Newborn

Abnormal newborn screen
Birth Trauma
Congenital infections
Cyanosis
Depressed newborn
Hypoglycemia
Hypothermia
Hypotonia / floppy newborn
Large for gestational age
Neonatal abstinence syndrome
Newborn physical exam (normal, abnormal)
Prematurity
Respiratory distress
Sepsis
Small for gestational age
Trisomy 21
Vitamin K deficiency

  • Describe basic embryology and fetal development and how alternations may lead to congenital abnormalities
  • List factors affecting fetal growth
  • Describe normal and abnormal patterns of fetal growth
  • Define pre-term, term, and post-term gestation
  • Identify prenatal risk factors for adverse outcomes in a newborn
  • Describe the processes of transition and adaptation from intrauterine to extrauterine life
  • Define asphyxia and describe its biochemical and physiological effects on the newborn at birth
  • Describe glucose homeostasis in the newborn
  • Describe the extrinsic and intrinsic factors that predispose newborns to infection

Overview & Foundational Knowledge

Phillpi WJB.  Care of the well newborn. Pediatrics in Review 2012; 33: 4-18.

Overview article; very comprehensive article covering many aspects of neonatal evaluation and care (antenatal care, early postpartum transitioning, anticipatory guidance, discharge readiness).

Ramachandrappa A & Jain L. Health Issues of the Late Preterm Infant. Pediatric Clinics of North America 2009; 56(3): 565-577.

Quite detailed but a good, comprehensive overview of late preterm health issues and their management.

Hermansen, C. and Lorah, K. Respiratory Distress in the Newborn. American Family Physician 2007; 76(7). Available at:

http://www.aafp.org/afp/2007/1001/p987.pdf

Covers diagnosis and management of common causes of respiratory distress in the newborn (transient tachypnea of the newborn, respiratory distress syndrome, meconium aspiration) with good visuals (X-rays). Gives a good differential of less common causes.

Polin, RA. Management of Neonates with Suspected or Proven early-onset Bacterial Sepsis. Pediatrics 2012; 129(5): 1006-15. Epub 2012 April 30. 

A good overview. Discusses infants at risk for early-onset sepsis, including evaluation, treatment, prevention, as well as clinical challenges.

Peredo, D. The floppy infant: Evaluation of Hypotonia. Pediatrics in Review 2009; 30: e66.

Hypotonia overview. Good visuals, nice tables.

Uhing MR. Management of birth injuries. Pediatric Clinics of North America 2004; 51(4): 1169-89 xii.

Overview of birth trauma, hypothermia in the newborn and the depressed newborn.

McGowan JE. Neonatal Hypoglycemia. Pediatrics in Review 1999; 20: e6-14.

Hypoglycemia overview. Includes foundational knowledge including glucose homeostasis. Covers transient and prolonged hypoglycemia. More detailed than required.

University of Texas: Medical Genetics and Dysmorphology Website

http://www.utmb.edu/pedi_ed/CORE/MedicalGenetics/page_06.htm

Covers a range of topics related to medical genetics and dysmorphology and includes quiz questions.

Bull MJ and the Committee on Genetics; AAP Clinical Report-Health Supervision for Children with Down Syndrome.

Very detailed but the student can focus on syndrome description and on table 1- major comorbidities

Fetal Alcohol Syndrome.

http://www.cps.ca/en/documents/position/fetal-alcohol-syndrome

http://www.cps.ca/fr/documents/position/syndrome-alcoolisation-foetale

Canadian Paediatric Society Position Statement (2002, 2013) For new diagnostic criteria – table 1

Del Pizzo J. Focus on Diagnosis: Congenital Infections (TORCH); Pediatrics in Review 2011; 32(12) : 537-542.

A good, simple overview of congenital infections. Covers route of infection, clinical manifestations, diagnosis and treatment, however does not discuss when to consider congenital infections in a neonate.

Oelberg DG. Consultation with the Specialist: Prenatal Growth: The sum of maternal, placental and fetal contributions. Pediatrics in Review 2006; 27: 224-229.

Covers issues relating to prenatal growth including IUGR, SGA and LGA infants.

Hanley WB. Newborn screening in Canada- Are we out of step? Paediatrics and Child Health 2005; 10(4): 203-207.

Addresses issues with newborn screening. Newborn screening in Canada is a provincial mandate. Table 2 provides a general overview but may not be up to date. Please check your provincial program.

Goldberg MJ. Early Detection of Developmental Hip Dysplasia: Synopsis of the AAP Clinical Practice Guideline. Pediatrics in Review 2001; 22(4): 131-134.

Brief guidelines regarding management of abnormal hip examination. No pictures.

Mooney JF & Emans JB. Developmental Dislocation of the Hip: A Clinical Overview. Pediatrics in Review 1995; 16: 299.

Images only. For more up-to-date management, please see other article.

Anhalt H, Neely EK & Hintz RL. Ambiguous genitalia. Pediatrics in Review 1996; 17(6): 213-220.

Foundational knowledge, good tables, fairly detailed. 

Docimo SG, Silver RI & Cromie W; The Undescended Testicle: Diagnosis and Management. American Family Physician 2000; 62(9): 2037-2044. Available at:

http://www.aafp.org/afp/2000/1101/p2037.html

Nice overview. Covers management as well as consequences of untreated undescended testes.

Red Reflex Examination in Neonates, Infants, and Children. Pediatrics 2008; 122 (6): 1401-1404.

Abnormal exam: absent red reflex. Statement from AAP Section on Ophthalmology and other associations.

Routine administration of vitamin K to newborns.

http://www.cps.ca/documents/position/administration-vitamin-K-newborns

http://www.cps.ca/fr/documents/position/administration-vitamine-K-nouveau-nes

Canadian Paediatric Society Position Statement (1997, 2013)

Clinical Resources

Screening guidelines for newborns at risk for low blood glucose

http://www.cps.ca/en/documents/position/newborns-low-blood-glucose

http://www.cps.ca/fr/documents/position/hypoglycemie-nouveau-nes

Canadian Paediatric Society Position Statement (2004, 2013)

Chudley AE et al. Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ 2005; 172 (5 suppl)

http://www.cmaj.ca/content/172/5_suppl/S1.full.pdf+html

Canadian guidelines for diagnosis of FASD. Very comprehensive. Good tables for diagnostic criteria; good pictures. More detail than required.

Abnormal Red Reflex (Chapter 19)

http://www.mhprofessional.com/downloads/products/0071633804/luederch19.pdf

Good images. Original textbook source unknown.

Clinical Presentations