Newborn examination includes overall condition, growth and maturity assessment, feeding observation, reflexes, and examination of individual organ systems.
General assessment
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Assess whether the newborn looks well or sick and is alert or unconscious.
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Check temperature and cold stress, respiratory rate, retractions, grunt or stridor, heart rate, palpable femoral arteries, blood pressure, capillary refill time, cry, and apneic spells.
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Record weight, length, head circumference and chest circumference. Assess gestation using physical criteria, with more detailed assessment by the expanded New Ballard examination.
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Classify growth as appropriate, small or large for gestational age; identify symmetric or asymmetric small size and signs of intrauterine growth retardation.
Physical findings, feeding and reflexes
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Examine from head to toe for malformations and look for trauma, including cephalohematoma.
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Look for cyanosis, jaundice, pallor, bleeding, pustules, edema and a depressed fontanel.
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Inspect for caput, eye discharge, umbilical stump discharge or redness, jitteriness and oral thrush.
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Record developmental peculiarities such as toxic erythema, Epstein pearls, breast engorgement, vaginal bleeding, capillary hemangioma and mongolian spot.
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Observe breastfeeding to check positioning and attachment, and assess Moro, grasp and rooting reflexes.
Systemic examination
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Examine chest shape, respiratory rate, retractions, air entry and adventitious sounds; assess the apical impulse, heart sounds and murmurs.
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Examine the abdomen for distension, wall edema, tenderness, palpable liver, spleen or kidneys, other lumps, ascites and hernial sites; examine gonads and genitalia.
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Assess musculoskeletal deformities, developmental dysplasia of the hip and club foot.
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Neurological examination includes consciousness, vision, pupils, eye movements, facial sensation, hearing, sucking and swallowing, muscle tone, posture, power and tendon reflexes.