From the Guidelines
A comprehensive newborn visit checklist should prioritize parental education, physical examination, feeding assessment, screening tests, vaccinations, safety education, maternal health check, and follow-up planning to ensure the best possible outcomes for the newborn's health and development. When creating a newborn visit checklist, it is essential to consider the following key areas:
- Physical examination:
- Weight, length, head circumference
- Skin color and condition
- Head shape and fontanelles
- Eyes, ears, nose, and mouth
- Heart and lung sounds
- Abdomen and umbilical cord
- Genitalia and anus
- Reflexes and muscle tone
- Feeding assessment:
- Breastfeeding or formula feeding
- Frequency and duration of feeds
- Wet diapers and bowel movements
- Screening tests:
- Hearing screening
- Metabolic/newborn screening
- Jaundice check
- Vaccinations:
- Hepatitis B vaccine if not given at birth
- Safety education:
- Safe sleep practices
- Car seat usage
- Home safety
- Maternal health check:
- Postpartum depression screening
- Breastfeeding support
- Follow-up planning:
- Schedule next visit
- Provide emergency contact information As noted in 1, parental education and involvement in the care of the infant are crucial for their confidence and readiness to assume full responsibility for the infant's care at home. Additionally, 1 highlights the importance of newborn screening and the need for a uniform screening panel and system, which should be considered when developing a newborn visit checklist. By prioritizing these areas and considering the latest evidence, healthcare providers can ensure that newborns receive comprehensive care and support, leading to better health outcomes and improved quality of life.
From the Research
Essential Components of a Newborn Visit Checklist
The following are key components to include in a newborn visit checklist:
- Physical examination to diagnose neurological or neurosurgical conditions 2
- Assessment of gestational age 3
- Vision screening to detect ocular risk factors and abnormalities 4
- Examination for size, macrocephaly or microcephaly, changes in skin color, signs of birth trauma, malformations, evidence of respiratory distress, level of arousal, posture, tone, presence of spontaneous movements, and symmetry of movements 5
- Review of birth history, prior screenings, diet, sleep, dental care, and medical, surgical, family, and social histories 6
- Head-to-toe examination, including a review of growth 6
- Immunizations review and update 6
- Screening for postpartum depression in mothers of infants up to six months of age 6
Specific Examination Components
The newborn examination should include:
- Examination of the head, including assessment for hydrocephalus 2
- Neurological and developmental evaluation 2
- Assessment of extraocular movements and alignment, and evaluation of the red reflex 4
- Examination of the skin, including assessment for signs of birth trauma, malformations, and changes in skin color 5
- Examination of the chest, including assessment for respiratory distress and murmurs 5
- Examination of the neck, including assessment for masses and facial nerve palsies 5
Additional Considerations
- Total and direct bilirubin levels should be measured in newborns with jaundice 5
- A complete blood count should be obtained in newborns with pallor or a ruddy complexion 5
- Neurosurgical consultation is necessary in infants with craniosynostosis accompanied by restricted brain growth or hydrocephalus, cephaloceles, or exophytic scalp nodules 5