A nurse is completing the admission assessment of a newborn. Which of the following anatomical landmarks should the nurse use when measuring the newborn’s chest circumference?

Choice A reason:

“The cause might be too short or infrequent feedings.”: Newborns typically lose weight in the first few days after birth, which is normal. However, if the weight loss is significant, it could be due to inadequate feeding. Breastfed newborns should be fed 8-12 times in 24 hours to ensure they are getting enough milk. Short or infrequent feedings can lead to insufficient intake, resulting in weight loss2. Ensuring proper latch and feeding techniques can help address this issue.

Choice B reason:

“It is due to the newborn’s loss of the influence of the maternal hormones.”: While maternal hormones do influence the newborn, their loss is not a primary cause of significant weight loss. The initial weight loss is more related to fluid loss and the transition to breastfeeding.

Choice C reason:

“This might be related to your baby having 3 stools a day.”: Frequent stools are common in newborns, especially those who are breastfed. While it can contribute to weight loss, it is usually not the main cause of significant weight loss. Monitoring the baby’s feeding and ensuring they are getting enough milk is more critical.

Choice D reason:

“You might want to offer water supplements between feedings.”: Offering water supplements to a newborn is not recommended, especially for breastfed babies. Breast milk provides all the necessary hydration and nutrients. Introducing water can interfere with breastfeeding and reduce the baby’s intake of breast milk, potentially leading to further weight loss.

Choice A reason:

The dorsogluteal muscle is not recommended for intramuscular injections in newborns due to the risk of damaging the sciatic nerve. Additionally, this muscle is not well-developed in newborns, making it a less effective site for medication absorption.

Choice B reason:

The vastus lateralis muscle, located on the lateral aspect of the thigh, is the preferred site for intramuscular injections in newborns. This muscle is well-developed at birth, providing a large and safe area for the injection. It also has fewer major blood vessels and nerves, reducing the risk of injury. The vastus lateralis muscle ensures effective absorption of the medication, making it the optimal choice for administering vitamin K to prevent vitamin K deficiency bleeding (VKDB).

Choice C reason:

The deltoid muscle is not typically used for intramuscular injections in newborns because it is relatively small and underdeveloped at birth. This muscle is more suitable for older children and adults, where it can accommodate larger volumes of medication without causing discomfort or injury.

Choice D reason:

The ventrogluteal muscle is another site that is not commonly used for newborns. While it is a safe and effective site for intramuscular injections in older children and adults, it is not as easily accessible in newborns. The vastus lateralis remains the preferred site due to its size and ease of access.