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Newborn and infant physical examination video

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Newborn and infant physical examination video

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Newborn and infant physical examination (English)

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Public Health England (PHE) created this information on behalf of the NHS. In this information, the word 'we' refers to the NHS service that provides screening.

This short video explains screening for eyes, heart, hips and testes in newborn babies.
Newborn and infant physical examination video
The newborn physical examination is recommended by the NHS.

1. Purpose of screening

Within 72 hours of giving birth, you will be offered a top-to-toe physical examination for your baby. This will include 4 specific screening tests to find out whether your baby has a suspected problem with their eyes, heart, hips or, in boys, their testes which would benefit from early investigation and possible treatment.

The screening tests are carried out again between 6 and 8 weeks of age as some conditions do not develop or become apparent until then.

2. About the conditions

Each part of the physical examination is looking for different conditions.

About 2 or 3 in 10,000 babies have problems with their eyes that need treatment. The examination checks the appearance and movement of the eyes. The main reason for screening is to identify a condition called cataracts (a clouding of the transparent lens inside the eye). The examination cannot tell how well your baby can see.

Around 8 per 1,000 babies will have a heart problem or condition. This could range from a heart murmur to a problem needing specialist care or treatment. A murmur is a noise made by the blood as it passes through the heart. In almost all cases when a murmur is heard, the heart is normal. Murmurs are common in babies and this does not always mean there is a problem.

Babies can be born with hip joints that are not formed properly and if untreated this can lead to a limp and to joint problems. About 1 or 2 in 1,000 babies have hip problems that need treatment.

Baby boys are checked to make sure their testes are in the right place. It can take several months for testes to drop down (descend) into the scrotum. About 1 in 100 baby boys have problems with undescended testes that need treatment to reduce the risk of problems later in life, such as reduced fertility.

3. The screening test

A trained health professional will carry out a physical examination of your baby and ask you questions about your baby's general wellbeing.

Your baby will need to be undressed for part of the examination. During the examination the health professional will:

look into your baby's eyes focusing on how their eyes look and move

listen to their heart using a stethoscope to detect heart sounds

examine their hips to ensure the joints are working properly

examine baby boys to check if their testes are in the right place

These screening tests are carried out within 72 hours of birth and again when your baby is between 6 and 8 weeks of age.

4. Safety of the test

There are no risks associated with having this test.

5. Screening is your choice

The examination is intended to identify any of the problems early so that treatment can be started as soon as possible.

The general physical examination including this screening is therefore recommended for your baby.

6. Not having the test

You can decide to have your baby examined and screened for any or all of the conditions. If you have any concerns you should discuss them with your midwife and the health professional who offers the examination.

7. Possible results

Usually there will be nothing of concern found. If the health professional finds a possible problem, your baby will be referred for further assessment and tests if appropriate.

8. Getting my results

The health professional carrying out the examination will give you the results straight away. If a referral for further assessment is needed, this will also be discussed with you at the time of the examination.

The results will be recorded in your baby's case notes and personal child health record ('red book'). You will need to keep this record safe and make sure it is available whenever your baby sees a health professional.

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Eyes, heart, hips and testes (physical examination)

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Public Health England (PHE) created this information on behalf of the NHS. In this information, the word 'we' refers to the NHS service that provides screening. This short video explains screening for eyes, heart, hips and testes in newborn babies. Newborn and infant physical examination video The newborn physical examination is recommended by the NHS.

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Looking at your baby's heart, eye, hips, and testicles (balls) - easy read guide

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Looking at your baby's heart, eye, hips, and testicles (balls) - easy read guide

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Public Health England (PHE) created this information on behalf of the NHS. In this information, the word ‘we’ refers to the NHS service that provides screening.

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Newborn hearing screening: your baby’s visit to the audiology clinic

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Newborn hearing screening: your baby’s visit to the audiology clinic

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Public Health England (PHE) created this information on behalf of the NHS. In this information, the word 'we' refers to the NHS service that provides screening.

This leaflet explains why your baby needs to see an audiologist for more tests at an audiology clinic and what those tests involve. An audiologist is a health professional who specialises in hearing.

1. Your baby's visit to the audiology clinic

Audiology clinics have special equipment to test your baby's hearing. These tests will give better information about your baby's hearing.

Early testing means you will know if your baby has a hearing loss when they are still very young. This is important for their future development.

Your baby needs more tests because their hearing screening tests did not show a clear response in one or both ears. About 2 to 3 babies in every 100 do not show a clear response and are referred to audiology.

Most babies tested at an audiology clinic are found to have satisfactory hearing.

