A 2050-g newborn of 36 weeks' gestation was born by vaginal vertex delivery with low forceps assistance after 16 hours of labor. The newborn's Apgar scores were 4 and 8 at 1 and 5 minutes, respectively. The mother, a 14-year-old girl, had received no prenatal care. The infant forcefully vomited the first formula feeding, given at age 12 hours.
Results of physical examination showed the newborn to be active and in no distress. The newborn's length was 49 cm, and the head circumference, 35 cm. An extensive left parietal cephalohematoma was present. The white blood cell count was 14.9 × 109/L, and the differential count was as follows: neutrophils, 53%; lymphocytes, 37%; and monocytes, 10%. The hemoglobin value was 120 g/L, and the bilirubin value was 128 μmol/L.
Because of continued vomiting and regurgitation of feedings, a frontal roentgenogram of the abdomen was obtained after insertion of a