Screening tests for your newborn baby
You will be offered an all over physical examination of your baby within 72 hours of birth. This examination includes four specific screening tests to find out whether your baby has a problem with their eyes, heart, hips, or in boys, their testes. The screening test is carried out again at around 6 to 8 weeks of age.
The examination checks the appearance and movement of the eyes and looks to see if your baby has cataracts and other problems. 2 or 3 babies out of 10,000 are born with cataracts. The examination does not tell how well your baby can see.
There will be a general examination of your baby’s heart and sometimes murmurs can be picked up. Murmurs are noises made by the blood passing through the heart and are common in babies. In most cases the heart is normal but for 1 in 200 babies there is a heart problem that needs to be treated. If a problem is found your baby will be referred for further investigation and review by a senior doctor.
Some babies are born with hip joints that are not formed properly and if untreated this can lead to a limp and to joint problems. 1 or 2 babies in 1,000 are born with hip problems that need to be treated. If problems are found or if there is a strong family history of hip problems your baby will be referred for further investigation.
All baby boys are checked to make sure their testes are in the right place, for example, that they have descended. Testicles can take several months to drop down into the correct place in the scrotum. About 1 in 100 boys have problems with undescended testicles that may need treatment to reduce the risk of problems in later life such as infertility.
TB, BCG Vaccination and your baby
From April 2016 we will be offering women to have their babies immunised at about 2 weeks of age in a midwifery led clinic either at East Surrey Hospital or Crawley hospital.
This service is offered to babies who are more likely than the general population to come into contact with someone with TB. This will have been highlighted during your antenatal booking appointment and at your babies new-born baby check on the postnatal ward following birth.
You can visit the NHS website for more information at www.nhs.uk/vaccinations.
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What happens during the examination?
At SASH your baby will be examined by either a midwife specially trained to perform Examination of the Newborn or by a paediatrician. The examiner will ask you questions about how your baby is feeding, how alert they are, and their general wellbeing. Your baby will need to be undressed for part of the examination.
The examination will include:
- Looking into your baby’s eyes to see how they move and look
- Listening to their heart using a stethoscope to detect heart sounds
- Checking the oxygen levels in your baby’s blood
- Examining the hips to ensure the joints are in a correct place
- Examining the testicles to see if they are in the right place
The health professional carrying out the examination will give you the results straight away and these results are recorded in your baby’s case notes and in the red child health book if you have it with you. Usually there will be nothing of concern found. If the health professional finds a possible problem your baby will be referred for further assessments and tests if appropriate.
For further information go to www.newbornphysical.screening.nhs.uk
Newborn hearing screening
Around 1 to 2 babies in every 1,000 are born with some permanent hearing loss in one or both ears. Hearing loss can significantly affect a baby’s development. Finding out early will give your baby a much better chance of developing speech and language skills. It will also help your baby make the most of family relationships from an early age.
At SASH you will be offered a hearing screening test for your baby before you leave the hospital or if taking an early discharge or your baby was born at home you will be invited to attend a clinic appointment. The test can be done up to 3 months of age.
The test takes a few minutes and is called the AOAE (automated otoacoustic emission).
How is the test performed?
A small soft earpiece is placed in the outer part of your baby’s ear and soft clicking sounds are played. When the ear receives the sounds the inner part responds and this is picked up by the screening equipment.
It is not always possible to get clear responses from the first test and this does not mean that your baby has a hearing loss, but it may be due to the following:
- Your baby was unsettled during the test
- There was background noise
- Your baby has fluid or a temporary blockage which will pass with time
- Your baby has a hearing loss
If the responses are not clear then your baby will be offered another test. This repeat test may be the same as the first test or could be another type of test called AABR. (automated auditory brainstem response) This test involves three sensors being placed on your baby’s head and neck. Soft headphones are placed over your baby’s ears and soft clicking sounds are played. The test takes between 5 and 15 minutes.
You will get your baby’s results as soon as the test is complete. If the test results do not show a clear response you will be offered an appointment with the audiology department to see a hearing specialist.
Click the image to download the Newborn hearing screening programme leaflet.
This leaflet is available in other languages from the newborn hearing screening page.
Contact the SASH newborn hearing screening team
Telephone: 01737 304177
Newborn blood spot screening
This test is offered to your baby when he/she is 5 days old. Your midwife or maternity support worker will prick your baby’s heel using a special device to collect some drops of blood onto a card. The heal prick may make your baby cry as it can be uncomfortable. You can help your baby by making sure they are warm and comfortable and by cuddling and feeding them. Occasionally the test has to be repeated and your midwife will explain why, it does not mean that there is something wrong with your baby. The test cannot harm your baby and there are no known risks.
It is recommended that your baby is screened for these conditions but it is not compulsory. You can choose to have your baby tested for all or some of the conditions. If you decide for your baby not to be screened you can change your mind up to 12 months of age except for cystic fibrosis, for which you can change your mind up to 8 weeks of age.
What is the test for?
The test looks to see if you baby has any of 9 rare but serious health conditions. Early treatment can improve your baby’s health and can prevent severe disability or even death. Please tell your midwife if you, the baby’s father or a family member already has one of these conditions.
Sickle Cell disease
1 in 2,000 babies born in the UK has sickle cell disease (SCD). These are inherited blood diseases and affect the haemoglobin, the part of the blood that carries oxygen around your baby’s body. If your baby has SCD he /she will need specialist care throughout his /her life.
People with SCD can suffer from severe pain attacks, get serious life threatening infections and are usually anaemic (their bodies have difficulty carrying oxygen). Babies with SCD identified will receive early treatment, including immunisations and antibiotics in order to help prevent serious illness.
For further information please visit the Sickle Cell Society website.
1 in 2,500 babies born in the UK has Cystic Fibrosis (CF). This is an inherited condition that affects digestion and the lungs. Babies with CF do not gain weight well and frequently have chest infections. Babies can be treated early with a high energy diet, medicines and physiotherapy. These children can become very ill, but early treatment will help them live longer, healthier lives.
For further information please visit the Cystic Fibrosis Trust website.
1 in 3,000 babies born in the UK has congenital hypothyroidism (CHT). These babies do not have enough of the hormone thyroxine. These babies do not grow properly and can develop serious physical problems and learning disabilities. These babies are treated with thyroxine tablets and will then develop normally.
Inherited metabolic disorders
Your baby will be screened for 6 inherited metabolic diseases (IMDs). These are:
These inherited conditions cause babies to be unable to process certain substances found in food. If these babies are not treated they can become seriously ill. There are different symptoms and some can be life threatening or can lead to developmental problems. They can be treated with a carefully managed diet and medicine which is different for each condition.
You will get your baby’s results from a healthcare professional by the time your baby is 6 to 8 weeks old. Most babies will have normal results that indicate it’s unlikely that they have any of the conditions. A small number of babies will be found to have one of the conditions and will be referred for specialist care and treatment. Some babies may be offered further testing. When you get your baby’s results please put them in the personal child health record (red book) and bring this with you to any appointments you have with your baby.
For further information please visit the NHS newborn blood spot (NBS) screening programme page.