• http://www.youtube.com/watch?v=5saiPFibVKk• http://www.youtube.com/watch?v=BgZ5z6RB06c&NR=1

The Neonate: Birth to One Month• Neonate: birth to 1

month• Physical

Development: Usually weighs 7-9 lbs and is 18-22” in length–Heredity and

maternal nutrition affect the weight and length of baby

• Newborn infant head is ¼ of it’s entire length!

Neonate…• Bones are not fixed at birth for

the purpose of delivery• This permits molding (sliding of the

bones over one another)• Molding may cause the head to

look “pointy” but will quickly disappear and become more round

• 2 Soft spots (fontanels): – Anterior, or front fontanel, is

diamond shaped• Closes between 1-2 yrs of age• Can see pulse here sometimes

– Posterior, or back fontanel, is triangular shaped• Smaller and closes by 3rd month

• Must support head!– Neck muscles weak

Newborn Skin• Usually loose and wrinkled and somewhat red

• At birth, hands may be cyanotic (bluish) and usually pinken with a few breaths

• Skin color varies first few days (temp, activity, and circulatory changes) Can look blotchy

• Skin may peel• Vernix caseosa, a white waxy substance that

protected the skin while in the uterus, may be in fold of skin

• May also have lanugo (soft downy hair) covering body

• Milia, small white bumps, are often around nose/chin and go away naturally

• Remaining umbilical cord “stump” (1-1.5”) white/waxylook and darkens prior to falling off near the 10th day

-Jaundice, yellowing of the skin, can occur first few days (liver;

too much bilirubin from RBC

break down) -whites of eyes yellow,

urine & feces dark yellow

Other Physical Characteristics• Newborn’s eyes may be puffy (traumatic

journey!)• Possible blisters on lips from thumb sucking• Breast/genitalia may be swollen (mother’s

hormones)• Closed fists.• Tend to assume fetal

position (how they were in the uterus)

Reflexes in the Newborn• Protective: Blinking, yawning, coughing,

sneezing, withdrawing from pain• Grasping: holds onto things tightly• Rooting: will turn head towards touch on

cheek– In an attempt to feed

• Sucking: reflexive upon something touching lips/mouth– Consoling to the infant

Reflexes in Newborn• Babinski: fanning of toes (hyperextension)– Stroke sole from heel to toes

• Tonic neck: (fencer position) when supine with head to side, extremities on same side straighten while the others flex

• Stepping: when held upright and one foot is placed on a flat surface, the infant will put one foot in front of the other.

Reflexes in Newborn

• Moro: Startle reflex. When the newborn is startled, they straighten, with arms and hands outward and knees flexed. Hands spread forming a “c”.

Neonate Development Physical (cont.)• Newborns cry for a

variety of reasons (for communication)

• Eat 7-8 times a day• Can see objects within

6”-8”– Brightness rather

than color• Prefer high-pitched

tones• How baby sees the w

orld

Neonate Development• Intellectual-Cognitive Development ~ –will calm if picked up and held firmly– Tune out disturbing stimulation • By sleeping

• Social Development ~ –Respond to stimulation– Establish an individual activity pattern–Responds to soft, gentle voice

Neonate Development

• Psycho-Emotional Development ~– Show excitement and distress

• Which reflex is this newborn showing?

Neonate Development• Healthcare ~–Keep warm (especially at birth) • Temp regulates respiration

–Cord care• Vitamin K injection to slow bleeding from cord

and “painted” with antibacterial solution• Daily care ~ avoid getting wet, apply alcohol

–Medicated eye drops to prevent infection• Within an hour of birth

Neonate Development• Healthcare ~– Sponge baths only…till cord falls off–Water taste test to ensure swallowing–Breastfeeding• Important that the baby nurses right

away• Assist mother with breastfeeding• Assure baby has latched on and is sucking

properly

AdvantagesBreastfeeding Bottle Feeding• Perfect balance of

nutrients for baby• Contains infection

fighting antibodies• Easily digested and

absorbed• Free• Always perfect temp.• Available any

time/place• Helps mom lose

weight

• Anyone can feed baby

DisadvantagesBreastfeeding Bottle feeding• Mother must be

available for feeding or provide pumped milk

• Mother must pump if feeding is missed

• Uncomfortable first week

• Mother has to watch what she eats/drinks

• Leaking breasts

• Cost ($100-$200 month)

• Have to warm formula

• Preparation time– Cleaning bottles– Preparing bottles

• Have to carry a lot of items with you

Discussion

• How would you feel if you saw a woman breastfeeding?

• What is your opinion of breastfeeding in public areas?

Circumcision• Boys are born with a hood of skin (foreskin) covering

the head of the penis• Circumcision ~ surgical removal of the foreskin,

exposing the head of the penis• Usually performed

within the first 48hours.

• Jewish culture/8thday of life.

• Common practice inUSA.

Discussion• What are your thoughts on circumcision?

• Will you have your sons circumcised?