Newborn Examination

• Active?
• Appearance — Normal / Abnormal
• Dysmorphic? What are the dysmorphic features?
• Colour: Pink / Pale / Cyanosis (peripheral / central) / Jaundiced

• Skin lesion? (e.g. Petechiae, Café-au-lait spots)

• Fontanelle — Normal / Sunken / Depressed / Bulging
• Sutures — Normal / Abnormal
• Abnormal swelling? — Cephalhaematoma / Subaponeurotic haemorrhage / Encephalocoele

• Red reflex — present / absent
• Eye discharge — present / absent
• Cornea — clear / cloudy
• Eye haemorrhage — present / absent

• Normal / Abnormal

• Normal / Abnormal

Cleft palate: present / absent
Cleft lips: present / absent

• Neck swelling — present / absent

• Stridor?
• Tachypnoea?
• Nasal flaring?
• Grunting?
• Subcostal / Intercostal / Suprasternal recession?

• Heart murmur — present / absent
• Femoral pulses — present / low volume / absent

• Shape — normal / distended / scaphoid
• Umbilicus
– Umbilical artery — single (abnormal) / two
– Hernia — present (abnormal) / absent
– Foul-smelling / Discharge / Bleeding
– Periumbilical flare
• Hepatomegaly?
• Splenomegaly?
• Kidney palpable?

• Other abnormalities e.g. Omphalocele 

• Male or female?

Male genitalia
– Testes — descended / undescended
– Hydrocoele — present (abnormal)/ absent
– Hypospadias — present (abnormal)/ absent

• Spine — normal / spinal defect / sinus / tuft of hair / swelling
• Barlow’s — positive (abnormal) / negative
• Ortolani — positive (abnormal) / negative

• Congenital Talipes Equinovarus — present (abnormal) / absent. If present:
– Fixed / Positioned
– Right / Left / Bilateral

• Grasp reflex — Present / Absent (abnormal)
• Moro reflex — Complete / Incomplete (abnormal) / absent (abnormal). If incomplete / absent:
– Bilateral / Left / Right
• Sucking reflex — Present / Absent (abnormal)
• Tone — Normal / Flaccid (abnormal)/ Increased (abnormal). If abnormal:
– Bilateral / Left / Right

Square window (wrist)
• Wrist flexibility and/or resistance to extensor stretching are responsible for the resulting angle of flexion at the wrist.
• Video

Arm recoil
• Take infant’s hand → briefly set flex elbow → momentarily extend elbow → release hand
• Note the angle of recoil of the arm
• Video

Popliteal angle
• Hip is flexed to 90°and the knee is extended to a point where it becomes tight.
• Video

Scarf sign
• Bring one arm across the infant’s chest until. resistance is met
• Video .

Heel to ear
• Video