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Newborn Screening

The newborn physical examination is an assessment of the overall health and well-being of your baby.

It includes a general top-to-toe assessment as well as checking for specific conditions including: congenital heart disease, cataract and retinoblastoma, developmental dysplasia of the hips and undescended testes.

Early detection and diagnosis of conditions and health problems provides the best chance for effective treatment and support. The examination is offered to parents of newborn babies within 72 hours of birth. For babies in the Neonatal Intensive Care Unit (NICU), Special Care Baby Unit (SCBU), or who are unwell, some components of the examination may be conducted beyond 72 hours. Depending on where you give birth, this examination will either be undertaken in hospital, at home, at a children's centre or at a GP clinic, with your consent.

Top-to-toe check for your newborn

The overall top-to-toe check includes examining your baby's:
• skin to see that it is not dry and the folds of your baby's neck, under the arms and groin to exclude any septic spots.
• colour and any discoloration.
doctor examining newborn baby
• eyes, gums and the roof of the mouth to confirm they are not yellow due to jaundice.
• head and face to check that they are clear of infection.
• mouth to see that there is no cleft palate that may hinder feeding.
• abdomen to see that it is soft and all the organs are the appropriate size.
• reflexes to see that they are present and normal and also checking that the spine is complete and straight.
• arms and legs to check that they are straight.
• genitalia to check that they are healthy.
• ability to maintain appropriate eye contact.

Newborn Screening examinations

In addition to the top-to-toe check specific screening examinations will also be carried out to identify any problems or conditions which may need monitoring, further investigation or treatment. These include checking your baby's:
• heart – for problems such as congenital heart disease (i.e. a problem with the structure of the heart or the way in which is blood is being pumped to and/or from the heart. The check includes observing your baby's colour, noting how well s/he feeds, feeling the pulses and listening to the heart using a special stethoscope.
• hips – for problems such as developmental dysplasia of the hip – where the hip joint is dislocated or the ball or socket part of the hip joint have failed to develop normally. The check involves gentle manipulation of the hip joints to see whether they are dislocated or dislocatable.
• eyes – for problems such as cataract (a clouding of the usually clear lens inside the eye) or retinoblastoma (a type of childhood eye cancer). The movement and appearance of your baby's eyes are checked using an ophthalmoscope (special torch).
• testes – for problems such as undescended testes. Your baby boy will be clinically examined to check that his testes are in the right place.
Newborn Screening Examination

After the newborn physical examination

Anything identified during the examination, and any subsequent monitoring, investigation or treatment, will be discussed with you. Some conditions may not be present at birth, but can develop over time. So, another physical examination (called the infant examination) will be offered when your baby is 6 to 8 weeks of age – this examination repeats the checks carried out in the newborn examination. The outcome of the examinations will be recorded in your baby's personal child health record (PCHR) book.

April 2010

More information
More information about the newborn and infant physical examinations, and the conditions they screen for, is available at: http://newbornphysical.screening.nhs.uk/public. If you have any questions about the newborn or infant physical examinations then speak to your midwife, health visitor or GP.
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