Newborn assessment

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.