Editing Maternal and Newborn Nursing (section)

=== Normal newborn values and assessment ===

* Heart rate '''110 to 160''' bpm awake (may drop to about 90 in deep sleep and rise to 180 when crying); respiratory rate '''30 to 60''' per minute, irregular, with periodic breathing and short pauses under 20 seconds; axillary temperature '''97.7 to 99.5 degrees F (36.5 to 37.5 degrees C)'''; blood pressure roughly 60 to 80 over 40 to 50.
* Weight roughly 2,500 to 4,000 g at term. A weight loss of up to about 7 to 10 percent in the first days is expected, regained by 10 to 14 days.
* '''Normal findings often mistaken for problems''': acrocyanosis (blue hands and feet) in the first 24 to 48 hours, milia, erythema toxicum, congenital dermal melanocytosis (formerly Mongolian spots), vernix caseosa, lanugo, molding, pseudomenstruation and breast engorgement from maternal hormones, transient tachypnea, and epstein pearls.
* '''Abnormal findings requiring report''': '''central cyanosis or circumoral cyanosis, grunting, nasal flaring, retractions, sustained respiratory rate above 60, apnea longer than 20 seconds, temperature instability, jitteriness, a single umbilical artery''' (normal cord has '''two arteries and one vein'''), and '''jaundice in the first 24 hours'''.
* '''Caput succedaneum''' is scalp edema that '''crosses suture lines''', is present at birth, and resolves in days. '''Cephalhematoma''' is subperiosteal bleeding that '''does not cross suture lines''', appears hours after birth, resolves over weeks, and '''increases the risk of hyperbilirubinemia''' as the blood breaks down.
* '''Fontanels''': anterior (diamond) closes at 12 to 18 months; posterior (triangle) closes by about 2 to 3 months. They should be soft and flat. Bulging suggests increased intracranial pressure; sunken suggests dehydration.
* '''Reflexes''': Moro (startle), rooting, sucking, palmar and plantar grasp, Babinski (fanning is ''normal'' in infants), tonic neck (fencing), and stepping. An '''asymmetric Moro''' suggests clavicle fracture or brachial plexus injury.
* '''Elimination''': first void within 24 hours and first meconium stool within 24 to 48 hours; failure to pass either is reported. Stools progress from meconium to transitional to yellow seedy (breastfed) or pale yellow to tan and firmer (formula fed).
* Gestational age is estimated with the '''New Ballard score'''; infants are classified as small, appropriate, or large for gestational age.