8/17/2019 Emma 3 Week Oldgirl

1/3

Emma 3-week old girl

Visit agenda

Resources (forms, book chapters, etc.) *links to these!:

Well Baby Information Resources: http://www.rourkebabyrecord.ca/parents/  

- great parent resource website where they can look up age specific information

regarding whether their child is healthy and growing/developing normally, as well as

breasting feeding, nutrition, colic, weaning, etc

- Also information for HCP

Guidelines for development that focus on parental health and child health:

https://brightfutures.aap.org/materials-and-tools/guidelines-and-pocket-guide/Pages/default.a

spx/ 

Chapter 9-10 from course textbook (Newborn + 1st year)

Key questions relevant to age, gender, development, etc.:

RED FLAGS:

- How are the feeding? sucking poorly, feeds slowly

- How active are they in movements? rarely move, stiffness OR excessively

loose/floppy

- How is the mom doing? any sadness?

Key Questions:- How often are they feeding? Every 2-3 hours, up to 8-12x/day

- Are you and baby taking vitamin D?

- How many wet diapers do they have a day? 6-8/day

- What is your Baby’s routine and schedule like now?

- Is your baby sleeping well?

- Can your baby hear sounds?

- Does your baby look at your face?

- When crying, can your baby be calmed?

Relevant screening exams, objective tools (questionnaires, lab work, etc.):

Length, Weight, Head Circumference

Head: head deformities

Primary Reflexes:

- grasping: touch palm → grasps tightly

- Moro: sudden movement/loud noise → startles, arms legs shoot out then back in

- Rooting: stroke cheek → turns to source

https://brightfutures.aap.org/materials-and-tools/guidelines-and-pocket-guide/Pages/default.aspx/https://brightfutures.aap.org/materials-and-tools/guidelines-and-pocket-guide/Pages/default.aspx/http://www.rourkebabyrecord.ca/parents/

8/17/2019 Emma 3 Week Oldgirl

2/3

- Tonic neck: lay on back, turn head to one side → ipsilateral arm extension;

contralateral flexion

- Parachute: suspend child by trunk, forward flexion → upper extremity extension, does

not appear until 6-9months

Vision: red light reflex, clarity of cornea, response to bright lightHearing: startle to loud noise

Heart: auscultation for murmurs, palpate femoral pulse

 Abdomen: masses, note healing on umbilicus

MSK: Ortolani and Barlow maneuvers (https://www.youtube.com/watch?v=imhI6PLtGLc )

 Any modifications for physical exams:

RED FLAGS:

- Bright light shown: no blink- Doesn’t focus/follow an object moving side to side

- Don’t respond to loud sounds

Use distraction and play while examining the infant-- they can only pay attention to one thing

at a time, so while they focus on the distraction, you can complete your examination.

- keep infant on parents lap

- do the examination in whatever order the infant will allow you, saving the mouth and

ear for final exam

BP should only be taken in high risk infants, otherwise wait until 3 YOA

HR: 90-190, average 140 bpmRR: 30-60

Temp: auditory canal most accurate

Head: examine sutures and fontanelles, scalp veins for dilation, skull symmetry and head

circumference

Lung, Heart and Abdomen are similar to adults, just start with a good inspection to look for

signs of issues before proceeding.

Relevant anticipatory guidance:

Parenting: address response to crying, maternal rest/diet, holding and support

- When an infant cries, they are trying to communicate something→ you can’t spoil

them at this age, they need to build a trust bond

- Use of skin on skin contact, baby-wearing

Breastfeeding

- Discuss latch, expression and storage of milk, general breast care

https://www.youtube.com/watch?v=imhI6PLtGLc

8/17/2019 Emma 3 Week Oldgirl

3/3

Sleep Safety

- Supine vs Prone, Firm sleep surface

- Co-Sleeping is fine as long as the surface is firm without pillows for possible

smothering

- SIDS Modifiable and Non-Modifiable Risk Factors

Car Seats + Safety- ensuring up to date, well working condition

Chemical Exposure

- personal care products for both mom and baby

Others: Diaper rash, fever, vaccines

Establishing schedules, Routines

- this is when they learn there is a routine to life (day time is awake time, night time is

sleep time)

- At 3 weeks: 8.5 hours of night time sleep, 8 hours of day time sleep