Course Syllabus ©National College of Midwifery 2012
07/2012
Course Title: Newborn Physical Assessment
Credits: 1.0
Course Description: This course is designed to teach the student the anatomy and
physiology of the newborn as well as assess the general health and appearance of the
newborn. Students will become competent in performing a complete newborn exam and
understanding the deviations from normal that sometimes occur in the newborn. This course
uses current research in midwifery and obstetrics to broaden the student’s understanding of
the following NARM skills and MANA core competencies learned under clinical supervision:
NARM Skills
I. Midwifery Counseling, Education and Communication
(6)-I F. Educates the mother concerning the natural physical and emotional processes of
pregnancy, labor, birth and postpartum
I J. Provides education, counseling and/or referral, where appropriate for:
(19)-I J 10. Newborn care including normal/abnormal newborn activity, responses, vital signs,
appearance, behavior, etc
IV F. Assesses the condition of, and provides care for the newborn immediately after the birth
by:
(107)-IV F 1. Making initial newborn assessment
(113)-IV F *7. Performing a newborn examination
VII. Well-Baby Care
(149)-VII A. Provides well-baby care 2-6 weeks
(150)-VII B. Assesses the general health and appearance of baby
MANA Core Competencies:.
II. General Knowledge and Skills
The midwife provides care incorporating certain concepts, skills and knowledge from a variety
of health and social sciences including, but not limited to:
2 B. Human anatomy and physiology relevant to childbearing
2 C. Community standards of care for women and their developing infants during the
childbearing cycle, including midwifery and bio-technical medical standards and the rationale
for and limitations of such standards
2 O. Knowledge and application of various health care modalities as they apply to the
childbearing cycle
IV. Care During Labor, Birth and Immediately Thereafter
The midwife provides health care, support, and information to women throughout labor, birth
and the hours immediately thereafter. She determines the need for consultation or referral as
appropriate. The midwife uses a foundation of knowledge and/or skill which includes the
following:
4 B. Parameters and methods for evaluating maternal and fetal well-being during labor, birth
and immediately thereafter, including relevant historical data.
4 L. Understanding of and appropriate support for the newborn's transition during the first
minutes and hours following birth.
VI. Newborn Care
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Course Syllabus ©National College of Midwifery 2012
07/2012
The entry-level midwife provides health care to the newborn during the postpartum period and
support and information to parents regarding newborn care. She determines the need for
consultation or referral as appropriate. The midwife uses a foundation of knowledge and/or skill
which includes the following:
6 A. Anatomy, physiology and support of the newborn’s adjustment during the first days and
weeks of life
6 B. Parameters and methods for evaluating newborn wellness including relevant historical
data and gestational age.
6 C. Nutritional needs of the newborn.
6 D. Community standards and state laws regarding indications for, administration of, and the
risks and benefits of prophylactic bio-technical treatments and screening tests commonly used
during the neonatal period.
6 E. Causes of, assessment of, appropriate treatment and emergency measures for neonatal
problems and abnormalities.
Learning Activities:
A. Student reads appropriate sections from the Learning Materials/Resources.
B. Student answers the questions listed in the Learning Objectives by researching the
Learning Materials/Resources for the course and correctly cites the sources and page
numbers for each of their answers.
C. Student presents answers the questions listed in the Learning Objectives for review by
preceptor.
D. Student participates in preceptor elaboration/discussion of Learning Objectives.
E. In the case that the required texts are more than 5 years old, the student must research,
prepare & present a summary of current best midwifery care/practices appropriate to a
topic covered in this course from a current journal article/study, less than 5 years old.
F. Recommended Role-playing and/or Clinical Interactions
Note: The clinical requirement of NARM /Clinical Skills is completed at any time
throughout the ASM apprenticeship during actual clinical practice and is NOT a
requirement to complete this academic course.
Activities specific to NARM skills learned in this section:
1. Role play or talk through how you would perform a complete physical exam on a
newborn, using the Practical Skills Guide for Midwifery as a guide for the steps.
2. Practice a complete physical exam on as many newborns as possible.
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Course Syllabus ©National College of Midwifery 2012
07/2012
3. Shadow/observe a neonatal nurse practioner or other nursery staff in a newborn
nursery for a half day or full day.
Learning Materials / Resources:
Please use textbooks less than 5 years old or most recent edition.
1. Thureen, et al. Assessment and Care of the Well Newborn. 2nd ed. Elsevier Saunders.
2005.
2. Fraser, DM, et al. Myles Textbook for Midwives. 15th ed. Churchill Livingstone Press.
2009.
3. Varney, Helen. Varney’s Midwifery. Fourth Edition. Jones and Bartlett Publishers. 2004
rd
4. F. Cunningham, et al. William’s Obstetrics. 23 Edition. McGraw-Hill Professional. 2009.
5. Frye, Anne. Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth
Practice, Vol. 2: Care of the Mother and Baby from the Onset of Labor Through the First
Hours After Birth. Labrys Press. 2004.
th
6. Weaver, Pam and Evans, Sharon K. Practical Skills Guide for Midwifery, 4 Edition.
Morningstar Publishing Co. Wasilla. 2007.
