- Episode Written By : Kyla Freeman PGY2 Rural Family Medicine
- Episode Reviewed By : Dr. Ram Venkata, Paediatrician
- Hosts : Kyla Freeman & Patricia Massel
- Episode Art : Aikansha Chawla
Today’s episode and episode 10 will focus on the newborn exam. The newborn exam can be completed quickly, but careful attention needs to be paid for any abnormalities. With these episodes we hope to highlight common and critical abnormalities, the differentials for abnormal findings, and at times touch on workup and management. Part 1 is all about the head and face. We will talk about head shape and size, fontanelles, sutures, eyes, ears, and mouth. Part 2 tackles common birth trauma injuries, cardiac, respiratory, abdominal, genitourinary, and dermatologic conditions. Resource wise there will be one hand-out for both episodes.
Quick Links to Useful Resources
- CPS Hypoglycemia https://cps.ca/documents/position/newborns-at-risk-for-low-blood-glucose
- CPS Hyperbilirubinemia https://cps.ca/documents/position/hyperbilirubinemia-newborn
- CPS Facilitating Discharge https://cps.ca/documents/position/facilitating-discharge-from-hospital-of-the-healthy-term-infant
- CPS Tongue Tie https://cps.ca/en/documents/position/ankyloglossia-breastfeeding
- BCCH Positional Plagiocephaly http://www.bcchildrens.ca/neurosciences-site/Documents/BCCH034PlagiocephalyCliniciansGuideWeb1.pdf
- The Newborn Foot Exam https://www.aafp.org/afp/2004/0215/p865.html
- UBC Learn Pediatrics https://learn.pediatrics.ubc.ca/body-systems/cardiology/approach-to-pediatric-tachycardia/
- Pictures of Rashes https://dermnetnz.org/
References – Part 1
- Amit M, Canadian Paediatric Society, Community Paediatrics Committee. Vision screening in infants, children and youth. Paediatr Child Health 2009;14(4):246-248. Reaffirmed 2018. https://cps.ca/documents/position/children-vision-screening
- BC Children’s Hospital. A clinician’s guide to positional plagiocephaly : Everything you need to understand, prevent, identify, and treat positional plagiocephaly. http://www.bcchildrens.ca/neurosciences-site/Documents/BCCH034PlagiocephalyCliniciansGuideWeb1.pdf. June 2008
- Buchanan EP. Overview of craniosynostosis. Editors Weisman LE, Firth HV. https://www.uptodate.com/contents/overview-of-craniosynostosis?search=craniosynostosis&source=search_result&selectedTitle=1~64&usage_type=default&display_rank=1#H1377304. Updated May 4, 2021.
- Centers for Disease Control and Prevention. Birth Defects : Microcephaly. https://www.cdc.gov/ncbddd/birthdefects/microcephaly.html. Last updated October 23, 2020.
- Centre of Disease Control and Prevention. Facts about craniosynostosis. https://www.cdc.gov/ncbddd/birthdefects/craniosynostosis.html. Last updated October 23, 2020.
- CMV Programs : BC Children’s Pilot Program for CMV testing http://www.bcchildrens.ca/about/news-stories/stories/improving-hearing-in-newborns
- Definition of sacral promontory : https://www.merriam-webster.com/medical/sacral%20promontory
- Dominguez M. Neonatal Birth Injuries. https://step2.medbullets.com/pediatrics/121783/neonatal-birth-injuries. Updated December 29, 2021.
- Drutz JE. The pediatric physical examination: HEENT. Editor Duryea TK. Last updated July 2021. https://www.uptodate.com/contents/the-pediatric-physical-examination-heent?search=red%20ligth%20reflex%20&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H20
- Grantt Sm Bitnun A, Renaud C, Kakkar Fm Vaudry W. Diagnosis and management of infants with congenital cytomegalovirus infection. Paediatrics & Child Health.2017;22(2):72-72. doi: 10.1093/pch/pxx002
- How to test for the red reflex in a child. Community Eye Health. 2014;27(86):36. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194850/
- Isaacson GC. Congenital anomalies of the ear. Editors Messner AH, Firth HV. https://www.uptodate.com/contents/congenital-anomalies-of-the-ear?sectionName=Preauricular%20pits&search=newborn%20head%20molding&topicRef=4984&anchor=H9&source=see_link#H9. Last updated January 21, 2022.
