5 Tips for Conducting Infant Physical Exams

Physically assessing a baby is a critical skill for a lactation care provider to have. Depending on what background experiences brought you to the profession, this may be a familiar role for you — or it may feel very new.

Either way, there are a few key points to remember to make your infant physical exam as helpful as possible for you and as comfortable and stress-free as possible for families. Below, Sarah Stilling, Pediatric Nurse Practitioner and IBCLC, shares some advice from her years of experience examining babies.

Always ask permission. It sounds obvious, but it’s often skipped: Ask the parent’s permission before you begin examining their baby. Just because a parent and baby are in a clinic or hospital setting, don’t assume consent to examine. “I see this assumption made all too often in the hospital setting,” Stiling says. “It’s a vulnerable position to be a patient or the parent of a patient. Respect their autonomy, dignity, and control by asking for consent.”

And while you’re asking, be specific about what you intend to do; “examine your newborn” may mean different things to different people.

Be prepared. Another tip: Before you begin, make sure you have everything you need to complete your exam. Don’t disturb a newborn and then discover you don’t have what you need!

Listen to the parents. Before you begin your physical assessment, take the time to make sure parents are ready. A parent with a specific question or concern will probably need to talk about what’s on their mind before you move on to a physical exam. “A parent who is preoccupied with a concern needs to focus on that before they will be ready to hear what you have to say or learn something new,” Stilling notes.

Don’t rush the parent, and instead invite them to voice their concerns and repeat back to them what you’ve heard. This establishes a trusting relationship and allows them to feel understood. Reassure them that you will be sure to address their concern once you have gathered more information through your assessment.

Be systematic, yet flexible. Having a set plan for your physical exams can be helpful in terms of not forgetting anything, but keep in mind that your plan may need to change based on the infant’s state.

Remember the parents. “Remember that you have two patients,” Stilling says. “Especially for new providers, it is easy to become focused on the baby during a newborn assessment, but remember that the family are your patients as well.”

Stilling shares a key moment in her career where she learned this lesson — she had been listening to a baby’s heart, and afterward, she realized that the parent was upset. When she questioned why, the parent told her that she had looked very concerned while listening to the baby’s heart and had seemed to listen for a long time, leading the parent to worry that something was wrong. Stilling has never forgotten that teachable moment, and urges keeping your body language and facial expressions in mind during physical exams, along with communicating about what you are doing.

Practice Makes Perfect
If you are new to conducting infant physical assessments, don’t worry. You will soon develop your own unique style and approach. “This may seem like a great many tasks to put together and in motion,” Stilling says. “But I assure you, it will come, with practice and time!”

Ready for More?
In her 5.5-hour course “Infant Assessment, Growth, and Development,” Stillings covers growth and development from birth to 24 months as well as newborn physical and neurological assessment. Her depth of knowledge and experience will leave you with a whole new set of tools and understanding before your next consult!