Before Your First Outpatient Newborn Visit

This episode describes how to prepare for a newborn’s first outpatient visit after they have been discharged from the birth hospital, including the information that you need to obtain from the medical record before the visit, the topics you need to discuss during the visit, and how to approach the physical examination in a newborn. Introduction Socio-emotional state of parents Before the visit, you should review Prenatal history Delivery history, gestational age Physical exam at time of birth Preventative treatments Course in newborn nursery or NICU Type of feeding Concerns for infection Bilirubin Screening tests Newborn visit Parental questions and concerns Feeding history and any problems with feeding Elimination  Sleep and safe sleep Social history and parental support system Review of systems – irritability, fever, rashes.  Normal newborn vital signs Infant growth parameters and weight trajectory Physical exam General Head size and shape Eyes – pupil shape, red light reflex, scleral icterus Cardiovascular – murmurs, capillary refill Respiratory Abdominal Genitourinary – testicles, hernias/hydroceles, circumcision, vaginal discharge Musculoskeletal-  clavicles, hip  Skin – jaundice, birthmarks, sacral dimples Neurological: tone, reflexes Anticipatory guidance Fever Safe sleep Prevention of shaken baby syndrome Postpartum depression Appropriate feeding Next follow up ap...

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