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Neonatology Starter Kit
Baby care, stepwise and simple.
Done at 1 min (tolerance of birth) and 5 min (adaptation). Each component scored 0–2.
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Appearance (color)
- 0 — Blue/pale all over
- 1 — Pink body, blue extremities
- 2 — Completely pink
❤️
Pulse
- 0 — Absent
- 1 — <100 bpm
- 2 — ≥100 bpm
😮
Grimace (reflex)
- 0 — No response
- 1 — Grimace/weak
- 2 — Cry, cough, sneeze
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Activity (tone)
- 0 — Limp
- 1 — Some flexion
- 2 — Active movement
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Respiration
- 0 — Absent
- 1 — Slow/irregular
- 2 — Strong cry
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Interpretation
- 7–10 normal adaptation
- 4–6 moderate distress
- 0–3 severe — resuscitate
- Score <7 at 5 min = NICU consideration
✨ Baby is booting up like a new device loading software ⚙️
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Moro
- Startle → arms abduct then adduct
- Disappears 4–6 months
👃
Rooting
- Touch cheek → turns to feed
- Disappears 3–4 months
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Sucking
- Automatic sucking on nipple
- Persists early infancy
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Palmar grasp
- Finger in palm → tight grasp
- Disappears 5–6 months
🦶
Babinski
- Upgoing toes in infants (normal)
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Red flags
- Absent reflexes = neurological dysfunction
- Asymmetry = brachial plexus injury
✨ Baby reflexes are factory-installed safety settings 🧸
🫁 Neonatal Respiratory Distress
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Signs
- Tachypnea (>60/min)
- Grunting
- Nasal flaring
- Chest retractions
- Cyanosis
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Causes
- RDS (prematurity, surfactant deficiency)
- TTN (fluid retention)
- Meconium aspiration
- Pneumonia / sepsis
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First step
- Pulse oximetry
- Chest X-ray
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Emergency signs
- Apnea
- Severe cyanosis
- Exhaustion
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Management
- Oxygen support
- CPAP / ventilation if severe
- Surfactant if RDS
✨ Lungs learning to breathe like a new toy starting up 🎈
🟡 Neonatal Jaundice Approach
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Timing
- <24h → pathological 🚨
- 2–3 days → physiological
- >14 days → prolonged jaundice
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Type
- Unconjugated (most common)
- Conjugated (always pathological)
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Causes
- Physiological
- Breast milk jaundice
- Hemolysis (ABO/Rh)
- Sepsis
- Biliary atresia (conjugated)
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Investigation
- Serum bilirubin (total + direct)
- Blood group + Coombs test
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Management
- Phototherapy
- Exchange transfusion if severe
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Red flags
- Pale stools + dark urine → biliary atresia
✨ Bilirubin is baby's yellow paint that didn't get cleared yet 🎨
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Signs
- Poor feeding
- Lethargy / floppy baby
- Temperature instability
- Respiratory distress
- Hypoglycemia
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Causes
- Group B Streptococcus
- E. coli
- Listeria
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First step
- Blood culture (before antibiotics if possible)
- CBC, CRP
- Lumbar puncture if stable
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Immediate Tx
- IV antibiotics immediately (don't wait)
- Ampicillin + gentamicin (classic)
- Fluids + glucose support
✨ Infection spreads fast in a newborn like wildfire in dry grass 🔥