About 1 in 15 babies tested at the audiology clinic have a permanent hearing loss in one or both ears. Some have a temporary hearing loss. Finding out about hearing loss early gives babies a better chance of developing language, speech and communication skills as well as making sure their families receive the support they need.

It is important you bring your baby to the appointment. This is because they may need other tests to find a possible cause if they do have a hearing loss. These tests should be performed within the first few weeks of birth.

Some babies who have a hearing loss do react to sounds. The hearing loss may not be picked up without the tests in audiology.

If your baby does have a hearing loss, it is important to find out as soon as possible.

2. What happens at the clinic

The appointment will usually take about 1 to 2 hours. This includes time to settle your baby. The tests give more detailed information about your baby's hearing. They will not hurt or be uncomfortable for your baby. You can stay with your baby while they are tested.

The audiologist may use an otoacoustic emission ( OAE) test. This involves putting a small soft-tipped earpiece in the outer part of your baby's ear. The earpiece sends clicking sounds down the ear.

The inner part of the ear, known as the cochlea, usually produces a response when it receives sound. The testing equipment can pick up this response.

They may also use an auditory brainstem response ( ABR) test. This involves placing small sensors on your baby.

Sounds at different frequencies are played in your baby's ears. A computer records the response so the audiologist can measure how well your baby's ears respond.

Your audiologist will tell you what the results mean and if your baby needs any more appointments.

3. Possible results

If the tests show a hearing loss, your audiologist will explain what the results mean. Your baby may need more tests to measure the amount and type of hearing loss.

The results of the tests will help the audiologist give you and your baby the right support and information.

If you are told your baby has satisfactory hearing, this means they are unlikely to have a hearing loss. But children can develop a hearing loss later, so it is important to check their hearing as they grow up.

Your personal child health record book contains checklists of the sounds your baby should react to and the sounds they should make as they grow older.

If you have any concerns you should discuss them with your health visitor or GP. Your child's hearing can be tested again at any age.

4. More information

You can contact the audiology department that will carry out the test. You can also speak to your hearing screening team, health visitor, midwife or GP.

If the time of the appointment you have been given is not convenient, please telephone to rearrange. As you may be in the audiology clinic for a while, please make sure you have enough nappies and feeds for your baby. You may also want to bring somebody with you.

Read more about newborn hearing on the NHS website.

Contact the National Deaf Children's Society:

The NHS Screening Programmes use your personal information to ensure you are invited for screening at the right time. Public Health England also uses your information to ensure you receive high quality care. You can find out more about how your information is used and protected, and your options.

You can contact us for a Braille version of this leaflet.

Get more information about newborn hearing screening.

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Newborn hearing screening: your baby's visit to the audiology clinic

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Public Health England (PHE) created this information on behalf of the NHS. In this information, the word 'we' refers to the NHS service that provides screening. This leaflet explains why your baby needs to see an audiologist for more tests at an audiology clinic and what those tests involve.

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Click the link below the picture.

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This information was created on behalf of the NHS. In this information, the word 'we' refers to the NHS service that provides screening.

This short video explains blood spot screening in newborn babies.
Newborn blood spot video
Blood spot screening is recommended by the NHS.

1. Purpose of screening

To find out if your baby has any of 9 rare but serious health conditions.

Early treatment can improve your baby's health and prevent severe disability or even death. If you, the baby's father, or a family member already has one of these conditions, please tell your health professional straight away.

2. About these conditions

2.1 Sickle cell disease

About 1 in 2,800 babies born in the UK has a sickle cell disease ( SCD). These are serious, inherited blood diseases. They affect haemoglobin, a part of the blood that carries oxygen around the body. Babies who have SCD will need specialist care throughout their lives.

People with SCD can have attacks of severe pain, get serious, life-threatening infections and are usually anaemic (their bodies have difficulty carrying oxygen). Babies with SCD can receive early treatment, including vaccinations and antibiotics, which, along with support from their parents, will help prevent serious illness and allow them to live a healthier life.

2.2 Cystic fibrosis

About 1 in 2,500 babies born in the UK has cystic fibrosis ( CF). This inherited condition affects the digestion and lungs. Babies with CF may not gain weight well and frequently have chest infections. Babies with CF can be treated early with a high-energy diet, medicines and physiotherapy. Although children with CF may still become very ill, early treatment can help them live longer, healthier lives.

2.3 Congenital hypothyroidism

About 1 in 2,000 babies born in the UK has congenital hypothyroidism ( CHT). Babies with CHT do not have enough of the hormone thyroxine. Without thyroxine babies do not grow properly and they can develop permanent serious physical problems and learning disabilities.

Babies with CHT can be treated early with thyroxine tablets and this will allow them to develop normally.

