When you have birthed your baby, he or she will be given a thorough examination by one of Origin’s panel of paediatricians. But what exactly are they looking for, and why? Drs Hennie Liebenberg and Wayne Hough are the two latest paediatricians to join Origin’s team, and they explain all.
All babies should have an examination within the first few days of life to exclude major abnormalities or, if an abnormality is diagnosed before birth, to attend to the problem as soon as possible after birth. The initial newborn examination is the first opportunity to assess the medical status of the newborn thoroughly, and may be the beginning of a long relationship between the paed, the patient and the family.
This examination includes a detailed review of the mother’s medical history, pregnancy history, and detailed report of the labour and delivery – including the gestation at which baby is born, the mother’s blood group and other relevant maternal blood results.
The weight, height and head circumference of the newborn are measured and plotted on a growth chart.
The vital signs, which include the heart rate, respiratory rate, oxygen saturation in the blood and temperature, are measured. The blood sugar level is also measured after the first feed (or earlier, depending on the situation).
A detailed head-to-toe examination is then performed to exclude major abnormalities. This examination includes:
· Head size and shape, swellings on scalp due to labour, fontanelles and sutures
· Eyes, ears and nose
· Mouth size and shape, tongue and oral cavity including hard and soft palate
· Jaw size
· Neck and spine/back
· Cardiac and respiratory examination
· Abdominal and umbilical examination
· Hips and limbs
· Genitalia and anus.
Sometimes paediatricians are asked to be present at the birth when the risk of having newborn complications is high, such as:
· After a difficult/prolonged labour or assisted delivery (including c-section)
· Where there is a known congenital abnormality which needs urgent/immediate attention
· In the case of premature labour
· Where there is maternal infection.
The paediatrician will examine the baby for the next 2 to 3 days to make sure that urine and stool are passed, to monitor the blood sugar level, monitor the weight, attend to any problems or questions the mother has, and to make sure that the newborn’s blood results are sent for analysis and followed up on. As our paediatricians say, they become their patient’s advocate, which is not only a big privilege but also a big responsibility, and something that they take great pride in.