Checks and Tests for Newborn Babies

Within few hours after the birth of your baby, there will be several examinations and tests undertaken to ensure that your baby is healthy and fine. Once you are aware of what doctors actually look for, your mind will be at rest and you will get a chance to clear all your doubts that might arise after the birth.

What All Tests Will Your Baby Have?

Your newborn will have various examinations and checks within the very initial few hours of his birth. The Apgar is the first one and will be done by your midwife after a minute and then again, after five minutes. This test can be simply done by observing your baby’s breathing, activity, color, posture, and behavior. Through these observations, your midwife will know if your baby is suffering from any immediate problem that requires medical support. Nearly all babies are well, or may simply require to be observed for a few seconds. In case your newborn does need any help, then your midwife will probably have to clear his airways or supply him with some oxygen to aid his breathing process.

Shortly later, the midwife will measure the weight of your baby and his head circumference. Later, these details will be recorded in the section of developmental charts of his Personal Child Health Record (the ‘Red Book’), which will be given to you by the health visitor after your baby is ten days old. This will allow you to keep a track of his progress with time.

The heel-prick blood test will be carried out within 7 days of your baby’s birth. This test involves taking a few drops of blood from the baby’s heel in order to test for deficiency of a particular enzyme (phenylketonuria), cystic fibrosis (which can affect the digestive system and lungs), a kind of thyroid deficiency, and sickle cell disorders. Since March 2009, screening for MCADD (an odd condition that influences the way blood converts the body fats into energy) has also been started for newborn babies. Babies generally cry a bit while their blood is being taken but soon recover from it.

It is within 4-48 hours of your baby’s birth that his complete examination will be carried out. This gives a chance to your baby to adjust to his newly discovered world and also allows for rapid medical attention that may be required in the rare event of a problem being detected.

Who will do the Newborn Tests?

Your baby’s examination will most probably be carried out by a midwife having some professional training, a pediatrician, or you GP in case the delivery was done at home. The examination will require yours as well as your partner’s presence so you can clarify your doubts as and when it happens. The examiner will generally ask you things related to the medical history of your family and it is always better to mention the childhood problems (if any) existent within the family.

What will the Newborn Examination Involve?

The newborn examination will involve a head-to-toe observation of your baby to verify incidence of any condition or problem:

Head:

The nature and shape of the baby’s head is examined. A ‘molded’ or ‘squashed’ head is caused when your baby is squeezed while traveling through the narrow birth canal and is an ordinary feature of newborn babies. This usually resolves itself within a couple of days. The fontanelles and sutures are two very soft spots between the bones of the baby’s head that can cause these bones to move a bit. This condition will be dealt with by your pediatrician or midwife. It is very rare for newborns to have any problem; however, even if any problem does exist, you will be certainly informed about it.

In case the birth of your baby had required any assistance (with forceps or with ventouse), then there might be a small possibility of your newborn having bruises and/or cephalhaematoma (bruises on the skull bone). These will heal by themselves.

Eyes and Ears:

Your midwife will have already checked your baby’s eyes for any apparent problems. During your baby’s medical examination, an ophthalmoscope will be used to reflect light into his eyes and look for the red reflex, which is actually similar to the red eyes of flash photography. Presence of the red reflex indicates absence of cataracts.

Your hospital may also have a hearing checkup of your baby before getting you discharged. In case your hospital does not perform the hearing test, then your health visitor will offer this test. You can look up on hearing.screening.nhs.uk for more details.

Mouth:

Your midwife or doctor, after putting their finger in the baby’s mouth, will ensure that the roof of his mouth (palate) is complete. A slit in the cleft palate can make feeding complicated and will need surgical treatment. Your baby’s tongue will also be checked for tongue-tie (a condition in which the tongue is more fixed with the mouth’s bottom area than it is supposed to be).

Heart:

Your baby’s heart will be heard using a stethoscope so that extra heart murmurs or sounds are eliminated. These are quite common during the first few days, since the circulation pattern of your baby undergoes major changes at birth.

