|
Newborn birthweight and measurements
Your child's size and growth Average fetal length and weight chart Newborn Nutrition Q: What is the Apgar score? Q: How is the Apgar score done? Q: What does a high or low Apgar score mean? Q: When is the Apgar scoring done? Q: What does a persistently low Apgar score mean? Q: Why was the Apgar score developed? Q: How does the doctor score my baby? Q: What do the Apgar scores mean? Q: Infant development: What happens from birth to 3 months? Q: What is child development? Q: Child development and Child Growth: What's the difference? Q: What are developmental milestones? Q: Breast-feeding vs. formula: What's right for your baby? Q: Breast-feeding: Is your baby getting enough milk? Q: Baby's head shape: What's normal? Q: Do boys and girls grow at different rates? Q: When can we give our newborn baby water? Q: Is my baby supposed to have a bowel movement everyday? Q: How often should I feed my baby? Q: Newborn care: Should I wake my baby for feedings? Q: How do I know if my child is growing okay? Q: How should I keep track of my childs growth? Q: How often should my child be weighed and measured? Q: How long should I breast feed my baby? |
| Your child's size and growth |
| Average fetal length and weight chart |
|
Newborn birthweight and measurements
A baby's birthweight is an important indicator of his health. The average weight for term babies (born between 37 and 41 weeks gestation) is about 7 lbs (3.2 kg). In general, small babies and large babies are more likely to have problems. Newborn babies may lose as much as 10 percent of their birth weight. This means that a baby weighing 7 pounds 3 ounces at birth might lose as much as 10 ounces in the first few days. In most cases, the metric system is used for weighing babies. This chart will help you convert grams to pounds. Converting grams to pounds and ounces: 1 lb. = 453.59237 grams; 1 oz. = 28.349523 grams; 1000 grams = 1 kg. What other measurements are taken of the newborn? Other measurements are also taken of your baby. These include: head circumference - the distance around your baby's head (head circumference is normally about 1/2 your baby's body length plus 10 cm) abdominal circumference - the distance around the abdomen length - the measurement from crown of head to the heel |
| Newborn Nutrition |
|
What is the Apgar score?
Ninety percent of term infants make a successful and uneventful transition from living within the womb to the outside world. About 10% will need some medical intervention and approximately 1% will require extensive resuscitation. A reproducible and rapidly determined rating system is necessary for evaluation the newborn infant. The Apgar score is a practical method for assessing a neonate.
How is the Apgar score done?
The Apgar score is a number calculated by scoring the heart rate, respiratory effort, muscle tone, skin color, and reflex irritability (response to a catheter in the nostril). Each of these objective signs can receive 0, 1, or 2 points.
What does a high or low Apgar score mean?
A perfect Apgar score of 10 means an infant is in the best possible condition. An infant with an Apgar score of 0-3 needs immediate resuscitation. It is important to note that diligent care of the newborn is an immediate response to the current status of the infant. It is inappropriate to wait until Apgar scores are obtained to begin or continue to address the needs of the neonate.
When is the Apgar scoring done?
The Apgar score is done routinely 60 seconds after the birth of the infant and then is repeated five minutes after birth.
In the event of a difficult resuscitation, the Apgar score may be done again at 10, 15, and 20 minutes.
What does a persistently low Apgar score mean?
The persistence of low (0-3) Apgar scores at 20 minutes of age is predictive of high rates of morbidity (disease) and mortality (death).
Why was the Apgar score developed?
The score is named for the preeminent American anesthesiologist Dr. Virginia Apgar (1909-1974), who invented the scoring method in 1952. Having assisted at thousands of deliveries, Dr. Apgar wished to focus attention on the baby. Babies were traditionally dispatched directly to the nursery, often without much formal scrutiny after delivery. Apgar wanted the baby to be assessed in an organized meaningful manner by the delivery-room personnel. Dr. Apgar was the first woman to be appointed a full professor at Columbia University's College of Physicians and Surgeons.
How does the doctor score my baby?
