During the newborn hospital exam, your Pediatrician ensures your little one is healthy from the start by examining his/her body in detail. Have you ever wondered, “What is the Pediatrician looking for? Is my baby really okay? This is Part 2 of my series, Newborn Hospital Exam, where I review the examination of the hands, feet & arms after delivery.
Prefer to watch instead of read? Want extra details too? Click here to watch the full video on my YouTube channel!
05. Newborn Hospital Exam – Hands & Feet
10 Fingers & 10 Toes
It’s so true! Making sure there are 10 of each, no more, no less is really important.
Polydactyly
This is when a baby is born with extra fingers/toes. It is common & occurs in about 1 in 1,000 births. The extra digit is usually small & not fully functional. It can be a simple extra piece of skin to a full digit.
Treatment includes an x-ray & surgery. Any extra skin, bones, and/or nerves need to be removed.
Causes can be genetic or environmental, such as smoking, alcohol, or drugs.
Syndactyly
This is when a baby has fingers/toes that are joined or webbed. This is fairly common & occurs in about 1 in 2,000-3,000 births.
Treatment involves an x-ray. And surgery usually is done by one year old. Causes are unknown in most cases, but some are genetic. Genetic testing is recommended.
Macrodactyly
This is when a baby has fingers/toes that are abnormally large due to an overgrowth of the bone and/or soft skin tissue surrounding it. This is uncommon & occurs in about 1 in 100,000 births. It can be associated with other conditions (neurofibromatosis, tuberous sclerosis & more). Genetic testing is recommended.
Treatment involves an x-ray. Surgery may or may not be needed, if the size remains stable.
Single Palmar (Simian) Crease
There are typically 2 horizontal creases in the palm of a hand. A single palmar crease is common. It occurs in about 1 in 30 births. Causes are unknown but may be genetic. It may be associated with other conditions, such as Down’s Syndrome, Fetal alcohol Syndrome & more. Genetic testing may or may not be recommended after a more detailed medical & family history is obtained from the parents.
06. Newborn Hospital Exam – Arms
Erb’s Palsy
In newborns, this is a muscle weakness in the arm and/or shoulder that occurred at birth. Signs are a limp arm/shoulder & a hand position that’s turned toward the back with curled fingers. Damage occurs at the brachial plexus which is a bundle of nerves connecting the neck to the arm. This occurs in about 1-3 in 1,000 births.
Cause is typically due to a stretch injury at delivery. And the pressure needed at delivery can cause this injury.
There are many possible causes. Some causes are that the baby doesn’t deliver easily, is stuck in the mother’s pelvis, is a large baby at delivery, there is maternal diabetes, or baby was breech.
Treatment depends on the severity. In mild cases, this self-resolves in about 3 months. However, nerve testing might be needed for a full evaluation. Physical & Occupational therapy might be needed. If it isn’t resolved by 6 months old, then surgery might be needed.
Missing or Shortened Bones
When this happens at the radius (thumb side of the arm), it’s caused Radial Longitudinal Deficiency. When it happens at the ulna (pinky side of the arm), it’s called Ulnar Longitudinal deficiency. It can also have missing fingers associated with this. Treatment involves an x-ray, therapies, and possible multiple surgeries as the baby grows in their lifetime. A similar problem can occur in the legs, but with different bones affected.
What’s Next?
Stay tuned next week for “Newborn Hospital Exam – Part 3 – Legs, Feet & Hips.” Don’t forget to check out the video for more in-depth information on today’s topic! Click here to watch the full video on my YouTube channel
For more information, read “Newborn Hospital Exam – Part 1 – Heart, Lungs & Abdomen” or watch the video!
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