BABY CHECK

SIZE
Weight / Gestational Age / Plot Growth & Weight on Centile Chart

GENERAL OBSERVATION
Colour / Movement / Posture / Gross facies or dysmorphic features

CHEST
Do chest first... especially when baby is relaxed... otherwise difficult to listen to the chest..
Respiratory Rate (Put hand on the chest wall and count... comment: chest moves symmetricall, respi rate is.... per minute)
Auscultate Heart (heart sounds are normal)

ABDO + GENITALIA
Palpate abdomen
Liver / Spleen / Mass
Bowel sound
(Abdomen is soft and non-tender.. no masses felt.. but liver might be palpable subcostally sometimes... around 1 cm below the costal margin,
tip of the spleen may be felt too... then feel for left iliac fossa... if there are sort of 'masses' there.. must check for imperforate anus...)
Descended testes
(look... then comment... genitalia looks normal, testes are descended bilaterally)

FEMORAL PULSES
Present?
Equal?
Good volume?
(Coarctation of aorta --> reduced pulse pressure, PDA ---> increased pulse pressure)

PLANTAR REFLEX
Press on plantar arch (plantar reflex is present... up going or down going also okay both are normal...)
Number of toes?

HEAD
feel for fontanelle / sutures / head symmetry (comment.. fontanelle is soft and head is symmetrical)
Eyes, ears, nose, mouth (eyes, ears, nose and mouth are normal.. the upper 1/3 of the ears should be above the eye line... otherwise can say that there are low set ears)
Sucking reflex... then feel for palate with little finger.. any cleft palate/lip?

HANDS/PALMS
Count fingers...
Check.. for palmar crease... (single palmar crease may be present in normal babies)
Check for grasp reflex...
Then try to pull baby up to check for head lag... (can comment on the muscle tone and head lag..)

WHEN BABY IS HELD SITTING UP.....
do the Moro reflex...
Next... hold the baby up in ventral suspension
(comment... muscle tone is normal)
Check for midline.. run finger thru midline...
(comment: there are no tufts or pits along the midline)
Check for anus..
(comment: there is no imperforate anus)

Measure..Occipito-frontal circumference (get the biggest circumference... do 3 times... )
Red eye reflex (present... no cataract)
Hips
Barlow (bend and adduct knees, thumbs on midshaft of femur medially... middle fingers on the greater trochanter laterally.. try to dislocate hip/head of femur posteriorly and laterally)
Ortolani (bend and abduct knees, thumbs on midshaft of femur medially..
middle fingers on the greater trochanter laterally... try to push the head of the femur back into position... anteriorly and medially...)

NB: leave the measurement of the OFC , red reflex and hip dislocation tests at the end.. as they are uncomfortable...


The baby is NORMAL... yay!!!!