It's easy to remember what's being tested by thinking of the letters in the name "Apgar": Activity, Pulse, Grimace, Appearance, and Respiration. Here's how they're used to rate your baby:
Activity (muscle tone) 0 Limp; no movement 1 Some flexion of arms and legs 2 Active motion Pulse (heart rate) 0 No heart rate 1 Fewer than 100 beats per minute 2 At least 100 beats per minute Grimace (reflex response) 0 No response to airways being suctioned 1 Grimace during suctioning 2 Grimace and pull away, cough, or sneeze during suctioning Appearance (color) 0 The baby's whole body is completely bluish-gray or pale 1 Good color in body with bluish hands or feet 2 Good color all over Respiration (breathing) 0 Not breathing 1 Weak cry; may sound like whimpering, slow or irregular breathing 2 Good, strong cry; normal rate and effort of breathing What do the Apgar scores mean? The one-minute Apgar score This helps your practitioner decide whether your baby needs immediate medical help. If your baby scores between 7 and 10, it usually means he's in good shape and doesn't need more than routine post-delivery care. (Don't be disappointed if your baby doesn't score a perfect 10, though. It's unusual for a baby's hands and feet to have good color one minute or so after arrival.) If your baby scores between 4 and 6, he may need some help breathing. This could mean something as simple as suctioning his nostrils or massaging him, or it could mean giving him oxygen. If your baby scores 3 or less, he may need immediate lifesaving measures, such as resuscitation. Keep in mind, though, that a low score at one minute doesn't mean that your baby won't eventually be just fine. Sometimes babies born prematurely or delivered by cesarean section, for example, have lower-than-normal scores, especially at the one-minute testing. The five-minute Apgar score This helps your practitioner see how your baby is progressing and whether he has responded to any initial medical intervention. A score of 7 to 10 is still considered normal at this point. If your baby scores 6 or less at the five-minute mark, he may need medical help and your practitioner will determine what steps need to be taken. How often does my newborn need a bath? There's no need to give your newborn a bath every day. In fact, bathing your baby more than several times a week may dry out his or her skin. If you're quick with clean diapers and fresh burp cloths, you're already cleaning the parts that really need attention the face, neck and diaper area. Is a sponge bath good enough? A baby bath doesn't necessarily need to be done in a tub of water. The American Academy of Pediatrics recommends sponge baths until the umbilical cord stump falls off, and sponge baths are sometimes recommended for premature babies but often the choice between sponge baths and tub baths is up to the parents. If you'd like to give your baby a sponge bath, you'll need: * A warm place with a flat surface. A bathroom or kitchen counter, changing table or firm bed will work. Even a blanket or towel on the floor is OK if it's warm enough. * A soft blanket, towel or changing pad. Spread it out for your baby to lie on. * A free hand. Always keep one hand on your baby. On a changing table, use the safety strap as well. * A sink or shallow plastic basin to hold the water. Run 2 to 3 inches (about 5 to 8 centimeters) of warm water into the basin or sink. Check the water temperature with your hand to make sure it's not too hot. * Essential supplies. Gather a washcloth, a towel, cotton balls, mild baby shampoo, mild moisturizing soap, baby wipes, a clean diaper and a change of clothes. When you're ready to begin the sponge bath, undress your baby and wrap him or her in a towel. Lay your baby on his or her back on the blanket, towel or pad you've prepared. Wet the washcloth, wring out excess water and wipe your baby's face. There's no need to use soap. Use a damp cotton ball or clean cotton cloth to wipe each eyelid, from the inside to the outside corner. When you're ready to move on, plain water is usually OK. If your baby is smelly or dirty, use a mild moisturizing soap. Pay special attention to creases under the arms, behind the ears, around the neck and in the diaper area. Also wash between your baby's fingers and toes. To keep your baby warm, expose only the parts you're washing. What type of baby tub is best? When you're ready to give your baby a tub bath whether you do so right from the start or you try sponge baths first you'll have plenty of choices. Many parents choose free-standing plastic tubs specifically designed for newborns. Others opt for plain plastic basins or inflatable tubs that fit inside the bathtub. Lined with a towel or rubber mat, the kitchen or bathroom sink may be another option. Safety is the most important consideration, not necessarily the type of tub. Gather your supplies ahead of time so that you can keep one hand on the baby at all times. If you're interrupted, take your baby with you. Never leave your baby alone in the water. How much water should I put in the tub? You'll need only 2 to 3 inches (about 5 to 8 centimeters) of warm water for a baby bath. To keep your baby warm, pour warm water over his or her body throughout the bath. What about water temperature? Warm water is best. To prevent scalding, set the thermostat on your water heater to below 120 F (49 C). Always check the water temperature with your hand before bathing your baby. Be sure the room is comfortably warm, too. A wet baby may be easily chilled. What's the best way to hold my newborn in the tub? A secure hold will help your baby feel comfortable and stay safe in the tub. Support your baby's head and torso with your arm and hand. Wrap your arm under your baby's back, grasping your baby firmly under