Newborn Physical Assessment

Normal findings for full-term neonates:

Posture

General Appearance
Flexed, with good muscle tone

Skin

Soft, smooth, good turgor

Possible peeling and dryness of hands and feet
Erythema toxicum, Mongolian spots Vernix caseosa,
Lanugo, Milia

Color/Perfu
sion

Pink/ruddyacrocyanosis; Brisk capillary refill (2secs)

Respiratory
rate

Heart rate

Vital Signs
30-60 per minute; short periods of periodic breathing
Passing tachypnea
Breath sounds clear
Respirations shallow and irregular
Breathing is abdominal and movements are symmetric

110-160 per minute (100 when asleep 180 when crying)

Temperatur 97.5 99.3 F (36.5 37.5C)

e
Axillary temperature preferred (one rectal temp may be
done initially to assess for rectal patency)
Weight

5lb 8oz 8lb 13oz

Weight loss of 5-10% normal in first few days
Should return to birth weight by first week

Length

45-55cm (17.5 21.5 in)

Head
Circumfere
nce
Chest
Circumfere
nce

31-38 cm

31-36 cm

HeadTo-Toe Assessment
Head

Face
Nose
Mouth
Eyes

Ear

Neck
Chest

Abdomen

Genitals

Extremities

Spine
Hips

Reflexes
Rooting
Sucking
Grasp
Moro/Startle
Babinski
Step, dance
Tonic neck
(Fencing)
Senses
Vision
Hearing

Vaginal birth molding evident

Cesarean birth well rounded, unless labor preceded surgical intervention
Anterior/posterior fontanels palpable, flat, soft
No bruising, abrasions, swelling
Cephalhematoma or caput present or absent
Symmetrical facial movement
Milia on nose/chin
Nares patent bilaterally
Mouth midline, symmetric, mucous membranes pink, palate intact
Symmetric
Sclera white to bluish white
Strabismus and nystagmus possible
Pinna recoils
Placement in line with eyes
Abnormal shape placement or rotation should be documented
Short; symmetric; supple
Round, symmetric, slightly smaller than head
Areola stippled, raised
No crepitation; clavicles intact
Protrudes, no distension
Umbilical cord has 2 arteries and 1 vein
Bowel sounds present
Passing meconium/patent anus
Female labia majora covers clitoris and labia minora
Vaginal opening patent
Vaginal discharge possible (white or pinkish/bloody)
Male penis straight; Urethral opening at the end of the penis
Testes palpable in scrotum
Symmetric, flexed, nail beds pink
Three creases in palm (one continuous crease across palm is a finding associated
with Downs Syndrome)
No creases on plantar surface
Straight, at midline
No sacral dimple of tuft of hair
No clunk noted with manipulation of hips
Leg folds symmetrical
Knees height level with each other
Stroke cheek head turns toward touch
Present; well developed at birth
Pressure on palms or soles of feet causes flexion of fingers or toes
Immediate, bilateral, symmetrical response to sudden jarring or abrupt change in
equilibrium
Stroke lateral plantar surface toes flare out
Stepping movements noted when held upright
Lying on back with head turned to one side, arm and leg on same side
extended/opposite arm/leg flexed
Normal term infant sees clearly 9-12 inches away from eyes
Newborns turn toward sound; can discriminate parents voices; mothers voice

Taste
Smell
Touch

preferred
Can taste; prefers sweet over salty
Highly sensitive sense of smell; physiologic change when exposed to strong odors
Very sensitive to touch and pain