CHARACTERISTICS OF

NEWBORN & REFLEXES

 INTRODUCTION
•The neonatal period is the first 4 weeks of a child's life. It
is a time when changes are very rapid. Many critical events
can occur in this period:
•Feeding patterns are established.
•Bonding between parents and infant begin.
•The risk for infections that may become more serious are
higher.
•Many birth or congenital defects are first noted.
 DEFINITION
• A baby from birth to 28 days of age is
called newborn. A healthy infant
born at term (between 38-40 weeks)
should have an average birth weight
for the country (usually exceed 2500
gm.), cries immediately following
birth, establishes independent
rhythmic respiration and quickly
adapts to changed environment.
 PHYSIOLOGY
AND
CHARACTERISTICS
Vital signs: OF NEWBORN.
• Temperature : 97.7 degree Fahrenheit or 36.4 to
37.2 degree Celsius.
• Pulses: normal- 120-160 beats per min.
• Respiration: normal- 40-60breath /min.
• Blood pressure :normal range 60-70/31-45mmHg. BP is
directly related to gestational age and birth weight of
the infant.
 PHYSIOLOGY
AND
CHARACTERISTICS
Anthropometric measurements OF NEWBORN.
Height – 45- 55 cm
Weight – 2.5 – 3.5 kg
Head circumference – 33- 35
cm
Chest circumference - 31- 33
cm
Posture The newborn assumes the attitude of its
 CHARACTERISTICS
OF NEWBORN
SKIN.
SKIN CHANGES
At birth, the skin of a normal
infant is purplish-red in color,
then within minutes, the skin
pinks up.
 CHARACTERISTICS
OF NEWBORN
SKIN.
SKIN CHANGES
Acrocyanosis
Acrocyanosis is a condition that causes
the hands and feet to turn blue. The
main cause of this is the constriction of
the tiny arteries at the ends of the arms
and legs. In newborns, it is common in
the first few hours.
 CHARACTERISTICS
OF NEWBORN
SKIN.
SKIN CHANGES
Vernix Caseosa
Vernix caseosa is a white, creamy,
naturally occurring biofilm covering the skin
of the fetus during the last trimester of
pregnancy. Vernix coating on the neonatal
skin protects the newborn skin and facilitates
extra-uterine adaptation of skin
 CHARACTERISTICS
OF NEWBORN
SKIN.
SKIN CHANGES
Lanugo
Lanugo is the hair that covers the
body of some newborns. This downy,
unpigmented hair is the first type of
hair that grows from hair follicles.
 CHARACTERISTICS
OF NEWBORN
SKIN.
SKIN CHANGES
Jaundice
-The skin and whites of the eyes appear yellow.
-yellow color comes from a pigment called Bilirubin which is
released from the normal breakdown of RBC.
-The liver removes Bilirubin and excretes into the
Gastrointestinal tract
-the Bilirubin builds up faster due to high RBC breakdown and
since, the liver is immature, it cannot eliminate fully
-Bilirubin gets accumulated in the baby’s body which is the
cause for causing Jaundice
 CHARACTERISTICS
OF NEWBORN
SKIN
SKIN CHANGES
Desquamation
• Babies lose their outer layer of skin after they
are born. You'll see flaking. Especially around
the ankles, feet, hands and extremities
• caused due to the change in environment since
the baby had been living inside a fluid
environment in the mother’s womb for the past
9 months
 CHARACTERISTICS
OF NEWBORN
SKIN.
SKIN CHANGES
Erythema Toxicum
• develop a patchy red rash called erythema
toxicum (also called “flea bites”) which
fade by the time the baby is several weeks
old
•Caused due to the accumulation of
eosinophils in dermal lesions
 CHARACTERISTICS
OF NEWBORN
SKIN.
SKIN CHANGES
Stork bites
• red areas around their foreheads, eyelids,
and noses or on the backs of their necks

