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infant
Author
Tiffany M McKee-Garrett, MD
Section Editor
Leonard E Weisman, MD
Deputy Editor
Melanie S Kim, MD
Disclosures
All topics are updated as new evidence becomes available and
our peer review process is complete.
Literature review current through: Mar 2013. | This topic last
updated: Nov 27, 2012.
The major components of routine care for the term (gestational age
≥37 weeks) and late preterm (gestational age between 34 to
36 6/7 weeks) neonate are:
If yes is the answer to all the questions, the infant does not require
further intervention and should be given to the mother. Healthy term
or late preterm infants should remain with the mother to promote
infant-maternal bonding by skin-to-skin contact and early initiation of
breastfeeding.
If the answer to any of the questions is no, then the infant requires
further evaluation and intervention [ 1,3,4 ]. The following
interventions may be required and are discussed in greater detail
separately. (See "Neonatal resuscitation in the delivery room" .)
Oxygen administration
Positive pressure ventilation
Chest compressions
Use of resuscitative medications (eg, epinephrine)
Heart rate
Respiratory effort
Muscle tone
Reflex irritability
Color
During this period of time, the clinical status of the infant should be
assessed every 30 to 60 minutes to ensure further
interventions and/or evaluations beyond routine care are no longer
required for successful transition to extrauterine life. The following
clinical parameters are monitored beginning in the delivery room and
continuing in either the nursery or mother's room:
Since there are no efficacy data for any of the above suggested
alternatives, providers should be alert to the possibility of failure of
prophylaxis. At the first postnatal visit within 48 to 72 hours after
discharge, the infant should be examined closely for ophthalmia
neonatorum. Infants with ophthalmia neonatorum should be tested
for Neisseria gonorrhoeae infection and should be reported to the
local health department and CDC as a prophylaxis failure.
Technique — After wiping each eyelid with sterile cotton gauze, the
prophylactic agent is placed in each of the lower conjunctival sacs
[ 6 ]. The agent should be spread by gentle massage of the eyelids,
and excess solution or ointment can be wiped away after one minute.
The eyes should not be irrigated after the application because doing
so may reduce efficacy.
Premature infants
Infants who are large or small for gestational age
Infants of diabetic mothers
Infants whose mothers were treated with beta adrenergic or
oral hypoglycemic agents
Infants who require intensive care
Infants with polycythemia
Infants with symptoms consistent with hypoglycemia such as
jitteriness, tremors, hypotonia, irritability, lethargy, stupor,
apnea, poor feeding, hypothermia or seizures
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