Most countries offer a newborn baby a head-to-toe physical examination in the first days, a hearing check, a blood test taken from the heel, and weight checks, followed by routine vaccinations starting in the first weeks or months. What is offered, and when, differs between countries, so this page describes the shape of it and points you to your own service's schedule. It is health information for learning and it is not medical advice about your baby. Whether a check has been done, and what any result means, belongs with your midwife, health visitor or paediatrician.
The newborn physical examination
NHS guidance describes a physical examination offered to every baby, normally before they are three days old, and offered again by a doctor at six to eight weeks because some findings take longer to appear.
The examination is a general look over the whole baby, plus four specific checks: the eyes with a light, the heart and pulse, the hips, and, for boys, whether the testicles have descended. NHS guidance names childhood cataracts, congenital heart conditions, developmental dysplasia of the hip and undescended testicles as the conditions it looks for.
It is not painful and there are no known risks to the baby. It is offered rather than imposed, and you can ask the person doing it what they are looking at as they go.
Hearing screening
A hearing check is usually offered in the first weeks, sometimes before you leave hospital and sometimes at home or a clinic afterwards.
It is quick and does not disturb most babies. Being asked back for a second attempt is common, and the audiology team explains what the next step is.
The blood spot, or heel prick, test
A few drops of blood are taken from the baby's heel onto a card and sent to a laboratory. In the UK this is usually done around day five.
The conditions screened for differ by country. NHS screening covers several rare conditions including sickle cell disease and cystic fibrosis, while in the United States every state runs its own newborn screening programme with its own panel, so two babies born in different places are screened for different lists.
Screening is not the same as a diagnostic test. A result that needs following up means more testing, not an answer.
Vitamin K
NICE's postnatal care guideline recommends that parents are offered vitamin K for their baby to protect against vitamin K deficiency bleeding, which is rare and serious. Practice varies between countries in how it is given.
You can ask what your service offers, and ask questions before you decide. This is a discussion with a clinician, not a form to sign quickly.
Weight and development reviews
Babies are weighed at birth and again in the first weeks, and then far less often unless there is a reason. NHS guidance sets out a series of reviews with a health visitor over the first years, recorded in a personal child health record.
Take that record to every appointment if you are given one, and add to it yourself. It is the one document that follows your baby between services.
Vaccinations, and why schedules differ
Routine immunisation schedules are set nationally, using WHO's recommendations as a base and then adapting them to the diseases that are common locally. WHO publishes summary tables of routine immunisation recommendations that national programmes build on.
The differences are real. The NHS schedule gives the first routine baby vaccines at eight weeks, and offers BCG for tuberculosis and hepatitis B vaccination to babies at higher risk rather than to everyone. CDC's schedule for the United States begins at birth, with a first hepatitis B dose given before a baby leaves hospital.
So a schedule from one country is not advice for another. Ask your own service for its schedule, keep the record, and ask about catch-up if an appointment is missed.
Vaccination appointments are also a good moment to raise anything that has been worrying you, because you have a clinician's attention and a baby who is being looked at properly.
Your own six-week check
You have a check of your own around the same time as your baby's, and it is easy to lose it in the noise. The six-week postnatal check covers what yours should include and how to prepare for it.
The first six weeks after birth covers your recovery over the same period.
When to see a doctor
Seek urgent care for any sign in the box below, whatever is scheduled next. A booked appointment is never a reason to wait with an unwell newborn.
Contact your midwife, health visitor or doctor if a check has not been offered when you expected it, if you were not given a result, or if you have a question about vaccination. Your newborn in the first two weeks covers what is usual, and newborn warning signs covers what is not.
Seek care now: Contact your local emergency services or go to your nearest emergency department if a baby under three months old has a temperature of 38C or higher, is breathing fast, working hard to breathe or grunting, has blue, grey, pale or mottled skin, is floppy, is difficult to wake, is refusing feeds, has far fewer wet nappies or none in the past 12 hours, has a bulging or sunken soft spot on the head, has a rash that does not fade when you press it, or has a fit. Femio cannot assess a baby.
Frequently asked questions
Are newborn checks compulsory?
They are offered and recommended rather than compulsory. Ask what each one looks for, and what happens if you decline.
My baby needs a repeat hearing test. Is something wrong?
A repeat is common and means the first attempt did not give a clear reading. The audiology team is the right place for that question.
Why is the schedule here different from the one my sister was given abroad?
National programmes adapt WHO's recommendations to local disease patterns. Follow the schedule of the country your baby lives in.
What if we miss a vaccination appointment?
Contact your service and ask about catching up. Schedules are designed with catch-up in mind.