• more visible when the baby cries and

disappear by itself during the first year

• Caused when blood vessels dilate under the

skin during fetal development and hence, the
blood flow increases to that area
 CHARACTERISTICS
OF NEWBORN
SKIN.
SKIN CHANGES
Milia
• look like "white heads
• usually appear on the nose or chin
• usually disappear by themselves in the first
weeks of life
• Occurs when the sweat glands get blocked
since they are not fully developed
 CHARACTERISTICS
OF NEWBORN
SKIN.
SKIN CHANGES
Mongolian Spot
• refers to a macular blue-gray pigmentation usually on
the sacral area of healthy infants
• usually present at birth or appears within the first weeks
of life
•Occurs when the pigment cells make melanin under the
skin’s surface during embryonic development
•typically disappears spontaneously within 4 years but can
also persist for life
 CHARACTERISTICS
OF NEWBORN
SKIN.
SKIN CHANGES
Petechiae
• small, blue-red dots on the infant's body
caused by breakage of tiny capillaries
• seen on the face as a result of pressure exerted
on the head during birth
CHARACTERISTICS OF NEWBORN HEAD
Fontanelles
Neonate is born with six fontanelles (soft membraneous gaps)
•Anterior Fontanel-on the top of the head , diamondshaped
•PosteriorFontanel–onthebackof thehead, triangularshaped
•MastoidFontanel–totaltwo -oneonleftsideandotherontherightsideofthehead
•SphenoidFontanel- totaltwo-oneonleftsideandotherontherightsideofthehead

FUNCTIONS:
•Bonesarenotjoinedtogetherfirmlyatbirthwhichallowstheheadtochangeshapetohelpitpassthroughthebirthcanal.
• allows the brain and skull to grow during the infant’s first year .The fibrous connective tissue(suture)
found at the joining of the bone in the skull gradually gain minerals and hardens, firmly joining the skull
bines together
Closure:
1. Posterior Fontanelle:2-3 months
2. Anterior Fontanelle : 12-18 months
3. Sphenoid Fontanelle : 6 months
4. Mastoid Fontanelle : 6-18 months
CHARACTERISTICS OF NEWBORN HEAD.
Molding
During a head first birth, pressure on the head caused by the tight
birth canal may 'mold' the head into an oblong (elongated shape)
rather than round shape. Newborn head molding is a common
occurrence that usually disappears after a few days.
CHARACTERISTICS OF NEWBORN HEAD
Caput Succedaneum
• swelling of the scalp in a newborn
•caused by pressure from the uterus or vaginal wall during a
head-first (vertex) delivery. Vacuum extraction or Forceps done
during a difficult birth can also increase the chances of a caput
succedaneum
•It will clear up on its own within a few days
CHARACTERISTICS OF NEWBORN HEAD.
Cephalohematoma
•Accumulation of blood under the scalp
•During the birthing process, shearing forces on the skull and scalp result
in the separation of the periosteum from the underlying skull resulting in
the subsequent rupture of blood vessels
Note: The periosteum is a dense, fibrous connective tissue sheath that
covers the bones
CHARACTERISTICS OF NEWBORN HEAD.
Craniosynostosis
-occurs when one or more of the sutures closes early
before the baby’s brain is fully formed
-As the brain grows, the skull will take an unusual
shape.
CHARACTERISTICS OF NEWBORN EYES
Eye Lid Edema
•Newborn tend to have their eyes tightly closed
•Pressure on face during childbirth can make newborn's
eyelids temporarily puffy or swollen
CHARACTERISTICS OF NEWBORN EYES.
Lacrimal Apparatus
•The lacrimal Apparatus(glands) is

small and nonfunctioning at birth

and tears are not usually

produced with crying until one to

three months of age.

 CHARACTERISTICS
OF NEWBORN
GASTROINTESTINAL SYSTEM
 MOUTH

• The infant's lips should be pink and the tongue

smooth and symmetrical. The tongue should not
extend or protrude between the lips
• No salivation for the first 3 months.
• babies (unlike adults) do have lipase in their
mouths to initiate fat digestion
NEW BORN BREAST
Breasts Both male and female newborns may
have some swelling under the nipples. This is a
result of maternal hormones and will disappear
over a few weeks. Occasionally, some milky
discharge may occur. This is normal. Simply
wipe any discharge away.
 GENITALS

• Both male and female infants may develop swollen

and red genitals during their passage through the
birth canal

• Genital Areas Vaginal Discharge: It is common for baby girls

to have a thick creamy or bloody vaginal discharge for the
first two to three weeks of life. This is the result of maternal
hormones and is not a reason for concern.
NEWBORN

REFLEXES
 NEWBORN REFLEXES
• Rooting reflex:- When the Sucking reflex:-
cheek or corner of the mouth is stroked, the When touching or stroking
infant’s head should turn towards the the lips, the mouth opens and
stimulus and the mouth should open.It sucking movements begin.It
disappear at about age 3-4 months but begins to diminish at 6
may persist for up to 12 months months
 NEWBORN REFLEXES