the armpit. When you clean your baby's back and buttocks, lean him or her forward on your arm. Continue to grasp your baby under the armpit. What should I wash first? Most parents start with the baby's face and move on to dirtier parts of the body. Wash inside skin folds, and rinse the genitals carefully. Should I wash my newborn's hair? Wash your newborn's hair if it seems dirty or your baby develops cradle cap a common condition characterized by scaly patches on the scalp. Supporting your baby's head and shoulders with your free hand, gently massage a drop of mild baby shampoo into your baby's scalp. Rinse the shampoo with a damp washcloth or directly under the faucet. If your baby has cradle cap, loosen the scales with a soft-bristled baby brush or toothbrush before rinsing off the shampoo. Do I need a special type of soap? There's no need to use a special type of soap for a baby bath. In fact, plain water is fine for newborns. When needed, use a mild moisturizing soap. Avoid bubble bath and scented soaps. Will lotion after a baby bath help prevent rashes? Most newborns don't need lotion after a bath. In fact, greasy lotions or ointments may make a rash more likely by blocking your baby's tiny sweat glands. The best way to prevent rashes is to dry inside your baby's folds of skin after each bath. Is it better to bathe my baby in the morning or at night? That's up to you. Choose a time when you're not rushed or likely to be interrupted. Some parents opt for morning baths, when their babies are alert and ready to enjoy the experience. Others prefer evening baths as part of a calming bedtime ritual. Q) Is my baby supposed to have a bowel movement everyday? Q) How often should I feed my baby? Q) Infant development: What happens from birth to 3 months? Q) Breast-feeding vs. formula: What's right for your baby? Q) Baby's head shape: What's normal? Q) Breast-feeding: Is your baby getting enough milk? Q) Newborn care: Should I wake my baby for feedings? Q) How do I know if my child is growing okay? Q) How should I keep track of my childs growth? Q) How often should my child be weighed and measured? Q) Do boys and girls grow at different rates? Q) How long should I breast feed my baby? Q) When can we give our newborn baby water? Q) What is child development? Q) Child development and Child Growth: What's the difference? Q) What are developmental milestones? What is child development? Child development refers to how a child becomes able to do more complex things as they get older. Development is different than growth. Growth only refers to the child getting bigger in size. If you are concerned about your child's development, please see Developmental Delay on YourChild. When we talk about normal development, we are talking about developing skills like: Gross motor: using large groups of muscles to sit, stand, walk, run, etc., keeping balance, and changing positions. Fine motor: using hands to be able to eat, draw, dress, play, write, and do many other things. Language: speaking, using body language and gestures, communicating, and understanding what others say. Cognitive: Thinking skills: including learning, understanding, problem-solving, reasoning, and remembering. Social: Interacting with others, having relationships with family, friends, and teachers, cooperating, and responding to the feelings of others. What are developmental milestones? Developmental milestones are a set of functional skills or age-specific tasks that most children can do at a certain age range. Your pediatrician uses milestones to help check how your child is developing. Although each milestone has an age level, the actual age when a normally developing child reaches that milestone can very quite a bit. Every child is unique! Where can I find some good links with developmental milestones for my child's age group? Overall developmentâgross and fine motor, language, cognitive, and social skills The first two years: 1 month 3 months 7 months Milestones for the first year (broken down into 3, 6 and 12 months) 12 months Second year (broken down into 18 and 24 months) 2 years podcast Listen: YourChild podcast interview with UMHS pediatrician Dr. Layla Mohammed (July 2007) about early child development from birth to age two. Includes discussion about how to get help for your child if they have developmental delay. The preschool years: Third year 3 years Fourth year 4 years 5 years Child development, age six to age 12: Development in children ages 6 through 12, includes advice for how to help children reach their potentials. Adolescent Development: Physical, cognitive and psycho-social and what parents can do to help. Social and Emotional Development Zero to Three offers these milestones for how children develop and the role that parents play at different stages. The emphasis here is more on social and emotional development: Birth to 8 months 8-18 months 8 months to 3 years Speech and Language Development YourChild: Speech and Language Delays and Disorders includes a chart of language milestones. Speech and language milestones with links to interactive checklists and a good explanation of what it all means. Also in Spanish: Habla y idioma: Hitos del desarrollo. How does your child hear and talk? Lists hearing, understanding and talking milestones for birth to five years of age, and includes information on where to get help. Also in Spanish: ¿Qué tal habla y oye su niño? How does my child's doctor check my child's development? Assessing your childâs development is a team effort. Your family plays an important role. At your childâs well-child visit, your pediatrician will spend time watching your child and talking with you to find out about what your child is doing since your last visit. Tell your childâs doctor about any worries or