Normal Newborn (Neonate) Full-term Born between end of week 37 and end of week 42

Neonatal periodfrom birth to 28 days

Preterm (premature): born after 20th week and before completion of 37th week of gestation, regardless
of weight
Post-term (post-mature): born after 42 weeks of gestation, regardless of weight

Immediate Goals of Newborn Care:

Establish and maintain an airway and support respirations
Maintain warmth and prevent hypothermia
Protection from injury, infection, or hemorrhage
Identify actual or potential problems that might require immediate attention
Facilitate parent-infant interaction

Initiation of Respirations:
First vital task in newborn adaptation to extrauterine life.
Lungs at birth collapsed and fluid-filled. Large force required for first breath.
First breath: forceful contraction of the diaphragm, causing air to enter lungs and expand lungs
Increased oxygen content of blood in the lungs contributes to the closing of the ductus arteriosus

Cardiovascular
Fetal circulation is marked by right-to-left shunting of blood around the unventilated lungs through a
patent ductus arteriosus (connecting the pulmonary artery to the aorta) and foramen ovale (connecting
the right and left atria). Shunting is encouraged by high pulmonary arteriolar resistance and relatively
low resistance to blood flow in the systemic (including placental) circulation.
Profound changes to this system occur after the first breath.
Pressures in the left atrium are greater than in the right, causing the foreman ovale to close
Increased pressures contribute to the closing of the ductus arteriosus

Hepatic Portal Circulation

Ductus venosus closes (becomes a ligament); hepatic portal circulation begins

Thermoregulation-Drop in temperature
Skin is thin with little insulating fat and blood vessels close to skin surface
Poor mechanisms for body temperature regulation during first days of life
Body temperature maintained through a flexed posture and brown adipose tissue
Flexed position reduces heat loss

Apgar Scoring-Evaluates the newborns physical condition at birth (1 & 5 minutes): Based on: Heart
rate Respiratory effort Muscle tone Reflex irritability Color
Score: 0, 1, 2 Heart rate: Absent Slow (below 100) Over 100
Respiratory: Absent Slow, irregular, weak Good cry
Muscle tone: Flaccid Some flexion Well flexed
Reflex: No response Grimace Vigorous cry
Color: Blue, pale Body pink/extremity blue Completely pink
Scores of 0 to 3 represent severe distress;
Scores of 4 to 6 signify moderate difficulty;
Scores of 7 to 10 indicate absence of difficulty