Moro Reflex :- There are many ways to elicit Moro

reflex. However, the most common method used is the “drop
method” wherein the nurse lifts the baby completely off the
bed while supporting the head and the neck, and then the
nurse lowers the baby rapidly till there is only 4-8 inches
between the
baby and the bed. It is important to note that while doing this,
the baby is kept in supine position. Complete Moro reflex involves
bilateral abduction of arms, extension of forearms, and fanning
of fingers with index fingger and thumb forming a C shape.
 NEWBORN REFLEXES
Tonic neck Reflex :-Turning a newborn’s head to one
sidewill cause the extremities to on that side extends while the opposite
extremities contracts or flexes. This is also called boxer of fencing reflex
because of the position of the newborn. This appears8 weeks or 2 month
and disappear at 3 – 4 month or 6 – 9 month.
 NEWBORN REFLEXES

Crawling Reflex
•When the infant is placed on the stomach and
pressure (such as hand) is applied to the sole of the
foot, the infant will attempt to push against the
hand and move the arms and legs in crawling like
motion

Dissapearance:
Few weeks to months after birth
 NEWBORN REFLEXES
• Extrution Blinking reflex
Reflex:- or Corneal
When substance
anterior portion ofplaced on it’ll Reflex
the tongue, Protection of :-
eye by rapid eye lid
be expelled out. It disappear at closure when the eyes are exposed
about age 4 month to bright light. It does not
disappear
 NEWBORN REFLEXES
•
Doll’s Eye
Reflex:- As head is moved
slowly to right to left , eye lag
behind and donot immediately
adjust to new position of head . It
disapear at the age of 3 month
 NEWBORN REFLEXES
• Glabellar Yawn reflex :-
Reflex:- Infant has spontaneous response to
glabella(bridge
Tapping brisklyofonnose) cause decreased oxygen by increasing
eyes to close tightly amount of inspired air, persists
throughout life.
 NEWBORN REFLEXES
•
Cough Reflex:- Babinski reflex :-
• Irritation of mucous membranes of When the bottom of the foot is stroked
larynx causes coughing, persists from the heel upward along the outward
throughout the life; Usually present part of the foot, the big toe bends back
after 1st day of birth. and the other toes spread out.
Disappear after one year of age
 NEWBORN REFLEXES
Plantar Grasp :- Palmar Grasp :-
When objects touch the soul of the When the objects are place in the
foot at the base of the toes,toes palm of newborn, it grasps the
grasps around very small object. Diminishes by 3 month of
object.Diminishs by 8 months of age
age
 NEWBORN REFLEXES

Step reflex:-
When holding the infant upright with legs and feet
touching a surface, the infant will move the legs like
steps or walking

Disappearance:
-About 3-4 months of age
 NEWBORN REFLEXES
Startle Reflex :- Startle reflex is different
from Moro reflex in the sense that it lacks full extension
and hand opening and can be elicited spontaneously by
sudden noise or movement. Disappear at 4 month
PERCEPTUAL SKILLS IN NEONATES
Perceptual skills include vision, hearing, smell, taste, and touch

VISION
• within the first month, their eye movement begins to strengthen.
• They can distinguish light from dark at birth.
• Prefer stripes and curved lines
• At birth lens, nerves and muscles of the eye are just developing
• Newborns can’t see small objects that are far away
• Prefer and identify mother’s face
 Newborns prefer to look at patterned figures rather
than plain figure. As they grow older they focus on
more complex patterns

Newborns initially look around the edge of image

to develop a unified whole,
1 month
2 months 3 months 4 months
Very fuzzy
image
HEARING Perception
• develops in utero and is fully operative at birth. auditory perception
appears to be influenced by prenatal experiences with sounds. For
example, newborns prefer listening to their own mother’s voice
over the voice of another woman.
• At birth
– Can hear better than they can see
– Can be startled by loud noises
– Can turn toward soft sounds
Can discriminate among sounds that differ in loudness, duration, direction, and
frequency/pitch
 Touch Perception
• The sense of touch develop before birth
• Newborns are sensitive to warm and cold- can understand well
the difference when placed on their cheeks
• A touch on lip –Suckling movement
• Sensitive to painful stimuli like needle pricks

Taste Perception
• Sensory receptors-taste buds on the tongue

• Newborns can distinguish sweet, bitter, and sour

tastes and show preference for sweet

• Sensitivity to taste present even before birth

 Smell
• Sensory receptors of smell are present in the nasal
passage
• Response positively to pleasant smell(Vanilla, Strawberry)
and negatively towards unpleasant smell(Rotten eggs, Fish
smell)
• Just after birth infants when placed down between
mother’s breast –they spontaneously latch on to nipple
and starts sucking within an hour
 NEEDS OF NEWBORN
• Love and affection
•Human contact and Sensory
stimulation
•Sucking and Breast feeding 2-3 hours
•Maintain body temperature
• Hygienic needs
• Prevention of injury/aspiration
• Prevention of infection and injury
•Provision of optimal nutrition
•Watch for danger signs of newborn like