Care of the Well Newborn

Lisa Stellwagen; Eyla Boies

doi:10.1542/pir.27-3-89

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Lisa Stellwagen, MD*
Eyla Boies, MD†

^*Associate Clinical Professor of Pediatrics, Division of Neonatology; Director of the Well Baby Unit, University of California, San Diego, Medical Center, San Diego, Calif
^†Clinical Professor of Pediatrics, Division of General Academic Pediatrics, University of California, San Diego, Medical Center, San Diego, Calif

Objectives

After completing this article, readers should be able to:

Describe the purpose of the prenatal visit.
Recognize the significance of common abnormalities found on prenatal ultrasonography.
Discuss the importance of growth and maturity assessment as well as the careful examination of the newborn.
Delineate prevention strategies for hepatitis B, syphilis, and group B streptococcal infections.
Explain the basics of car seat safety and sudden infant death syndrome prevention in the newborn unit.
List the basic tenets of providing breastfeeding support for the breastfeeding mother and infant.
Explain appropriate outpatient follow-up for the healthy newborn.

Introduction

Recent advances in obstetrics and pediatrics have brought about numerous changes in the care of the healthy newborn and have led to a re-evaluation of old routines, a commitment to helping mothers breastfeed their infants exclusively, and improvements in infant medical care and safety. In this article, we review the care of the newborn, including issues of antenatal testing, the prenatal visit, delivery, care on the postpartum/newborn unit, discharge from the hospital, and the first outpatient visit, emphasizing contemporary practices.

Prenatal Visit

The most important focus of the prenatal visit is to begin a positive relationship with the parents. In addition, data can be recorded about pertinent medical and psychosocial history and potential high-risk situations, and basic education of the family regarding their newborn can begin. The clinician needs to address the following:

The mother’s medical and pregnancy history, including any history of depression and use of medication, tobacco, or other substances
Maternal and paternal family medical history, including ethnicity, history of atopy, diabetes, neonatal jaundice, and children who have birth defects or serious illness
Social history, including parental employment, education, planned maternity/paternity leave, and the individuals who will be the support system for the expectant parents
Feeding plan and discussion of current breastfeeding recommendations
Anticipatory guidance
Routine …