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Skin
Skin reddish in color, smooth and puffy at birth
Edema around eyes, feet and genitals
Vernix CaseosaLanugo
Deviations
Jaundice within 24 hours of birthCircumoral cyanosis between feedingsRashes other than erythema toxicumHemangiomaPetechiaeSkin tags or extra digitsHarlequin color changes
Head
Anterior fontanel diamond shapedPosterior fontanel triangular shapedFontanels soft, firm and flatSutures palpable with small separation
between each
CHOANAL ATRESIA
Bilateral choanal atresia is easily recognized immediately after birth.
Signs may include pink while crying, becoming cyanotic and struggling for air when quiet (even with
good respiratory effort).
Inability to gently pass a small (3F) catheter through the nares into the pharynx suggests the diagnosis.
Problems arise because infants usually breath through their noses.
Mouth and Throat
Minimal or absent salivationTongue moves freely and doesn’t protrudeWell developed fat pads bilateral cheeksSucking, Rooting, and Gag reflexes
Deviations
WebbingLarge fat pad on back of neckPalpable crepitus, movement with palpation
of clavicle
Abdomen
Dome shapeSoft to palpationWell formed umbilical cordThree vessels in cordBilateral equal femoral pulsesBowel soundsVoiding within 24 hours of birthMeconium within 24 - 48 hours of birth
Deviations
Umbilical herniaPeristaltic waves visibleRedness or drainage at base of cordDistention or scaphoid shaped
Female Genitalia
Edematous labia and clitorisLabia majora are larger and surrounding
labia minoraVernix between labia
Common Variations
Hymenal tagPseudomenstruationSmegmaIncreased pigmentation“Brick dust” urine due to uric acid crystals
Male Genitalia
Urinary meatus at tip of glans penisPalpable testes in scrotumLarge, edematous, pendulous scrotum with
rugaeSmegma
Deviations
Limitation of movementSpina BifidaTuft of hairImperforate anusAnal fissuresPilonidal cysts
Extremities
Full range of motionEqual and bilateral movement and toneLegs appear bowedGrasp reflexNo hip click