concerns you may have. Your pediatrician may also use developmental screening in the office. Screening involves a series of questions and observations that gets at your childâs ability to perform certain age-appropriate tasks. Using developmental milestones as a guide can help pediatricians identify children who may be at risk for developmental delay. What if my child is not reaching their developmental milestones? If your childâs doctor finds anything that may be of concern, they can refer you to a specialist and/or work with your family to identify services that may help your child. If your child is delayed, you should start intervention as early as possible so your child can make the best possible progress. Please see Developmental Delay on YourChild for more on the importance of early intervention and how to get your child into the early intervention system. Where can I get more information and resources on child development? Zero to Three is a leading resource on the first three years of life. They offer great tips and information to parents on the development of babies and toddlers. Developmental milestones for children born prematurely, from birth to 18 months, with information on exceptions and concerns. This site also helps you figure out the corrected age of your premature baby. Head Start is a Federal community-based child development program for children aged three to five from low-income families (or children with disabilities). Early Head Start is for low-income pregnant women and families with children aged birth to three. Head Start online community for parents Find a Head Start Program near you Centers for Disease Control and Prevention (CDC) National Center on Birth Defects and Developmental Disabilities Child Development homepage and Learn the Signs. Act Early. Infants: (0-18 months) Safety Checklist for Caregivers: Basic Safety Did this child have any serious injuries, either before or since coming into your care? Does your child have any chronic health conditions? Do you have all the necessary medication and supplies? Do you have a First Aid Kit in your home? Check For: TVs and other pieces of standing furniture secured so that they cannot be pulled over? Exposed wires or appliance cords in reach of children? Preventing Falls Are there child safety window guards on all windows above the first floor? Are safety gates installed at the top and bottom of all staircases? Sleep Time Safety When you put your child to sleep in his/her crib, do you put them on their stomach or their back? Do you put any soft bedding beneath the baby? Do you use pillows or heavy comforters in the crib? Does your child ever sleep in bed with you or with other children? Are there any window blinds or curtain cords near your babyâs crib or other furniture? Do you tie a pacifier around your childâs neck or to his/her clothing with a string or ribbon? Do you ever cover mattresses with plastic or a plastic bag? Crib Safety Does crib have any missing, loose, improperly installed or broken hardware? Are crib slats more than two and three-eighths inches apart? Are there any corner posts over the end panels of crib? Do the headboards or footboards have any cutout areas? Is paint cracked or peeling? Are there any splinters or rough edges? Are top rails of crib less than Ÿ of the childâs height? Bath Safety What do you do if the telephone or doorbell rings while you are giving your child a bath? Do you use bathtub seats with suction cups? Do you check the water temperature to make sure that the bath is not too hot or too cold? Child care safety Who takes care of your child when you are not home? How do you know this person? How old is this person? Is there a way for your child to reach you when you are away from home? Is there a list of phone numbers for your doctor, local hospital, police, fire department, poison control center and a friend or neighbor near the phone? Does this child go to daycare or pre-school? If so, how many hours per week? How does your child get there? Who is responsible for drop-off and pick-up? Safety in the Streets Who watches your child when they play out-of doors? Does your child know what to do if a stranger talks to him or her on the street? Well-Being & Permanency Questions for Caregivers: What is it like for you to care for this child? What has been the effect on your family of having this child placed here? What did you expect it to be like? Describe who this child is. What about the child is easiest and most pleasurable? What is the most difficult aspect of this child for you to deal with? What are the things about this child that will help him/her in the future? What will be harder for him/her? How has the child changed since coming to live here? How has the child adjusted to this placement? What are the goals for this child and his/her family and what do you think/feel about that? What makes that okay; not okay? What do you think of the family visits with the child? What are the services this child is receiving? What do you think/feel about those? What do you think that this child needs? What things does this child like to do? To whom do you go if things arenât going too well? What are the things you need to support your continued care of this child? Does this child show warmth and affection across a range of interactions and with different people? Who does this child seek comfort from when s/he is hurt, frightened, or ill? How is this child's sleeping pattern? How is this childâs feeding pattern? Have you seen any weight changes since this child has been with you? Does this child show preference for a particular adult? How easy is it to soothe this child when s/he is upset? What is an infant formula? What are the main types of infant formula? Here are further guidelines. |