Newborn Screening

Prior to birth, all human babies exist in a 'parasitic' stage where they obtain their nutrients and requirements from their mothers. With birth, this secure state comes to an abrupt halt. Of all mammalian offspring, none is so vulnerable at birth as the human newborn. Your pediatrician will perform a newborn screening on the baby to look for any problem that may require medical attention. Just before your baby is ready to be discharged home, a second thorough medical examination will be performed again. Here are few observations that you may make in your baby at birth:
 

Head

Due to the pressure exerted on the soft skull when negotiating through the birth canal, the baby’s head will be oddly shaped. There are some non-harmful characteristics that your baby may display:
(a) cephalohaematoma - is a soft swelling seen on the side of the head caused by bruising when the baby pushes his way out of the birth canal. This swelling may 'grow' larger and ‘harden’ before it eventually resolves by 2 months of life.
(b) pressure marks or bruises on the side of the scalp or a ‘puffy’ head – is a result of instrumental delivery (for example, forceps) or the vacuum cup. Again, these will disappear with time.
soft spots at the top of the baby’s head – this is called the ‘fontanelle’ where the bone plates are yet to fuse (by 1 to 2 years old).
 

Hair

Lanugo hair (the fine, fuzzy hair) predominantly on the baby’s back and shoulder will drop off in the next few weeks of life. The color and amounts of hair is different for every baby and this will change when they grow up.
 

Eyes

You may notice some red spots in the white of his eyes. This is caused by small areas of bleeding secondary to the pressure on his neck during delivery. Again, this will go away in several days. Baby spends most of his time sleeping. He will be awake for a brief period before and after a feed or when disturbed. He will shut his eyes at bright light. When held erect, he will open his eyes and will be able to follow the human face that is brought close to him. Do not panic if he appears crossed eye. This will normalize when his eye muscles mature by 3 months of life.
 

Hearing

By 2 weeks, your baby with normal newborn hearing will be able to respond to a loud ticking clock or voice. Sudden loud sound will startle him and he may cry but a soft steady sound will soothe him.
 

Nose

Due to the narrow nasal passage, the baby may have noisy breathing. You are more likely to hear him sneeze and hiccup during this first month of life. Your baby has well-developed sense of smell at birth and is able to recognize the mother’s breast milk scent.
 

Skin

Wrinkled skin is commonly seen on newborn babies. Other common normal skin conditions include:
(a) Salmon patch – tiny red mark on the forehead, eyelids or next to the nose. This may last for months to a year before it resolves spontaneously.
Stork bite – small red mark on the nape of the neck (believed to have caused by the stork’s beak while ‘delivering’ the baby). This may last months to a year before disappearing.
(b) Hamangiomas – are rough, raised red spots that tend to enlarge in the first few months of life before shrinking and disappearing eventually.
(c) Mongolian spots – are bruise-like patches usually found on the buttocks, often mistaken as sign of child abuse. This will last longer into early childhood.
(d) Milia – tiny white spots on the tip of the nose that disappears within the first few weeks of life.
Erythema toxicum – are red patches on the limbs that resolves spontaneously in the first week of life.
 

Posture

Baby adopts a predominantly folded posture. He clenches and draws his fists near to his face, he also draws up and tucks his knees under the abdomen when placed in the prone. In a supine (lying with face up) position, he will adopt a symmetrical posture with his elbows bent and held close to his chest and his legs spread at his hips.
 

Abdomen  

This part of the body usually looks prominent and protruding. This is normal and will not be noticeable when the baby turns one year of age.
 

Genitals

Undescended testis (testis not felt in the scrotal sac) is not a cause of major concern until the boy turns one year old. Swollen labia in a girl are a norm at birth. Do not panic if you see blood stain on the diapers or bloody vaginal discharge as this is caused by the maternal hormones and will resolve soon.
 

Reflexes

Baby has automatic reactions called primitive reflexes. Most of these reflexes disappear by about 3 months of age. More readily recognizable reflexes are the rooting (when one side of the baby's cheek is stroked gently, he will turn his head towards the direction of the touch), grasp (clenching of his fist automatically if an object is placed in his palm) and Moro (startled) reflexes. 
The rooting reflex enables your baby to seek for the mother's nipple when his cheek is brushed against the breast. The grasp reflex is so strong that the baby can support his own weight holding onto your finger (although you should never try this!). The Moro reflex is a startled reflex where his arms and legs will be outstretched and then drawn inwards with his fingers curled getting ready to clutch at something when the head is drop back or startled.
 

More on Normal Early Childhood Development