Where you put an IV on a newborn will depend on how long the newborn needs treatment and how sick they are.
When starting an IV on a newborn doctors choose the site based on how long the newborn needs treatment and how sick they are.
However IVs are started on newborns in the peripheral veins in the hands, feet and scalp as well as central lines via the umbilical cord.
The common peripheral sites where you start IV on newborns include:
The hands, which include the dorsal venous network on the back of the newborns hand.
The feet, which includes the saphenous veins or the dorsal arch on top of the newborns foot.
The scalp, which includes the superficial temporal, frontal, or auricular veins, which are also often prominent and visible in neonates.
And the arms, which include the Antecybital fossa or the inner elbow veins, although flexion areas are also prone to dislodging.
The special and central sites for starting an IV on newborns include:
An umbilical venous catheter or (UVC), which uses the vein in the umbilical cord stump for rapid or ey delivery room access and long term fluids.
PICC lines, which are peripherally inserted central catheters that are threaded through the arm, leg or scalp veins for long term nutrition.
And intraosseous (IO), which involves emergency bone marrow access in the tibia or femur if the veins of the newborn fail.
For peripheral intravenous (IV) access in infants, the dorsum of the hand and the great saphenous vein at the ankle/foot are considered the safest and most standard primary sites.
Distal veins are preferred first to preserve vein health, and selection depends heavily on the infant's mobility level.
Safety and Placement Considerations for IVs in newborns include:
Catheter size: A small, short 24-gauge or 26-gauge catheter is standard to minimize vessel trauma.
Joint avoidance: Avoid areas of flexion (like the wrist or antecubital fossa) whenever possible to prevent the line from kinking or dislodging.
Immobilization: Careful splinting of the limb is vital because infant movement easily dislodges peripheral lines.
Monitoring: Frequent hourly checks are required to catch fluid leakage into surrounding tissue (infiltration) early.