7. MEAC Abbreviated NARM Skills Form.
8. MANA Core Competencies for Midwives
9. Midwives Model of Care®.
10. Students must find 1 article/study less than 5 years old. Recommended internet links
as needed for latest developments in midwifery care:
The Cochrane Collaboration
EBSCO
National Library of Medicine
PubMed
Medline
SCIRUS
Medscape
World Health Organization
Evaluation Tools / Methods:
Minimum passing grade for each course is a cumulative 80% / B-. Students and preceptors
are encouraged to work together until the student masters the information.
Final grade for the course is based on preceptor evaluation of the following:
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Course Syllabus ©National College of Midwifery 2012
07/2012
A. Learning Objectives count for 80-90% of the final grade.
The preceptor evaluates each answer based on three elements:
1. Answers should reflect a thorough review of current literature regarding best
current practices in midwifery care.
2. Each answer should be formed in the student’s own words or paraphrased
from the text. The answer should be minimal, not a re-write of the entire text,
but enough to show appropriate comprehension of the learning objective.
3. Student identification of sources and page numbers for each of the Learning
Objectives. (Preceptor should do a random check to determine that sources
cited are correctly identified.)
B. Summary of current journal article / study counts for 10% of the final grade in the case that
other scholarly resources used are more than five years old.
C. Exam counts for 10% of the final grade.
Course credit:
One Academic credit equals approximately 15 hours of formal time plus 30 hours of additional
study or homework. Formal time is defined as the amount of time taken to answer the Learning
Objectives to the level of 80% and to complete any learning activities to the preceptor's
satisfaction, including any time spent face to face with the preceptor. Informal time includes
any time spent actively reading relevant sources and textbook/s, researching Learning
Objectives, and studying for examinations.
Learning Objectives:
A. The student must research, prepare & present a summary of an aspect of current best
midwifery care/practices appropriate a topic from this course from a current journal
article/study.
B. Student answers the questions below and cites the sources and page numbers.
1. Discuss the rationale for carrying out the newborn examination on an unclothed baby in
a warm, comfortable and well-lit environment.
2. Give an overall description of the normal newborn body symmetry, head size, hip size,
chest size, and abdominal appearance.
3. Name the expected relationships between head, abdomen and chest circumference.
4. Describe under what circumstances it is important to assess gestational age.
5. Describe how the Ballard score can be used to assess gestational age.
6. Describe the criteria for determining if a baby is low birth weight.
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Course Syllabus ©National College of Midwifery 2012
07/2012
7. Describe the criteria for determining if a baby is small for gestational age.
8. Describe the criteria for determining if a baby has suffered intraunterine growth
restriction (IUGR).
9. Describe the criteria for determining if a baby is large for gestational age.
10. Describe the criteria for determining if a baby is high birth weight.
11. Explain why there is an expected 3-5% weight loss from birth weight in the first 3 days
after birth.
12. When is birth weight expected to be recovered and why?
13. How many ounces should a healthy newborn gain per week?
14. At what age should the baby’s birth weight be doubled?
15. Describe the factors that contribute to the newborn's size.
16. Describe the normal newborn's activities and what causes these.
17. Discuss the significance of a persistent weak cry.
18. Discuss the significance of a persistent high-pitched cry
19. Discuss the significance of a persistent inconsolable cry.
20. Discuss the significance of a cry that stops when the infant is picked up.
21. Discuss the significance of a pink infant with bluish nail beds, palms, and soles of feet,
whose color improves with activity.
22. Explain the significance of an infant with acrocyanosis whose color deteriorates with
crying or activity.
23. Explain why babies of dark-skinned parents are often light-skinned at birth.
24. Discuss when edema is normal in the newborn.
25. Define milia.
26. Define Seborrheic dermatitis.
27. Define vascular nevus or nevi. Give 3 examples and expected course for each.
28. Define pigmented nevus or nevi.
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Course Syllabus ©National College of Midwifery 2012
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29. Define Mongolian spots.
30. Discuss the significance of skin marbling.
31. Discuss harlequin color and its significance.
32. Explain how trauma might show up on the skin.
33. Discuss the significance of a deep blue face with a pink body.
34. Discuss the expected findings for the anterior and posterior fontanels during the
newborn exam.
35. Discuss the expected findings for the cranial sutures during the newborn exam.
36. Discuss the cause and significance of caput succedaneum.
37. Discuss the etiology and significance of cephalohematoma.
38. What physical assessments of the newborn should be repeated after the initial exam
during routine visits?
Describe the examination of the following on the neonate after birth. What findings are
expected, what are 2 deviations that may be found, and what is the significance of these
deviations?
39. Eyes
40. Nose
41. Ears
42. Mouth
43. Neck
44. Hands
45. Arms
46. Legs
47. Feet
48. Lungs
49. Breasts
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Course Syllabus ©National College of Midwifery 2012
07/2012
50. Abdomen and umbilical cord
51. Genitalia, male and female
52. Heart
53. Back
54. Spine
55. Anus
56. Stools
57. Urine
58. Muscle tone
59. Posture
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