It is important to let your health professional know if you have a family history of a metabolic condition. Babies are screened for 6 inherited metabolic diseases (IMDs).

These are:

phenylketonuria (PKU)

medium-chain acyl-CoA dehydrogenase deficiency (MCADD)

maple syrup urine disease (MSUD)

isovaleric acidaemia (IVA)

glutaric aciduria type 1 (GA1)

homocystinuria (pyridoxine unresponsive) (HCU)

About 1 in 10,000 babies born in the UK has PKU or MCADD. The other conditions are rarer, occurring in 1 in 150,000 babies to 1 in 300,000 babies.

Babies with these inherited conditions cannot process certain substances in their food. Without treatment babies with some of these conditions can become suddenly and seriously ill. The symptoms of the conditions are different; some may be life threatening or lead to severe developmental problems.

They can all be treated by a carefully managed diet, which is different for each condition and may include additional medicines.

3. The screening test

When your baby is 5 days old the health professional will prick your baby's heel using a special device to collect some drops of blood onto a card. Occasionally this may be later than 5 days. The heel prick may be uncomfortable and your baby may cry. You can help by making sure your baby is warm and comfortable, and by cuddling and feeding them.

Sometimes, a second blood spot sample is required later on. If so, the reason will be explained. It does not necessarily mean there is something wrong with your baby.

4. Safety of the test

There are no known risks to your baby associated with having the test.

5. Screening is your choice

Screening your baby for all these conditions is recommended because it could save your baby's life but it is not compulsory. You can choose to have screening for SCD, CF or CHT individually but can only choose to have screening for all 6 IMDs or none at all. If you do not want your baby screened for any of the conditions or have any concerns about the test, please talk to your midwife.

Early screening is best as treatment can be started as soon as possible if needed. But if you choose not to have screening, your baby can have the test later if you change your mind. Babies can be screened up to 12 months of age for all the conditions except CF (only up to 8 weeks of age).

6. Possible results

Most babies will have normal results indicating that it is unlikely that they have any of the conditions. A small number of babies will screen positive for one of the conditions. This does not mean they have the condition but they are more likely to have it. They will be referred to a specialist for further tests.

Screening for cystic fibrosis finds some babies who may be genetic carriers of the condition. These babies may need further testing. Screening does not detect all carriers.

Occasionally, other medical conditions might be identified through these screening tests. For example, babies with beta thalassaemia major (a serious blood disease) will usually be detected. These children also need to be referred for lifelong treatment and care.

Screening for sickle cell disease also finds babies who are genetic carriers of these or other red blood cell diseases. Carriers are healthy although they can experience some problems in situations where their bodies might not get enough oxygen, for example, if they are having an anaesthetic.

7. Getting my results

You should receive the results from a health professional by the time your baby is 6 weeks old. The results should be recorded in your baby's personal child health record ('red book'). Please keep this safe and bring it with you to any further appointments. You will be contacted sooner if there is thought to be any problem with your baby.

8. My baby's blood spot card and data after screening

After screening blood spot cards are stored for at least 5 years and may be used:

to check the result or for other tests recommended by your doctor

to improve the screening programme

for research to help improve the health of babies and their families in the UK (this will not identify your baby and you will not be contacted)

In addition, there is a small chance that researchers may want to invite you or your child to take part in information gathering linked to the newborn blood spot screening programme. Researchers undertaking any additional studies would explain what is being done and you would then be asked if you wish to take part in that study. Please let your midwife know if you do not want to be contacted to discuss taking part in any additional information gathering.

All use of the blood spots is governed by the code of practice. Any research will have been approved by an independent research ethics committee.

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This information was created on behalf of the NHS. In this information, the word 'we' refers to the NHS service that provides screening. This short video explains blood spot screening in newborn babies. Newborn blood spot video Blood spot screening is recommended by the NHS.

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Click the link below to access all our resources about support in the postnatal period

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Click the link below to access all our resources about feeding your baby.

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COCH Welcome to transitional care leaflet

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COCH Welcome to transitional care leaflet

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Please click the link below to access all our resources about our neonatal unit and premature birth care

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Welcome to Cestrian Ward

We hope the information provided is helpful to you, please to not hesitate to ask the staff any other questions you may have. On arrival you should be allocated a named midwife who will be responsible for your care through their shift. Please ensure you know who your named midwife is. New named midwives will introduce themselves at the start of every shift.

We are a 27 bed ward, caring for both postnatal and antenatal inpatients. We have a combination of bays and side rooms. A call bell is available at your bedside and can be used to call for assistance at any time of the day or night.

In order to ensure the safety of our patients we ask that you keep the curtains open at all times unless undressing/breastfeeding etc. This helps staff to monitor the wellbeing, safety and security of all mothers and babies on the ward. This also ensures that the ward benefits from natural light, which improves the environment for all.

