When examining an infant which should be examined first?

The baby should be examined briefly immediately after birth. This should be confined to quick assessment of respiration, circulation, temperature, neurological status, and screening for anomalies or disease that might mandate emergency treatment. The initial examination should be done with minimal disturbance to the baby, taking particular care to prevent excessive cooling from exposure.

A complete examination should be performed within the first 24 hours and again at discharge from the nursery. The full examination should be performed when the baby is quiet. The baby should be observed from a distance before being touched since a great deal can be learned by observing the infant's spontaneous activity. See, then touch.

Auscultate the heart and chest and feel the pulses before the baby begins to cry, and then proceed systematically to the rest of the examination.

A normal head-first delivery leaves the head slightly misshapen for several days. The bones that form the skull overlap, which allows the head to become compressed for delivery. Some swelling and bruising of the scalp is typical. Sometimes bleeding from one of the bones of the skull and its outer covering causes a small bump on the head that disappears in a few months (called a cephalhematoma). When the baby is delivered buttocks, genitals, or feet first ( breech delivery Breech presentation Position refers to whether the fetus is facing rearward (toward the woman’s back—that is, face down when the woman lies on her back) or forward (face up). It’s important to check the baby’s... read more ), the head is usually not misshapen. However, the buttocks, genitals, or feet may be swollen and bruised. Delivery of a baby in the breech position is now usually avoided. When the baby is in the breech position, doctors usually recommend a cesarean delivery Breech presentation Position refers to whether the fetus is facing rearward (toward the woman’s back—that is, face down when the woman lies on her back) or forward (face up). It’s important to check the baby’s... read more or C section (the surgical delivery of a baby by incision through a woman's abdomen and uterus), which minimizes danger to the baby.

Pressure during a vaginal delivery may bruise the newborn's face. In addition, compression through the birth canal may make the face initially appear asymmetrical. This asymmetry sometimes results when one of the nerves supplying the face muscles is damaged during delivery. Recovery is gradual over the next few weeks.

The neck is examined for swelling, growths, and twisting or spasms.

Low-set ears may indicate genetic anomalies Overview of Chromosomal Anomalies Chromosomal anomalies cause various disorders. Anomalies that affect autosomes (the 22 paired chromosomes that are alike in males and females) are more common than those that affect sex chromosomes... read more , including trisomy 18 Trisomy 18 Trisomy 18 is caused by an extra chromosome 18 and is usually associated with intellectual disability, small birth size, and various congenital anomalies, including severe microcephaly, heart... read more

Down Syndrome (Trisomy 21) Down syndrome is an anomaly of chromosome 21 that can cause intellectual disability, microcephaly, short stature, and characteristic facies. Diagnosis is suggested by physical anomalies and... read more