One of the most important physical findings to be able to recognize in a newborn is the presence of retractions. Sepsis, pulmonary pathology, cardiac disease, metabolic disorders, polycythemia, cold stress, and others can all cause retractions -- it is a sign of a newborn in distress. In this photo, taken during inspiration, the shadows between the ribs can be clearly seen. Retractions may or may not occur in combination with other signs of distress: nasal flaring, grunting, and tachypnea.
photo by Janelle Aby, MD