5.5 The Newborn
Learning Objectives
- Describe two common procedures to assess the condition of the newborn.
- Describe problems newborns experience before, during, and after birth.
- Explain the merits of breastfeeding
- Discuss the importance of nutrition to early physical growth, including nutritional concerns for infants and toddlers such as marasmus and kwashiorkor
Assessing the Neonate
The Apgar assessment is conducted at one minute and five minutes after birth. This is a very quick way to assess the newborn’s overall condition. Five measures are assessed: Heart rate, respiration, muscle tone (assessed by touching the baby’s palm), reflex response (the Babinski reflex is tested), and color. A score of 0 to 2 is given on each feature examined. An Apgar of 5 or less is cause for concern. The second Apgar should indicate improvement with a higher score (see Figure 5.18).
Another way to assess the condition of the newborn is the Neonatal Behavioral Assessment Scale (NBAS). The baby’s motor development, muscle tone, and stress response are assessed. This tool has been used around the world to further assess newborn, especially those with low Apgar scores, and to make comparisons of infants in different cultures (Brazelton & Nugent, 1995).
Watch It
Watch this video that explains how to calculate the Apgar score for a newborn.
You can view the transcript for “APGAR Score – MEDZCOOL” here (opens in new window).
Problems of the Newborn
Anoxia
Anoxia is a temporary lack of oxygen to the brain. Difficulty during delivery may lead to anoxia which can result in brain damage or in severe cases, death. Babies who suffer both low birth weight and anoxia are more likely to suffer learning disabilities later in life as well.
Low birth weight
We previously discussed a number of teratogens associated with low birth weight such as alcohol, tobacco, and so on. A child is considered low birth weight if he or she weighs less than 5 pounds 8 ounces (2500 grams). About 8.2 percent of babies born in the United States are of low birth weight (Center for Disease Control, 2015a). A low birth weight baby has difficulty maintaining adequate body temperature because it lacks the fat that would otherwise provide insulation. Such babies are also at more risk for infection, and 67 percent of these babies are also preterm which can increase their risk for respiratory infection. Very low birth weight babies (2 pounds or less) have an increased risk of developing cerebral palsy.
Additionally, Pettersson et al. (2019) analyzed fetal growth and found that reduced birth weight was correlated with a small, but significant increase in several psychiatric disorders in adulthood. These include attention-deficit/hyperactivity disorder, autism, depression, and obsessive-compulsive disorder. Pettersson et al. theorized that “reduced fetal growth compromises brain development during a critical period, which in turn slightly increases the risk not only for neurodevelopmental disorders but a