Normally, the fontanelle feels soft and is either flat or slightly indented. The anterior
fontanelle usually bulges when the infant cries, coughs, or vomits.
o. Observe the general appearance of the infant's neck. The infant's neck is
usually short, thick, and covered with folds of tissue. The infant should be able to move
his neck from side to side, from flexion to extension, and can hold his head in the
p. Observe the infant's eyes for symmetry of size and shape. Note the infant's
eye movements. Strabismus caused by poor neuromuscular control is normal. An
infant older than ten days should look in the direction in which you turn. Note the color
of the infant's eyes.
q. Inspect the infant's ears for structure, shape, and position. The ears should
be firm with wee-formed cartilage. Tops of the auricles should be parallel to the outer
canthus of the eye (refer to figure 7-5).
r. Inspect the infant's nose for patency.
s. Inspect the infant's mouth for cleft palate by gently depressing his tongue
when he cries. Check the mucous membranes. Observe the soft and hard palate.
Make sure they are in tact.
t. Inspect the infant's skin and nails. Observe for jaundice, birthmarks, milia,
petechiae, and lanugo. Observe the infant's hands and feet for normal creases.
Observe the color of the infant's nail beds; they should be pink. Acrocyanosis may be
present up to 24 degrees, especially when the infant is crying.
u. Inspect the size, shape, and symmetry of the infant's chest. Normally, an
infant's chest is circular or barrel-shaped. The breast tissue of both male and female
infants may be slightly engorged during the first few days of life.
v. Palpate the infant's peripheral pulses (femoral, brachial, and radial).
w. Inspect the size and shape of the infant's abdomen. The abdomen should be
cylindrical in shape. Sunken or distended abdomen should be reported. Check the
umbilical cord for the number of vessels.
x. Auscultate the infant's abdomen for bowel sounds. Bowel sounds should be
present within one to two hours after birth.
y. Observe for excessive drooling, coughing, gagging, or cyanosis during
z. Place the infant on his abdomen and observe his spine for curves, masses, or