- Isaacson GC. Ankyloglossia (tongue-tie) in infants and children. Editor Messner AH. https://www.uptodate.com/contents/ankyloglossia-tongue-tie-in-infants-and-children?search=ankyloglossia&source=search_result&selectedTitle=1~16&usage_type=default&display_rank=1#H3. Last updated March 12, 2021.
- Jadcherla SR. Neonatal oral feeding difficulties due to sucking and swallowing disorders. Editor Abrams SA. https://www.uptodate.com/contents/neonatal-oral-feeding-difficulties-due-to-sucking-and-swallowing-disorders?search=newborn%20suck&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H1. Last updated March 21, 2020.
- Jones S, Samanta D. Macrocephaly. [Updated 2021 Jul 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560786/
- Kaufman PL, Kim J, Berry JL. Approach to the child with leukocoria. Edito Paysse EA. Last updated April 5, 2021. https://www.uptodate.com/contents/approach-to-the-child-with-leukocoria?search=red%20ligth%20reflex%20&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
- Lipsett BJ, Reddy V, Steanson K. Anatomy, Head and Neck, Fontanelles. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542197/
- Maternal Newborn Child & Youth Strategic Clinical Network. Alberta Pregnancy Pathways. https://www.albertahealthservices.ca/assets/about/scn/ahs-scn-mncy-pp-nb-pathway.pdf. September 2020.
- McKee-Garrett, T. Assessment of the newborn infant. Editors Martin R, Duryea TK. https://www.uptodate.com/contents/assessment-of-the-newborn-infant?search=newborn%20head%20molding&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H866248920. Last updated October 7, 2021.
- McKee-Garrett, TM. Neonatal birth injuries. Editors Weisman LE, Phillips WA, Patterson MC. https://www.uptodate.com/contents/neonatal-birth-injuries?search=cephalohematoma&source=search_result&selectedTitle=1~23&usage_type=default&display_rank=1#H7. Last updated November 23, 2021.
- Narvey MR, Marks SD, Canadian Paediatric Society, Fetus and Newborn Committee. Paediatr Child Health. 2019;24(8):536-544. https://cps.ca/documents/position/newborns-at-risk-for-low-blood-glucose.
- Nelson CRM, Demarsh A, Miller SP, Morris SK, Moore Hepburn C, Bitnun A, Moore A, et al. Small bite, big problem: Understanding severe microcephaly in Canada. Paediatrics & Child Health. 2017; 504-505. https://pcsp.cps.ca/uploads/publications/Highlight-Understanding-severe-microcephaly-in-Canada.pdf
- Newborn screening Ontario. Hearing Loss RTisk Factor Screening. https://www.newbornscreening.on.ca/en/page/congenital-cytomegalovirus. Last updated 2022.
- Ostermaier KK. Down syndrome: Clinical features and diagnosis. Editors Drutz JE, Firth HV. https://www.uptodate.com/contents/down-syndrome-clinical-features-and-diagnosis?search=dysmorphic%20features&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2. Last updated December 14, 2020.
- Provincial Health Services Authority. Hearing Testing. http://www.phsa.ca/our-services/programs-services/bc-early-hearing-program/hearing-testing. Last updated 2022.
- Roth DA, Lubin D, Kuint J, Teperberg-Oikawa M, Mendelson E, Strauss T, Barkai G. Contribution of targeted saliva screening for congenital CMV-related hearing loss in newborns who fail hearing screening. Dis Child Fetal Neonatal Ed. 2017;102;F519-524. doi:10.1136/archdischild-2016-311859
- Rowan-Legg A, Canadian Paediatric Society, Community Paediatrics Committee. Position statement : Ankyloglossia and breastfeeding. 2015;20(4):209-13. https://cps.ca/en/documents/position/ankyloglossia-breastfeeding
- Weitzman C, Rojmahamongkol P. Fetal alcohol spectrum disorder: Clinical features and diagnosis. Editor Voigt RG. https://www.uptodate.com/contents/fetal-alcohol-spectrum-disorder-clinical-features-and-diagnosis?search=FASD%20exam&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2. Last updated April 28, 2020.
- World Health Organization. The history of zika virus. https://www.who.int/news-room/feature-stories/detail/the-history-of-zika-virus. February 7, 2016.