CHAPTER 3: THE NEONATAL PHASE & INFANCY:
THE NEONATAL PHASE:
-The period between birth and when the baby is 4 weeks old.
THE PHYSICAL APPEARANCE OF THE NEWBORN:
-The proportions are very different from those of an adult.
-Head = ¼ of the total body size
-The neck is not strong enough to keep the head upright
-The arms and legs seem too short
-Exceptionally small hands & feet
-A yellowish colour of the skin (jaundice) = liver is still physiologically immature.
-The average weight = 2,5kg – 4,5kg (3,5kg is the most common)
-During the first few days, the baby can lose up to 10% of its birth weight (fluid loss,
poor intake of food and poor digestion)
-By about the 5th day = begins to regain weight
-By about the 10th – 14th day the baby should be the same weight as it was at birth
-The babies heart beats rapidly when the baby is crying and slowly when its resting.
-A healthy heartbeat = 120 – 150 beats per minute
ASSESSMENT OF THE NEWBORN:
-Apgar Scale
-The scale is applied twice (1 min after birth and again at 5 min after birth)
-Designed to evaluate 5 aspects;
Body colour (Appearance)
Heartbeat (Pulse)
Reflex Irritability (Grimace)
Muscle Tone (Activity)
Breathing (Respiration)
,-A score of 0,1 or 2 is given to each aspect after which the scores are added together (max score
of 10)
-A score of 4-6 is poor
-A score of 0-3 is dangerous
ADJUSTMENT TO BASIC LIFE PROCESSES:
1. Blood Circulation:
-Begins with the baby’s first breath.
-The umbilical cord is cut, and the heart adapts to force blood to the lungs which are
now responsible for the process of aeration (provision of oxygen)
2. Respiration:
-Begins when the baby comes into contact with air.
-Breathing is sometimes hindered by mucus and amniotic fluid in the air passages.
-Respiratory problems could lead to anoxia (if it lasts longer than a few minutes = brain
damage)
3. Digestion:
-Occurs gradually
-Babies are already equipped with sucking & swallowing reflexes at birth but takes
practice.
, -The need for nutrition is irregular and are set on the immediate satisfaction of their
needs.
-Intervals between feeding sessions may vary between 2-4 hours.
-The baby gets rid of waste matter a few minutes after birth – excretion of a dark green
substance.
4. Body Temperature:
-The baby’s skin needs to make a major adjustment.
-Prenatal temperature = 38C
-Temperature of the neonate is not very stable in the 1st week after birth.
-Does not have an insulating layer of body fat = heat is lost quickly.
5. The Nervous System:
-The brain weighs approximately 25% of an adult brain.
-The cerebral cortex is not nearly fully developed.
-Reflexes play a central role in the functioning & survival of the neonate.
THE NEONATAL PHASE:
-The period between birth and when the baby is 4 weeks old.
THE PHYSICAL APPEARANCE OF THE NEWBORN:
-The proportions are very different from those of an adult.
-Head = ¼ of the total body size
-The neck is not strong enough to keep the head upright
-The arms and legs seem too short
-Exceptionally small hands & feet
-A yellowish colour of the skin (jaundice) = liver is still physiologically immature.
-The average weight = 2,5kg – 4,5kg (3,5kg is the most common)
-During the first few days, the baby can lose up to 10% of its birth weight (fluid loss,
poor intake of food and poor digestion)
-By about the 5th day = begins to regain weight
-By about the 10th – 14th day the baby should be the same weight as it was at birth
-The babies heart beats rapidly when the baby is crying and slowly when its resting.
-A healthy heartbeat = 120 – 150 beats per minute
ASSESSMENT OF THE NEWBORN:
-Apgar Scale
-The scale is applied twice (1 min after birth and again at 5 min after birth)
-Designed to evaluate 5 aspects;
Body colour (Appearance)
Heartbeat (Pulse)
Reflex Irritability (Grimace)
Muscle Tone (Activity)
Breathing (Respiration)
,-A score of 0,1 or 2 is given to each aspect after which the scores are added together (max score
of 10)
-A score of 4-6 is poor
-A score of 0-3 is dangerous
ADJUSTMENT TO BASIC LIFE PROCESSES:
1. Blood Circulation:
-Begins with the baby’s first breath.
-The umbilical cord is cut, and the heart adapts to force blood to the lungs which are
now responsible for the process of aeration (provision of oxygen)
2. Respiration:
-Begins when the baby comes into contact with air.
-Breathing is sometimes hindered by mucus and amniotic fluid in the air passages.
-Respiratory problems could lead to anoxia (if it lasts longer than a few minutes = brain
damage)
3. Digestion:
-Occurs gradually
-Babies are already equipped with sucking & swallowing reflexes at birth but takes
practice.
, -The need for nutrition is irregular and are set on the immediate satisfaction of their
needs.
-Intervals between feeding sessions may vary between 2-4 hours.
-The baby gets rid of waste matter a few minutes after birth – excretion of a dark green
substance.
4. Body Temperature:
-The baby’s skin needs to make a major adjustment.
-Prenatal temperature = 38C
-Temperature of the neonate is not very stable in the 1st week after birth.
-Does not have an insulating layer of body fat = heat is lost quickly.
5. The Nervous System:
-The brain weighs approximately 25% of an adult brain.
-The cerebral cortex is not nearly fully developed.
-Reflexes play a central role in the functioning & survival of the neonate.
