Your newborn will be checked soon after birth and again within 72 hours of birth. This is to check for any signs of an underlying health problem. Your little ones heart, hips, eyes and testes (boys) will be examined as part of a top to toe physical examination. Here is what to expect and how:
Who will carry out the examination?
The examination is normally carried out by one of the healthcare professionals in the maternity unit such as the midwife, junior doctor or paediatrician.
When will it be done?
Your newborn will initially be checked immediately after birth for any obvious physical problems and then when baby is calm and settled, a more thorough examination will take place.
What is involved?
The top to toe physical assessment is to check for any obvious signs of any physical problems as well as specific screenings and examinations to identify if there are any underlying conditions that may need to be followed up, monitored or treated. The specific screenings will always check the following:Eyes – An ophthalmoscope (special torch) is used to check your newborns eyes for cataracts and other conditions, these conditions are identified by checking the movements and appearance of the eyes. Approximately 0.03% of babies have problems with their eyes that require treatment.Heart – Your little one will be observed feeding as heart problems can cause poor feeding. Her pulse will be checked and her heart listened to in order to identify any problems. It is estimated around 0.5% of babies have a heart problem that requires follow up/treatment.Hips – Each hip will be thoroughly examined as any problem left untreated could result in a limp or further joint problems. If further investigation is needed, an ultrasound may be arranged. Around 0.2% of babies have hip problems identified that require treatment.Testes – Your little boy will be checked to ensure his testes are in the right place. Most boys testes will have dropped (into the scrotum) by around 12 months of age. If they haven’t dropped by 2 years of age an operation may be required. Approximately 1% of boys have problems identified that require an operation.Ears – Usually carried out separately from the above tests, the newborn hearing screening will be conducted within a few days of birth. This is usually conducted on the maternity ward but in some areas this is offered at home. The test involves placing a small earpiece with a microphone and earphone attached into your child’s ear. A clicking sound is then played and the microphone picks up on whether the cochlea is functioning properly by monitoring the echo within the ear. This test is called the Octoacoustic emissions test. If the results of the OAE test are unsuccessful it could be due to a noisy atmosphere, fluid in the ear from birth or an unsettled baby. A second attempt is usually scheduled if this is the case. If the 2nd attempt is unsuccessful your child will be referred for further tests which involve monitoring the brain activity in response to sounds. This test is called the Automated Auditory Brainstem Response (AABR) test. Around 15% of newborns are referred to have the AABR test and approximately 3% of those children are then referred for a full diagnostic of their hearing at an audiology clinic. 0.2% of babies have some form of hearing loss in one or both ears.
What happens next?
The results of the examination and the reason for any follow up will be explained to you and the details recorded in your maternity notes and in your child’s ‘red book’ (which you will be given soon after birth). The physical examination will be carried out again when your baby is around 8 weeks old.
0.03% of babies have problems with their eyes, 0.5% of babies have a heart problem, 0.2% of babies have hip problems, 1% of boys have problems identified with their testes and 0.2% of babies have some form of hearing loss in one or both ears. These figures are not high but as a parent you can not help but worry. In some cases these problems will be minor, some can be corrected with surgery/treatment and in some cases it will be something you and your child have to live with. Identifying any sort of physical or underlying problem early helps with identifying and offering you and your child the support you will need (both medical and emotional).
Resources: Newbornphysical.nhs, ncds