Well Baby Check

Front 1

General things to do?

Back 1

 Introduces self / preceptor
 Gains consent
 Uses appropriate exam sequence
 Takes measures to keep baby warm

Front 2

Pregnancy history

Back 2

 Pregnancy #
 Antenatal tests
 Asks for antenatal ultrasounds
 Considers whether SGA/AGA/LGA

Front 3

Infection Risk Factors

Back 3

 Maternal smoking
 Maternal fever in pregnancy
 Mum has GBS
 Previous births GBS infection

 Prolonged rupture of membranes (>18hrs)
 Tachy CTG
 Premmie (<37/40)

 Baby has fever
 Baby respiratory distress

Front 4

Birth history

Back 4

 Labour & delivery
 Apgar scores
 Birth weight
 Growth percentiles
 Term/Pre-term

 Mum + baby's ABO type/Rh status
 Direct Coomb's test result (RBC-auto-antibodies in baby)
 Passed meconium? (Hirschsprung's)

Front 5

Skin

Back 5

 Colour
 Jaundice
 Other findings (e.g. milia)

Front 6

Head

Back 6

 Facies (cleft lip)
 Palpates fontanelles / sutures
 Notes haemorrhage / caput / moulding
 Measures head circumference

Front 7

Eyes

Back 7

 Checks red reflex

Front 8

Ears / nose / throat

Back 8

 Position
 Pre-auricular pits
 Checks for cleft-palate

Front 9

Thorax

Back 9

 Symmetry
 Breast tissue

Front 10

Lungs

Back 10

 Observes rate, depth of breathing
 Auscultates (with correct findings)

Front 11

Heart

Back 11

 Palpates for position
 Auscultates
 Identifies if murmur present

Front 12

Pulses

Back 12

 Brachial
 Femoral

Front 13

Abdomen

Back 13

 Palpates liver / spleen / kidney
 Inspects umbilicus

Front 14

Crotch area

Back 14

 Examines genitalia, and identifies abnormalities
 (Male) Palpates testes

 Checks anus for patency

Front 15

Spine

Back 15

 Dimples / sinus tracts
 Scoliosis / masses

Front 16

CNS assessment

Back 16

 Posture
 Movement
 Active/passive tone
 Checks Moro/rooting/sucking/palmar grasp
 Cry

Front 17

Reflexes (Explain procedures)

Back 17

 Moro (pick baby up, lightly dip - look for break-fall action)
 Rooting (stroke side of mouth - baby turns head to suckle)
 Sucking (Put own finger or baby's hand into mouth - baby will suck)
 Palmar grasp (put finger into baby's hand - baby will grasp)

Front 18

Extremities

Back 18

 Count fingers and toes
 Check for simian crease
 Feet – excludes talipes

Front 19

Hips

Back 19

 Examines to exclude hip
dislocation
 Barlow (anterior dislocation)
 Ortolani (posterior dislocation)