Neonatal Care, Congenital Disorders, and Immunizations

At birth, the placenta stops providing oxygen while the lungs must aerate and assume gas exchange. Pulmonary vascular resistance falls, pulmonary blood flow rises, and fetal circulatory pathways begin to close. This transition is why the first assessment centres on breathing, heart rate, tone, colour, temperature, and perfusion rather than on a long head-to-toe examination. Dry the newborn, provide warmth, position the airway, and support skin-to-skin contact when the infant is stable. A newborn who is apneic, gasping, persistently bradycardic, or not improving with initial steps requires neonatal resuscitation according to local protocol. Effective ventilation is the priority; Apgar scoring must never delay resuscitation. Apgar scores at 1 and 5 minutes describe the infant’s response to extrauterine life. They do not diagnose asphyxia or determine whether resuscitation should begin. A pink trunk with bluish hands and feet can reflect normal peripheral vasoconstriction during transition. Blue lips, tongue, or mucous membranes indicate central cyanosis and are abnormal. Grunting, nasal flaring, retractions, apnea, persistent respiratory rate above 60, temperature instability, weak pulses, or worsening pallor indicate that adaptation is failing. Reassess promptly...