1. Immediate Newborn Assessment 👶

APGAR Score (1 min and 5 min)

Sign	0	1	2
Appearance (color)	Blue/pale	Pink body, blue extremities	Completely pink
Pulse	Absent	<100	≥100
Grimace (reflex)	No response	Grimace	Cry, cough
Activity (tone)	Limp	Some flexion	Active
Respiration	Absent	Slow, irregular	Good, crying

Score: 7-10 = Normal, 4-6 = Moderate depression, 0-3 = Severe depression

Essential Newborn Care (EINC)

Immediate drying: With dry cloth, remove wet cloth
Skin-to-skin contact: Immediately after birth
Delayed cord clamping: 1-3 minutes after birth
Early breastfeeding: Within first hour

2. Normal Newborn Vital Signs 💓

Heart Rate

Normal: 120-160 bpm

During crying: Up to 180 bpm

Respiratory Rate

Normal: 30-60 breaths/min

Abdominal breathing is normal

Temperature

Axillary: 36.5-37.5°C

Prevent hypothermia! Skin-to-skin

Weight

Average: 2,500-4,000 grams

LBW: <2,500g | VLBW: <1,500g

3. Breastfeeding 🤱

Benefits of Breastfeeding

Baby: Complete nutrition, antibodies (IgA), bonding, reduces infections
Mother: Uterine involution, weight loss, bonding, delays ovulation
Colostrum: First milk (yellow), rich in antibodies and protein

Proper Latch (Attachment)

Mouth wide open
Lower lip turned outward (flanged)
Chin touching breast
More areola visible above than below
Slow, deep sucks with audible swallowing

Common Breastfeeding Problems

Engorgement: Warm compress before feeding, cold after
Cracked nipples: Correct latch, apply breast milk
Mastitis: Continue breastfeeding, antibiotics if needed

4. Common Newborn Conditions 🩺

Physiologic Jaundice

Appears after 24 hours of life
Peaks at 3-5 days, resolves by 2 weeks
Frequent breastfeeding helps

Pathologic Jaundice (Red Flags)

Appears within first 24 hours
Bilirubin rises rapidly
May need phototherapy or exchange transfusion

Umbilical Cord Care

Keep dry and clean (dry cord care)
Falls off in 7-14 days
Signs of infection: Redness, foul odor, discharge

Normal Variations

Milia (white spots on nose)
Mongolian spots (blue-gray on buttocks)
Erythema toxicum (red blotches)

💡 Board Exam Tips - Infant Care

✓ APGAR: Appearance, Pulse, Grimace, Activity, Respiration
✓ Jaundice within 24 hrs = Pathologic (needs immediate workup)
✓ Exclusive breastfeeding for first 6 months (WHO recommendation)

Infant Care