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Routine Chest Measurement in the Newborn

Myron M. Nichols, MD
Arch Pediatr Adolesc Med. 1996;150(7):771. doi:10.1001/archpedi.1996.02170320117028.
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Neonatal chest measurement—Who needs it? Apparently 75% of pediatricians (38% "almost never," 37% "never noted") who were recently surveyed in Arizona.1 Drs Patton and Bergeson conclude that if neonatal chest measurements were eliminated, nursing time would be freed for more important pursuits. I heartily agree that neonatal nurses have "more important pursuits."

The physician, not the nurse, should be measuring the infant. The physician (an eager young neonatologist or an old bag-toting doctor) can identify the small-for-gestational-age infant with intrauterine growth retardation and with small chest circumference compared with a "normal head" vs the infant of gestational diabetic mother with relatively large chest-to-head ratio. White babies' head circumferences are usually equal to or larger than their chest circumferences, while the reverse is usually found in African American babies.

Finally, noting at discharge an enlarging head and no change in chest circumference has enabled me to pick up several cases

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