PL-1/PL-2 Normal Nursery Rotation

Term Newborns - Duration, location, supervision

Residents generally have two rotations with term newborns, one in the PL-1 year and one in the PL-2 year; 1 to 2 PL-2s may elect to omit the second rotation. Each rotation is 4 weeks in duration. The site is UMass Memorial Health Care - Memorial Campus Nursery. Dr. Mary McMurray is responsible for the curriculum and education; clinical supervision is the responsibility of the pediatrician from the U. Mass. Department of Pediatrics Division of General and Community Pediatrics who is assigned to the Nursery for the month.

During the rotations, it is expected that the resident will become proficient in caring for healthy newborns and in recognizing and managing the common problems of the newborn period. Residents also gain confidence in talking with mothers about their babies' and in answering questions about infant care.

Topics Addressed During the Rotation

1. General examination - including variations of normal and common congenital abnormalities
2. Infant temperament and maternal-fetal interaction
3. Routine nursery procedures and care
4. Dubowitz examination; small-for-gestational-age and large-for-gestational age babies
5. Infant nutrition including breast feeding
6. Prolonged rupture of membranes and risks for sepsis
7. Hypoglycemia
8. Polycythemia
9. Heart murmurs, tachypnea and cyanosis
10. Jaundice
11. The well premature
12. The teenage mother
13. The baby of the drug-abusing, HIV positive or hepatitis B positive mother
14. The jittery baby
15. Gastrointestinal problems (vomiting, feeding difficulties, stooling problems

The following subjects are among those which the resident should expect to discuss with parents:

1. Integrity of the baby
2. Any abnormal findings - plans for further investigation and care
3. Feeding
4. Weight loss and gain
5. Sleep patterns
6. Impact of the new baby on the household including siblings
7. Circumcision
8. Stooling and voiding patterns
9. Umbilical cord care
10. Bathing
11. Dressing
12. Help at home
13. Coordination of future health care
14. Safety