Medical Council of Canada

Medical expert

Newborn Assessment - 74-1

Rationale

Primary care physicians play a vital role in identifying children at risk for disorders that are threatening to life or long-term health before they become symptomatic. In most cases, caregivers require reassurance and anticipatory guidance regarding the health of their newborn infant.

Key Objectives

Given a newborn presenting for routine assessment the candidate will conduct a skilled and comprehensive assessment to identify any significant abnormalities or risk factors and counsel caregiver(s) on newborn care.

Enabling Objectives

Given a newborn for routine assessment, the candidate will

  1. list and interpret critical clinical findings, including
    1. maternal and perinatal history (e.g., intrapartum fever, medications);
    2. neonatal history (e.g., Apgar scores, feeding and elimination);
    3. psychosocial history (e.g., maternal mental health, home environment, family supports);
    4. systematic newborn physical examination, with particular attention to indications of an acute illness (e.g., jaundice, hydration status);
    5. screening for important congenital malformations (e.g., red reflex, heart murmur);
    6. caregiver(s)' concerns;
  2. list and interpret critical investigations, including
    1. screening tests for acute illness (e.g., serum glucose);
    2. screening tests for clinical abnormalities (e.g., echocardiogram, genetic testing);
    3. bilirubin measurement;
  3. construct an effective initial management plan, including
    1. managing any acute illness appropriately, including referral for specialized care if needed;
    2. counselling caregiver(s) regarding breastfeeding and infant nutrition;
    3. counselling caregiver(s) about routine infant care (e.g., umbilical cord care) and safety (e.g., car seat, prevention of sudden infant death syndrome);
    4. discussing with caregiver(s) newborn metabolic screening;
    5. addressing any parental concerns.
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