NHS screening - newborn and 6 - 8 week infant examination

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Key messages from UK National Screening Committee:

• Two full physical examinations are recommended. The first by 72 hours, the second at 6-8 weeks old
• The examinations include a full general physical examination & detailed examination of: eyes, heart, hips, and testes
• Examinations are performed by a trained and competent healthcare professional Clinical standards, competencies, learning resource and information became available Summer 2008
• http://newbornphysical.screening.nhs.uk/

Newborn Physical Examination

• after the birth of their baby, parents should be offered two full physical examinations of their newborn baby with four screening components to identify congenital cataracts, congenital heart disease, developmental dislocation of the hip and undescended testes in males. The first examination should take place in the first 72 hours after birth (Health for All Children, Hall & Elliman 2003) and the second should be carried out when the baby is 6-8 weeks old

Carry out a complete examination of the baby within 72 hours of the birth and at 6 to 8 weeks after the birth (see the Public Health England newborn and infant physical examination [NIPE] screening programme). This should include checking the baby's (1):

• appearance, including colour, breathing, behaviour, activity and posture
• head (including fontanelles), face, nose, mouth (including palate), ears, neck and general symmetry of head and facial features
• eyes: opacities, red reflex and colour of sclera
• neck and clavicles, limbs, hands, feet and digits; assess proportions and symmetry
• heart: position, heart rate, rhythm and sounds, murmurs and femoral pulse volume
• lungs: respiratory effort, rate and lung sounds
• abdomen: assess shape and palpate to identify any organomegaly; check condition of umbilical cord
• genitalia and anus: completeness and patency and undescended testes in boys
• spine: inspect and palpate bony structures and check integrity of the skin
• skin: colour and texture as well as any birthmarks or rashes
• central nervous system: tone, behaviour, movements and posture; check newborn reflexes only if concerned
• hips: symmetry of the limbs, Barlow and Ortolani's manoeuvres
• cry: assess sound

At 6 to 8 weeks, assess the baby's social smiling and visual fixing and following.

Measure weight and head circumference of babies in the first week and around 8 weeks, and at other times only if there are concerns. Plot the results on the growth chart.

Reference:

1. NICE (April 2021). Postnatal care