Inside the uterus, both the sides of your baby’s heart function together. It is when your baby inhales for the first time that these two sides start functioning separately. The baby’s heart works hard during this phase and may also enlarge but it will eventually settle down with time. Heart murmurs often disappear by themselves but at times, may require further investigation and a second opinion or be considered in future examinations.

A further checkup of the heart condition is for testing the incidence of a particular pulse (the femoral pulse) in the groin area of your baby.

Lungs:

A stethoscope will be used to listen to your baby’s lungs and observe his breathing pattern. This is done to listen to clear and equal entry of air into both the lungs of the baby.

Genitals:

Genitals of your baby may appear dark and/or swollen because of those maternal hormones that were exposed to him before his birth. The same hormones can also result in your baby having engorged breasts, disregarding the sex of the newborn, and in baby girls having clear, slightly bloody, or white vaginal discharge during the first few weeks.

For boys, the penis is checked to confirm that the penis has the opening at its tip and not on its underside. Undescended testes are also checked by careful examination of the scrotum.

The examiner is also likely to check if the anus of your baby is normal and to ask you such questions as whether the newborn has passed meconium and urine.

Skin:

The examiner will also check your baby’s skin for birthmarks. These will include strawberry marks (raised reddish area), Mongolian spots (a dark patch of bluish pigment, mostly seen on the buttocks), and stork marks (purple or reddish v-shaped marks, mostly on the backside of the neck).

Arms and Feet:

The examiner will check your baby’s hands, arms, feet, and legs. His toes and fingers will be checked to ensure they are in the correct number and have the proper webbing. The baby’s palms will also be checked for both the palmar creases. It is less common to have a single palmar crease; however, 10% of the total population has just one hand having a palmar crease while 5% has both hands having the palmar crease. Sometimes, this is associated with the Down’s syndrome; however, in the very unlikely case of your baby having this condition, there will be other physical symptoms too.

Your baby’s ankles and feet in their resting position will also be observed to ensure absence of club foot or talipes where the frontal half of a foot turns down and in. If there is an incidence of talipes, then you may have already learned about it, since in some cases, it is detected during the ultrasound scan itself.

Spine:

The examiner will assess your baby’s spine for straightness. Tiny dimple, known as the sacral dimple, at the spine base is rather common in babies. Mostly, this is not likely to cause any problem. However, in some rare cases, a deep dimple can indicate that the lower section of the spine is having a problem. The occurrence of deep sacral dimple is also accompanied with other symptoms like urinary incontinence, cold, blue feet, and leg weakness.

Hips:

The examiner will manipulate your baby’s hips to check how stable the hip joints are. For this, his hips will be opened wide and bended and unbended and if clicky hips or any other instability is found, then the examiner will recommend going for further investigations.

Reflexes:

Your newborn will have several reflexes like rooting, grasping, and sucking. The National Institute for Health and Clinical Excellence proposes that the reflexes of your baby be checked by observing him. If a particular reflex cannot be seen, than your baby may be encouraged to demonstrate that reflex. The Moro reflex is one of the most common reflexes tested during such an examination. To check for this reflex, the examiner will gently and very safely allow your baby to drop his head a little. Your baby’s instant response will be stretching out both his legs, throwing out his arms, and spreading his fingers. He may also scream or cry for a while.

What will Happen Next?

Most newborns pass their newborn tests and checks with flying colors; even if any problem is found, they often resolve it on their own without requiring any kind of treatment. If your midwife or doctor examining your baby shows any concern and suggests that it would be better to go for further investigations and tests, then these are more for a precautionary reason. Your midwife or doctor must give you details regarding any suspected problem, answer all your queries, and advise you about places from where you can get more support and information.

Supposing all goes well, your doctor will call you for another screening test after 6-8 weeks. However, in case you have any worries about your newborn before, then it is always advisable to consult your health visitor, doctor, or midwife without much ado.

Checks and Tests for Newborn Babies

Within few hours after the birth of your baby, there will be several examinations...