Normal Newborn Transition

Birth is a handoff between two life-support systems. The placenta has supplied oxygen, removed carbon dioxide, regulated temperature, and provided a continuous glucose supply; after separation from the placenta, the newborn must breathe, circulate blood, conserve heat, and maintain glucose independently. That handoff is usually smooth, but the first minutes are not the time to assume that an unusual finding is harmless. Begin with the ACoRN Primary Survey—Airway, Breathing, Circulation, Disability, and Exposure—and correct threats to ventilation, perfusion, or temperature before completing a detailed examination. Observe respiratory effort, heart rate, color, tone, and temperature; assess glucose when the newborn is at risk or clinically unwell. A pink trunk with blue hands and feet may reflect normal transitional vasoconstriction, whereas blue lips or tongue requires immediate assessment. The sequence matters. Stabilize first, use the Apgar score to describe the newborn's condition at set times, and then interpret the head-to-toe findings in the context of gestational age, delivery, feeding, and the infant's trend.