Newborn physical examination

Within 72 hours of giving birth, all parents are offered a thorough physical examination for their baby. This includes babies who are born at home.

This examination includes specific screening tests to find out if your baby has any problems with their eyes, heart, hips and, in boys, the testicles (testes). This examination is part of the Newborn and Infant Physical Examination (NIPE) screening programme.

The newborn physical examination is usually carried out in hospital before you go home. Sometimes it's done at a hospital or community clinic, GP surgery, children's centre, or at home.

Ideally, both parents should be there when the examination is done. The health professional doing the examination should explain what it involves. This could be a doctor, midwife, nurse or health visitor, and they will have had specific training to undertake the examination.

Some parts of the examination may be a little uncomfortable for your baby, but it won't cause them any pain.

The aim is to spot any problems early so treatment can be started as soon as possible. Usually, nothing of concern is found. If the health professional carrying out the examination does find a possible problem, they may refer your baby for more tests.

You will be offered another physical examination for your baby at six to eight weeks, as some of the conditions it screens for can take a while to develop. This second examination is usually done at your GP's surgery.

How is the newborn physical examination done?

The health professional will give your baby a thorough physical examination. They will also ask you questions about how your baby is feeding, how alert they are, and about their general wellbeing. Your baby will need to be undressed for part of the examination.

During the examination, the health professional will also:

• look into your baby's eyes with a special torch called an ophthalmoscope to check how their eyes look and move
• listen to your baby's heart to check their heart sounds
• examine their hips to check the joints
• examine baby boys to see if their testicles are in the right place

What does the newborn physical examination check for?

The examination includes an overall physical check plus four different screening tests.

Eyes

The health professional will check the appearance and movement of your baby's eyes. They are looking for cataracts, which is a clouding of the transparent lens inside the eye, and other conditions.

About 2 or 3 in 10,000 babies are born with problems with their eyes that require treatment. However, the examination can't tell you how well your baby can see.

See how cataracts are diagnosed and treated.

Heart

The health professional will also check your baby's heart. This is done by observing your baby, feeling your baby's pulses, and listening to their heart with a stethoscope.

Sometimes heart murmurs are picked up. A heart murmur is where the heartbeat has an extra or unusual sound caused by a disturbed blood flow through the heart.

Heart murmurs are common in babies. The heart is normal in almost all cases where a murmur is heard. However, about 1 in 200 babies has a heart problem that needs treatment.

See more about diagnosing and treating heart problems in newborns.

Hips

Some newborns have hip joints that are not formed properly. This is known as developmental dysplasia of the hip (DDH). Left untreated, this can cause a limp or joint problems. About 1 or 2 in 1,000 babies have DDH that needs treating.

See more about developmental dysplasia of the hip.

Testicles

Baby boys are checked to make sure their testicles are in the right place. During pregnancy, the testicles form inside the baby's body. They may not drop down into the scrotum until a few months after birth.

In about 1 in 100 baby boys, the testicles descend only partially or not at all. This needs treating to prevent possible problems later in life, such as reduced fertility.

See more about undescended testicles.

Does my baby have to have the examination?

The aim of the examination is to identify any of the problems early so that treatment can be started as soon as possible. It's strongly recommended for your baby, but not compulsory.

You can decide to have your baby examined and screened for any or all of the conditions. If you have any concerns, you should talk to your midwife or the health professional who is offering the examination.

When will we get the results?

The health professional carrying out the examination will give you the results straight away. If your baby needs referring for more tests, they will discuss this with you there and then, too.

The results will be recorded in your baby's personal child health record (red book). You'll need to keep this safe and have it to hand whenever your baby sees a health professional.

If you have any concerns, you can discuss them with your midwife or the health professional who does the examination.

Download a leaflet about screening tests for you and your baby.