- Length/Height and Weight
- Head Circumference
- Blood Pressure (if risk factors)
- Vision/Hearing (if risk factors)
Developmental Surveillance: DENVER
Discuss With Parents of All Infants
- Signs of hunger include infant putting the hand in the mouth, sucking, rooting, pre-cry facial grimaces, and fussing (crying is a late sign hunger).
- Waking their infant for feeding if the infant sleeps for more than 4 hours.
- Helping their infant focus on feeding by rocking, patting, stroking, or swaddling the infant or feeding in a room with fewer distractions (lights, noise).
Discuss With Parents of Breastfed Infants
- Their infant settling into typical breastfeeding routine of every 2 to 3 hours in the daytime and every 3 hours at night, with 4- to 5-hour stretches between feedings; total of 10 to 12 feedings in 24 hours.
- After the mother’s milk comes in, infants should have about 6 to 8 wet diapers in 24 hours. (Infants may have stools [typically loose] after every feeding or as infrequently as every several days.)
- Avoiding artificial nipples (pacifiers, bottles) and supplements (unless medically indicated) until breastfeeding is well established; this occurs around age 4 to 6 weeks. (Some infants never use pacifiers or bottles.)
Discuss With Parents of Formula-Fed Infants
- Feeding their infant on average 20 oz of formula in 24 hours (2 oz of formula every 2–3 hours at first and more formula if the infant seems hungry).
Psychosocial/Behavioral Assessment: Parent Screening Questionnaire (SEEK) Maternal Depression Screening: Edingburg
In the past 7 days:
- Have you been able to laugh and see the funny side of things?
- Have you looked forward with enjoyment to things?
- I have blamed myself unnecessarily when things went wrong?
- I have been anxious or worried for no good reason?
- I have felt scared or panicky for no good reason?
- Things have been getting on top of me?
- I have been so unhappy that I have had difficulty sleeping?
- I have felt sad or miserable?
- I have been so unhappy that I have been crying?
- The thought of harming myself has occurred to me?
PHYSICAL EXAMINATION PROCEDURES
- Newborn Blood
- Newborn Bilirubin
- Umbilical cauterization
The first priority is to attend to the concerns of the parents. In addition, the Bright Futures Infancy Expert Panel has given priority to the following topics for discussion in this visit:
Social determinants of health: Risks (living situation and food security, environmental tobacco exposure), strengths and protective factors (family support)
Community agencies can help you with concerns about your living situation.
Programs like WIC and SNAP are available to help you if you have concerns about your food situation.
Don’t use tobacco/e-cigarettes. Keep car/home free of tobacco smoke/e-cigarette vapor. Call 800-QUIT-NOW (800-784-8669) for help to quit smoking.
Reach out to and accept help from family and friends.
Parent and family health and well-being:
Transition home, sibling adjustment Ask for help from family or friends. Rest and sleep when baby sleeps.
Spend time with your other children; maintain family routines to help them adjust to baby.
Newborn behavior and care: Early brain development, adjustment to home, calming, when to call (temperature taking) and emergency readiness (CPR), illness prevention (handwashing, outings) and sun exposure
Sing/talk/read to baby; avoid TV and other digital media.
Help baby wake for feeding by patting/diaper change/undressing. Calm baby with stroking head or gentle rocking.
Never hit or shake baby.
Take temperature rectally, not by ear or skin.
Create emergency preparedness plan (first aid kit, list of telephone numbers). Wash hands often; avoid crowds.
Avoid sun; use infant sunscreen.
Safety: Car safety seats, heatstroke prevention, safe sleep, safe home environment: burns
Use rear-facing car safety seat in backseat; never put baby in front seat of vehicle with passenger air bag. Keep baby in car safety seat at all times during travel.
Use seat belt; don’t drive under the influence of alcohol or drugs. Prevent heatstroke; never leave baby alone in a car.
Put baby to sleep on back; choose crib with slats less than 2⅜" apart; don’t use loose, soG bedding; have baby sleep in your room in own crib.
Don’t drink hot liquids while holding baby; set home water temperature less than 120°F.