advice

baby’s first exam:
what to expect at your baby's newborn examination

Your dear little baby has arrived. Amongst all the emotions of joy, exhaustion and relief, you'll no doubt want to know they're healthy and well. Within their first three days a full newborn examination will check this is the case.

baby being weighed for newborn examination

who, what, where

If you're in hospital, a paediatrician will most likely carry out the newborn baby check. If you had a home birth, it will be either your own GP or midwife. Both you and your partner can observe, and this gives you a good chance to ask any questions. Baby didn't come with a manual, so now's the time to be curious! Babies will need to be undressed for some of the tests, so have a snuggly blanket ready to wrap them up between checks.

newborn examination: what to expect

A physical screening is carried out from top to toe, with special emphasis on the eyes, heart and hips, plus the testicles in boys. Starting with the head, the soft spots (fontanelles) are examined. These might have been squashed on the passage through the birth canal, or by forceps or ventouse, but rest assured they resettle within 48 hours. A light is shone into the eyes with an opthalmoscope, just like flash photography, to rule out cataracts. Next, a finger in the mouth checks for sucking and that the palate is complete.

heart

With a stethoscope, the health professional will listen to your baby’s tiny heart. Murmurs are very common in the early days, as your clever baby is doing a big job adjusting their circulation. After their first breath, their heart starts to beat with the two sides working separately, whereas in the womb, they beat together. Most of these murmurs disappear by the second check at six weeks. Your baby’s pulse will also be felt, in the groin area strangely enough.

hips

Hips are gently manipulated to assess the stability of the joints, and to check for a condition known as 'clicky hips' (DDH). This may look a little peculiar, as the legs are bent out wide and back again. It shouldn’t hurt, although your baby may not appreciate it that much. Expect a squeal or two, but consider it their introduction to the joys of yoga.

baby boys' testicles

Both sexes may have swollen or dark-coloured genitals, as they have been absorbing mum's hormones in the womb. This can also cause engorgement to the breast tissues. These are completely normal, but just the sort of thing no-one warns you about. If you’ve had a son, the medic will feel his scrotum to see if the testicles have descended properly. They will probably ask you if baby has had a wee and done a sticky greeny-type of poo, called meconium.

extra checks

The examination also takes in a listen to the lungs, a check for birthmarks and a look at the hands and feet. They might test the Moro reflex, when babies fling out their arms and legs when the head is allowed to drop back a little. This can be a bit startling and your baby might cry, but a cuddle from you will set everything right again.

next steps

In the unlikely event that anything a bit untoward has been detected, there might be some further investigation, but most problems resolve themselves. The next test is the heel prick at five days and there will be another postnatal check at six weeks.