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Newborn: Development, Screening & Care

A newborn is a child in the first 28 days of life. During this phase, the body adapts rapidly to life outside the womb.

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Things worth knowing about "Newborn"

A newborn is a child in the first 28 days of life. During this phase, the body adapts rapidly to life outside the womb.

What Is a Newborn?

A newborn (medically referred to as a neonate) is a child from the moment of birth through the end of the 28th day of life. This early phase is medically significant because the infant's body must rapidly adapt to conditions outside the womb. The neonatal period falls under the specialty of neonatology, a branch of pediatrics focused on the medical care of newborns, including those born prematurely or with health complications.

Physiological Adaptations After Birth

Immediately after birth, a newborn undergoes a series of critical physiological transitions:

Breathing: The infant must begin breathing independently. The first cry inflates the lungs and triggers essential cardiovascular changes.
Circulation: The fetal circulation, which relied on the placenta, transitions to an independent pulmonary circulation. Certain fetal blood vessel connections (e.g., the ductus arteriosus) close within the first hours of life.
Thermoregulation: Newborns are unable to maintain a stable body temperature on their own and require external warmth.
Feeding: The infant begins taking nutrition by suckling at the breast or bottle. Breast milk is considered the optimal nutrition for newborns.

Assessment of the Newborn – The APGAR Score

Immediately after birth, the condition of the newborn is evaluated using the APGAR score. This assessment is performed at 1, 5, and 10 minutes after birth and evaluates five criteria:

Appearance (skin color)
Pulse (heart rate)
Grimace (reflex irritability)
Activity (muscle tone)
Respiration (breathing effort)

A score of 7–10 is considered normal. Lower scores indicate that the newborn may need medical support to adapt to life outside the womb.

Newborn Screening and Preventive Care

Shortly after birth, several important preventive health measures are carried out:

Newborn metabolic screening: A heel-prick blood test screens for more than 20 congenital metabolic and hormonal disorders, such as phenylketonuria (PKU) and congenital hypothyroidism.
Hearing screening: Both ears are tested using painless methods to detect any hearing impairment early.
Newborn physical examination: A thorough check of general health, reflexes, organ maturity, and potential congenital abnormalities is performed shortly after birth and again within the first days of life.
Vitamin K prophylaxis: To prevent hemorrhagic disease of the newborn, vitamin K is administered orally in multiple doses during the first weeks of life.

Common Health Features in Newborns

Some findings in newborns are entirely normal and resolve on their own:

Neonatal jaundice (icterus neonatorum): A temporary yellowing of the skin caused by elevated bilirubin levels. It affects approximately 60% of all newborns and is usually harmless.
Weight loss: Newborns physiologically lose up to 10% of their birth weight in the first few days, typically regaining it by the 10th day of life.
Skin changes: Conditions such as erythema toxicum neonatorum are benign and resolve spontaneously.

Other conditions require prompt medical attention, including respiratory distress, severe jaundice, fever, or poor feeding.

Care and Support of the Newborn

For healthy development, newborns need warmth, close physical contact, regular feeding (8–12 times per day), and loving attention. Skin-to-skin contact (bonding) immediately after birth promotes attachment between the child and parents and supports the newborn's physiological adaptation. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life as the ideal form of nutrition.

References

World Health Organization (WHO): Newborn health. Available at: https://www.who.int/health-topics/newborn-health (accessed 2024).
Fanaroff, A.A., Fanaroff, J.M.: Klaus and Fanaroff's Care of the High-Risk Neonate. 7th ed. Elsevier, Philadelphia 2020.
American Academy of Pediatrics (AAP): Newborn and Infant Screening Recommendations. Available at: https://www.aap.org (accessed 2024).

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