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The Neonatal Environment: Definition & Assessment

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  • 0:03 Neonatal Environment
  • 1:03 Apgar Assessment
  • 2:57 Brazelton Scale
  • 5:00 Lesson Summary
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Lesson Transcript
Instructor: Natalie Boyd

Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.

How do medical professionals make sure that a baby is healthy at the beginning of his or her life? In this lesson, we'll examine two common assessments given to measure physical and behavioral health: the APGAR Assessment and the Brazelton Scale.

Neonatal Environment

Jodie is a neonatal nurse. Her job is to make sure that babies are taken care of in their first few hours of life. Neonatal literally means 'newborn.' It is a combination of the Greek prefix 'neo-,' which means 'new,' and the Latin word 'natal,' which means 'to be born.' As a neonatal nurse, Jodie is the nurse who is in charge of taking care of newborns.

And what a job it is! There are many things that must be done in the first few hours of birth to make sure that the baby has the best chance possible to succeed. The neonatal environment is the world in which a newborn finds herself. Jodie's job is to make sure that the neonatal environment is a safe one and to make sure that the babies' reactions to the neonatal environment are normal and healthy.

Let's look at two assessments that medical professionals like Jodie use in order to judge how healthy a baby is: the APGAR Assessment and the Brazelton Scale.

APGAR Assessment

Jodie is one of the first people that a baby comes into contact with after being born. Right after birth, while still in the delivery room, Jodie takes the baby and gives him the APGAR Assessment. This test of the physical capabilities of the newborn was developed in the 1950s by Dr. Virginia Apgar, which is where it got its name.

But 'APGAR' is also an acronym for the tests that make up the assessment. They are:

1. Appearance

Jodie examines the baby to make sure that the color of the skin is normal all over. If a baby has a bluish coloring on the extremities or all over, it's a sign that something might be wrong.

2. Pulse

Jodie checks to make sure that the infant's heart rate is above 100 beats per minute, which is normal for a newborn. If the pulse is below 100 or if there is no pulse, Jodie knows that something must be done to help the baby.

3. Grimace response

If Jodie tickles the baby, she expects it to react with vigor. It should pull away, cry or cough. If the baby only reacts by making a face or does not respond at all, there might be a problem.

4. Activity and muscle tone

Jodie is looking for active movement from the baby and an indication that the baby is in control of his muscles. If the baby is floppy and seems to have no control over his body, Jodie knows that something's wrong.

5. Respiration

Jodie checks the baby's breathing rate and effort. A normal rate and healthy cry are what she's looking for. If the baby has a weak cry or no breath, she sounds the alarm.

When Jodie does the APGAR Assessment, she scores each of these five items on a scale of 0-2, and then adds up the score for a total score of up to 10. A baby who gets a 10 is a healthy baby who is reacting to his physical environment in a normal way.

Brazelton Scale

Physical health is important, but it's not the only aspect of a person. Many people also recognize that a person's psychological health is important, and babies are no exception. The problem is, you can't just put a baby on a couch and say, 'Tell me how that made you feel.' Dr. T. Berry Brazelton came up with a scale to assess the individual behavior of the baby.

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