To label a finding abnormal one has to be sure that it is not within normal limits. These limits are different in adults and children, even in children they differ from age to age. For this reason knowledge what is normal at a particular age? is essential and findings should be interpreted keeping in view the age of the patient (child).

FOLLOWING PRESENTATIONS / FINDINGS ARE CONSIDERED NORMAL
IN THE NEWBORNS
                                * Weight loss---< 10%, lost weight is regained by the age of 10 days.
 *Passage of stools after each feed----the color of meconium which is brownish-black starts changing at the age of 2-3 days, it becomes golden-yellow. Frequency increases on third to fifth day, 8-10 times/day is normal, but it should not be associated with dehydration or evidence of infection.
In some babies passage of stools may be delayed upto 24 hours after birth and urine upto 48 hours.
* Regurgitation of feeds? if only small amount is regurgitated, it is not associated with dehydration or evidence of obstruction or infection.
*Jaundice-if starts after 24 hours, not visible on limbs, is not associated with change in feeding pattern and crying, does not persist after one week, total bilirubin level is not above 12 mg% in full term and 14 mg% in pre term newborns.
*  Cyanosis if peripheral only, transient, not associated with evidence of respiratory-distress or septicemia, it improves on warming up of babies.
* Enlargement of breast and bleeding P/ V.
* Epstein?s(epithelial-pearls they present as whitish painless spots on the roof of mouth and prepuce).
* Mongolian blue spots (they present as well defined blue patches over buttocks and trunk)  usually they disappear before the age of 2 years.
* Sacrococcygeal pits and dimples.

   AFTER NEONATAL PERIOD

                 1--6MONTHS   6-12MONTHS       1-3YR         3---  5YR         5---8YR             8---12

HEART RATE        120-140/mt        110-130/mt        105-120/mt        100-110/mt          95-105/mt             80---95/mt

RESPIRATORY.RATE-     <55/mt          <50/mt              <45/mt                <40/mt             <35/mt                      <30/mt

B.P                          < 90/60mm                   < 94/64mm             <100/68mm            <110/70mm                <116/78mm

PALPABLE LYMPH NODES---if confined to one area, <2 in number, smaller than pea-nut, nontender

TONSIL ENLARGEMENT--- between 4-8 year without sore-throat, pain, follicles, membrane fever and obstruction of the oropharynx

THRILL/ MURMUR    -------consider it innocent if it is witthout specific radiation, cough, breathlessness, grunting, cyanosis, feeding-difficulties and evidence of cardiac failure or cardiomegaly

HEPATOMEGALY------- below the age of 2 year, less than 2 cm nontender and smooth

TELANGIECTASIA (Spider naevi) on hands and face, upto three marks is frequent finding.

BOWLEGGEDNESS (Bowing/arching of legs) if it is mild and observed in toddlers.

THERE ARE OTHER NORMAL PATTERNS / PRESENTATIONS / FINDINGS.

One needs to know the normal pattern for the various laboratory tests. Normal values are different  / may be different in children as compared to adults.

Key--/mt=per minute