Thank you for your co-operation

Staffing & Security

The safety of our patients and their babies is our main priority. The doors of the ward are always locked and can only be opened by members of staff. Please do not let other people in or allow them to tailgate behind you. All hospital staff will be wearing an identity badge, please challenge any member of staff whose ID is not visible to you.

Identifying staff

Ward Manager/Deputy Ward Manager (Navy blue)

Midwives (Blue & white striped tunic)

Maternity Assistants/ Maternity Support Workers (Lilac & white striped tunic)

Housekeepers (Light lilac tunic)

Ward clerk (Shirt/blouse)

Domestics (Dark lilac tunic)

Student midwives (Grey tunics)

Hearing screeners (Green scrubs)

Smoking policy

The hospital is no smoking zone and we ask that patients and visitors not to smoke anywhere inside the hospital or outside, particularly at the entrance to the Women & Children’s building and General Wing.

Fire Safety

If you discover a fire please tell a member of staff immediately.

Fire alarm systems are tested on a Wednesday at 11am. In the event of a fire, please follow the advice and instructions given by hospital staff.

We ask all visitors to sign in and out of the ward so we can keep everyone safe and accounted for in the event of a fire. The sign in book is located at the main ward station.

Visiting times

One birthing partner and patients own children only between 7:30am to 10pm.

Other Visitors are welcome between 12:30pm and 3:30pm and 5:30pm and 7:30pm.

We do ask that only 2 adults visit the bedside at the same time (including birth partner).

Mealtimes

Breakfast 7.30am to 08.00am

Lunch 11.45 to 12.30pm

Evening meal 5.15pm to 6.15pm

All are provided from the meal trolley and eaten at you bedside

We also have regular rounds with our hot drinks trolley and can provide snacks such as fruit, crisps and biscuits. The hot drinks trolley is available for you to make your own hot drinks too. Please ask staff if you need any refreshments or fresh water and inform us of any dietary requirements you may have. Toast and sandwiches are always available and there are vending machines on the ground floor. We have a patient fridge, please ensure any items are labelled with your name and date. We regret that we are unable to heat any food e.g. microwave meals due to health and safety.

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-Welcome to Cestrian ward

Transitional and neonatal care

- Going home

-Registering your baby's birth

-Newborn physical examination - looking at your baby's heart, eye, hips, and testicles (balls)

-Looking at your baby's hearing

-Newborn bloodspot tests

- Postpartum maternal health

-Caring for your baby

-Feeding your baby

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Once you are home, the maternity team are still available to you if you have any questions or require any support.

A midwife will visit you at home the day after discharge between 8:30am and 4:30pm. Please call the community midwives office if you haven't had a visit by 4pm.

You will also have a further routine visit or phone call on the second day you are home.

You will receive further visits from the maternity team on day 5 and day 10-14.

You can request a visit at any other time. You can also call the maternity team at any time with questions about your own wellbeing, baby's wellbeing or if you need support with feeding your baby.

Please register your baby with your GP as soon as possible.

Useful numbers:

8:30am-6pm everyday:

Community midwives Office - 01244 365166

8:30am-4:30pm Monday - Saturday:

Infant feeding Team - 01244 365401.

24hrs a day:

Maternity Triage - 01244 365806

24hrs a day:

Cestrian ward - 01244 365178

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It is a legal requirement to register your baby's birth within 42 days. You must make an appointment to do this online (see link below) or by calling Chester registry office on 0300 123 7037

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All births in England, Wales and Northern Ireland must be registered within 42 days of the child being born.

You should do this at the local register office for the area where the baby was born or at the hospital before the mother leaves. The hospital will tell you if you can register the birth there.

If you cannot register the birth in the area where the baby was born, you can go to another register office and they will send your details to the correct office.

Information you need when registering a birth

When registering the birth, you should know:

place and date of the birth

name, surname and sex of the baby

parents' names, surnames and address

places and dates of parents' birth

date of parents' marriage or civil partnership

parents' jobs

mother's maiden surname

You might not need to give all of this information, depending on who is registering the birth.

What you should take

You should take at least one form of identification when you go to the register office. You can use:

passport

birth certificate

deed poll

driving licence

proof of address (for example, a utility bill)

Council Tax bill

marriage or civil partnership certificate

You should also take your child's personal child health record or 'red book' as some registrars may ask to see it.

If you're going to the register office on your own, you may need proof of paternity from the other parent before you give their details.

After the birth is registered

Once you've registered the birth, you may be able to claim:

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Find out how to register a birth - who can register, birth certificates

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Information about Chester register office