1.Skin
(1) Fetal fat: after birth. The skin is covered with a layer of grayish white fetal fat, which has the role of protecting the skin. There are individual differences in the amount of fetal fat, which is gradually absorbed a few hours after birth, but the folds of fetal fat should be gently wiped away with warm water. If the fetal fat becomes yellow, it indicates the presence of jaundice, asphyxia or overdue birth.
(2) Jaundice: physiological jaundice mostly appears 2-3 days after birth. It usually disappears after a week of persistence.
(3) Edema: 3-5 days after birth, edema tends to appear in the hands, feet, calves, pubic bone area and eye sockets, etc. It disappears after 2-3 days and is associated with unstable water metabolism in newborns. Restricted edema confined to the lower extremities of female infants suggests the possibility of Tunner’s syndrome.
(4) Neonatal erythema: often appears within 1-2 days after birth. The cause is unknown. The rash is a maculopapular rash of variable size with indistinct margins, scattered over the head, face, trunk and extremities. The infant has no discomfort. The rash mostly fades rapidly within 1-2 days.
(5) Folliculitis: A raised pustule surrounded by a very narrow red halo, with more distribution at the root of the neck, axillae, behind the ears, and elbow bends, which fades within a few days.
(6) Corn rash: in the tip of the nose, nose, cheeks, face, etc., can often be seen due to the accumulation of sebaceous glands to form a pinhead-like yellow-white corn rash, peeling skin and disappearing naturally.
(7) sweat rash: in the hot season, often in the forehead, forehead and other places to see the size of a pinhead sweat rash, also known as white prickly heat. This is due to poor sweat gland function in newborns.
(8) Green marks: Some newborns often have blue-green spots on the back and buttocks, which are caused by special pigment cell deposits, commonly known as green marks or birth moles. It gradually recedes with age.
(9) Loose red spots: These are microvascular nevi distributed on the forehead and eyelids of newborns, which can disappear within a few months.
2.Head and face
(1)Skull: the skull is soft, the sutures are not closed, with fontanelle and posterior fontanelle, sometimes the third fontanelle can be touched in the fingertips of the anterior and posterior fontanelle. The fontanelle diameter is usually 2-100px2, and the posterior fontanelle can generally only accommodate the fingertips. Oversized fontanelles are commonly found in children with hydrocephalus, rickets and intrauterine infections. At birth, the skull is often deformed to varying degrees due to compression by the birth canal, and the bony sutures may overlap. The head of a newborn delivered parietal prepubertal may appear long and narrow, and edema and petechiae are often seen at the prepubertal site, which may fade within a few days. Newborns with cephalohematoma may have a cyst-like mass on the head that usually takes 2-3 months to dissipate.
(2) Eyes: On the first day after birth, the eyes often close, sometimes opening and closing, related to oculomotor function that has not yet been regulated by rubidium. Subconjunctival hemorrhage or a week of red-purple iris rim is sometimes seen in those with a history of obstructed labor, mostly due to capillary stasis or rupture, which can be absorbed in a few days. Bilateral upward slanting or medial canthus should be suspected of trisomy 21. The presence of eyelid edema and copious purulent discharge is often typical of gonococcal infection. Large corneal opacities with high ocular tone are indicative of congenital glaucoma. The normal pupil reflex is red, but if it is white, it suggests the possibility of cataract, tumor or retinal disease.
(3) Nose: low nasal bridge, easy to bend because of the soft nasal bones, can be seen skewed, but later do not stay deformed. Newborns breathe through the nose. If the posterior nostril atresia is deformed, it can show severe respiratory distress immediately after birth. Children with congenital syphilis may exhibit nasal congestion, open-mouth breathing, and eczema-like ulcers on the skin of the nasal vestibule after birth.
(4) Oral cavity: clear demarcation of the skin and mucous membrane of the mouth and lips, mucous membrane is red and moist, and small yellowish-white granules of epithelial cells or mucous encapsulation can be seen on the gums, commonly known as “plate teeth”, or “horse teeth”, which can exist for a longer period of time and should not be picked to prevent infection. Small yellow nodules (Peng’s beads) of varying sizes (about 2-4 mm) can be seen on the midline of the hard palate, which are also formed by epithelial cell accumulation and subside after a few weeks. The lingual tether has individual differences, either thin or thick, tight or loose. There is a raised fat pad on each side of the cheek, commonly known as the “mantis mouth”. It facilitates sucking of breast milk and should not be broken. Macroglossia suggests congenital hypothyroidism or Beckwith syndrome. Sometimes cleft lip or palate may be seen. The possibility of PierreRobin syndrome should be thought of for the small mandible.
(5) Ear: Its shape, size, structure and hardness are related to genetics and maturity, the more mature the ear cartilage, the harder it is. The ear chakra is lower than the orbital ear line and is called a low ear, which can be seen in some syndromes.
3. Neck
Very short, the neck folds are deep and moist and easily eroded. Sometimes a hematoma of the sternocleidomastoid muscle can be seen, which can lead to a subsequent sloping neck. Excessive folding of the skin at the back of the neck in the form of cervical webbing is one of the signs of Turner syndrome.
4.Thorax
The thorax is mostly cylindrical, with the tip of the raphe sometimes upturned, and the crosstalk can be palpated at the junction of the rib cartilage. Newborns have diaphragmatic breathing and sometimes tidal breathing.
The breast gland is enlarged, such as bean or walnut size, or see black areola area and lactation, 2-3 weeks can subside, this is due to the influence of maternal endocrine, do not squeeze to prevent infection.
5.Abdomen
Most slightly elevated, premature babies because of the abdominal wall is very thin, can see the intestinal type. The liver is soft, 50 px below the rib cage in the midclavicular line, and the spleen is sometimes just palpable. After the umbilical cord is aseptically ligated after birth, it usually falls off in 1-7 days and the gauze should be checked for blood leakage before falling off. The umbilicus should be kept dry after detachment. Sometimes an umbilical hernia can be seen.
6.Genitalia
After birth, there is often edema of varying severity in the scrotum or mons pubis, which will subside after a few days. Both testes are mostly descending, but also in the groin, or ectopic in the perineum, medial femoral fascia or suprapubic fascia, etc. Sometimes one or both sides of the syringomyelia are seen and are often absorbed within 2 months after birth. Some female infants may have grayish-white fluid discharge from the vagina 5-7 days after birth, which may last for two weeks, sometimes bloody, commonly known as “pseudomenstruation”. This is due to the interruption of the maternal estrogen effect on the fetus after delivery. The darkening of the genitalia is mostly associated with congenital adrenal hyperplasia.