Newborn assessment

Rationale

Primary care physicians play a vital role in identifying newborns 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 the newborn.

Key Objectives

Given a newborn that is brought in for routine assessment, the candidate will conduct a skilled and comprehensive assessment to identify any significant abnormalities or risk factors and counsel caregivers on newborn care.

Enabling Objectives

Given a newborn that is brought in for routine assessment, the candidate will

1. list and interpret critical clinical findings, including those based on
   1. a maternal and perinatal history (e.g., intrapartum fever, medications, parental genetics, prenatal care),
   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, femoral pulses, hip examination for developmental dysplasia), and
   6. caregiver concerns;
2. list critical investigations and interpret the results of the investigations, including
   1. screening tests for acute illness (e.g., serum glucose level),
   2. screening tests for clinical abnormalities (e.g., echocardiography, genetic testing), and
   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 caregivers regarding breastfeeding and infant nutrition,
   3. counselling caregivers about routine infant care (e.g., umbilical cord care) and safety (e.g., car seat, preventive measures against sudden infant death syndrome),
   4. discussing newborn metabolic screening with caregivers,
   5. advising caregivers of schedule for routine follow-up visits and immunizations, and
   6. addressing any caregiver concerns.