the neonates eyes and
genital area.continue B.F every 2 hours and cover
the breast also it is normal to pass a yellow greenish
stool after photo therapy
The narcotic antagonist naloxone (Narcan) may be
given to a neonate to correct respiratory depression
caused by narcotic administration to the mother
during labor.
In a neonate, symptoms of respiratory distress
syndrome include expiratory grunting or whining,
sandpaper breath sounds, and seesaw retractions.
SILVERMAN ANDERSON SCORING SYSTEM
is used for evaluation of PREMATURITY
The nurse/midwife should assess a breech-birth
neonate for hydrocephalus, hematomas, fractures,
and other anomalies caused by birth trauma.
In a neonate, long, brittle fingernails are a sign of
postmaturity. Born after 42 weeks gestation
Desquamation (skin peeling) is common in
postmature neonates.
A mother should allow her infant to breast-feed until
the infant is satisfied. The time may vary from 5 to
20 minutes.
In a neonate, hypoglycemia causes temperature
instability, hypotonia, jitteriness, and seizures.
Premature, postmature, small-for-gestational-age, and
large-for-gestational-age neonates are susceptible to
this disorder.
Neonates typically need to consume 50 to 55 cal per
pound of body weight daily.
A neonate whose mother has diabetes should be
assessed for hyperinsulinism. Or REBOUND
HYPOGLYCEMIA
The best technique for assessing jaundice in a
neonate is to blanch the tip of the nose or the area
just above the umbilicus.
Prolactin stimulates and sustains milk production.
Strabismus or cross eye and nystagus is a normal
finding in a neonate. Nystagmus is due to
IMMATURE EYE MUSCLES
Fetal demise is death of the fetus after viability.
To prevent her from developing Rh antibodies, an
Rh-negative primigravida should receive Rho(D)
immune globulin (RhoGAM) after delivering an
Rh-positive neonate. Rh mother and an Rh
+baby
The initial weight loss for a healthy neonate is 5%
to 10% of birth weight. Physiologic weight loss
The normal hemoglobin value in neonates is 17 to 20
g/dl.
The Apgar score is used to assess the neonates vital
functions. Its obtained twice (2x) at 1 minute and 5
minutes after delivery. The score is based on
respiratory effort, heart rate, muscle tone, reflex
irritability, and color.

The preterm neonate may require gavage feedings

or NGT because of a weak sucking reflex,
uncoordinated sucking, or respiratory distress,
Neonatal testing for phenylketonuria is mandatory
in the country this is the GUTHRIE TEST.
The nurse/midwife should place the neonate in a 30degree Trendelenburg position to facilitate mucus
drainage.
The nurse/midwife may suction the neonates
mouth firstand then nose as needed with a bulb
syringe or suction trap.
To prevent heat loss, the nurse/midwife should
place the neonate under a radiant warmer 25
watts during suctioning and initial delivery-room
care, and then wrap the neonate in a warmed blanket
for transport to the nursing.
The umbilical cord normally has two arteries and
one vein. AVA
SUA means single umbilical artery
When providing care, the nurse/midwife should
expose only one part of an infants body at a time.
In the neonate, temperature normally ranges from
98 to 99 F (36.7 to 37.2 C), apical pulse rate
averages 120 to 160 beats/minute, and respirations
are 40 to 60 breaths/minute.
The diamond-shaped anterior fontanel usually
closes between ages 12 and 18 months. The
triangular posterior fontanel usually closes by age
2 months.
In the neonate, a straight spine is normal. A tuft of
hair over the spine is an abnormal finding.
Supernumerary nipples are occasionally seen on
neonates. They usually appear along a line that runs
from each axilla, through the normal nipple area, and
to the groin.
Meconium is a material that collects in the fetuss
intestines and forms the neonates first feces, which
are black and tarry.
The presence of meconium in the amniotic fluid
during labor indicates possible fetal distress and the
need to evaluate the neonate for meconium
aspiration.
To assess a neonates rooting reflex, the
nurse/midwife touches a finger to the cheek or the
corner of the mouth. Normally, the neonate turns his
head toward the stimulus, opens his mouth, and
searches for the stimulus.
Harlequin sign is present when a neonate who is
lying on his side appears red on the dependent side
and pale on the upper side.
The Guthrie test (a screening test for
phenylketonuria) is most reliable if its done
between the second and sixth days after birth and
is performed after the neonate has ingested
protein.
To establish a milk supply pattern, the mother
should breast-feed her infant at least every 4

by: Jonas Marvin M. Anaque RM, RN

hours. During the first month, she should breast-feed

8 to 12 times daily (demand feeding).
To avoid contact with blood and other body fluids,
the nurse/midwife should wear gloves when handling
the neonate until after the first bath is given.;
BLEACH is used to clean blood products
If a breast-fed infant is content, has good skin
turgor, an adequate number of wet diapers, and
normal weight gain, the mothers milk supply is
assumed to be adequate.
Most authorities strongly encourage the
continuation of breast-feeding on both the affected
and the unaffected breast of patients with mastitis.
In a neonate, low-set ears are associated with
chromosomal abnormalities such as Down
syndrome.
Meconium is usually passed in the first 24 hours;
however, it is still NORMAL if passage may take
up to 72 hours.
Boys who are born with hypospadias urethral
opening is in the ventral surface or inferior side (V
is to VAVA) shouldnt be circumcised at birth
because the foreskin may be needed for constructive
surgery.
In the neonate, the normal blood glucose level is 45
to 90 mg/dl.
Hepatitis B vaccine is usually given within 48
hours of birth (RA 7846).
Infants of diabetic mothers are susceptible to
macrosomia as a result of increased insulin
production in the fetus.
To prevent heat loss in the neonate, the
nurse/midwife should bathe one part of his body at a
time and keep the rest of the body covered.
The occurrence of thrush in the neonate is
probably caused by contact with the organism
during delivery through the birth canal.
Moniliasis is a white cheezy patches in oral
mucusa of a baby

The nurse/midwife should keep the sac of

meningomyelocele moist with normal saline
solution. Position the child into a PRONE position
***Unlike formula, breast milk offers the benefit
of maternal antibodies IGA
Heart development in the embryo begins at 2 to 4
weeks and is complete by the end of the embryonic
stage
****CBQ: Heart starts to beat as early as 23 days
FetusA human being from about the eighth week
of life up until birth
The administration of folic acid during the early
stages of gestation may prevent neural tube defects.
With advanced maternal age, a common genetic
problem is Down syndrome.
Breast-feeding of a premature neonate born at 32
weeks gestation can be accomplished if the mother
expresses milk and feeds the neonate by gavage
The nurse/midwife must place identification bands
on both the mother and the neonate before they
leave the delivery room.
Erythromycin is given at birth to prevent
ophthalmia neonatorum.
According to the UnangYakap program (Essential
Newborn Care), the cord should not be clamped
until pulsations have stopped (thats about 1-3
minutes).
Infants subsisting on cows milk only dont receive a
sufficient amount of iron (ferrous sulfate), which
will eventually result in iron deficiency anemia.
An infant usually triples his birth weight by the end
of his first year

by: Jonas Marvin M. Anaque RM, RN