Eyes, heart, hips and testes (physical examination)
Updated 4 August 2022
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This publication is available at https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby/eyes-heart-hips-and-testes-physical-examination
Public Health England (PHE) created this information on behalf of the NHS. In this information, the word ‘we’ refers to the NHS service that provides screening.
This short video explains screening for eyes, heart, hips and testes in newborn babies.
Newborn and infant physical examination video
The newborn physical examination is recommended by the NHS.
1. Purpose of screening
Within 72 hours of giving birth, you will be offered a top-to-toe physical examination for your baby. This will include 4 specific screening tests to find out whether your baby has a suspected problem with their eyes, heart, hips or, in boys, their testes which would benefit from early investigation and possible treatment.
The screening tests are carried out again between 6 and 8 weeks of age as some conditions do not develop or become apparent until then.
2. About the conditions
Each part of the physical examination is looking for different conditions.
2.1 Eyes
About 2 or 3 in 10,000 babies have problems with their eyes that need treatment. The examination checks the appearance and movement of the eyes. The main reason for screening is to identify a condition called cataracts (a clouding of the transparent lens inside the eye). The examination cannot tell how well your baby can see.
2.2 Heart
Around 8 per 1,000 babies will have a heart problem or condition. This could range from a heart murmur to a problem needing specialist care or treatment. A murmur is a noise made by the blood as it passes through the heart. In almost all cases when a murmur is heard, the heart is normal. Murmurs are common in babies and this does not always mean there is a problem.
2.3 Hips
Babies can be born with hip joints that are not formed properly and if untreated this can lead to a limp and to joint problems. About 1 or 2 in 1,000 babies have hip problems that need treatment.
2.4 Testes
Baby boys are checked to make sure their testes are in the right place. It can take several months for testes to drop down (descend) into the scrotum. About 1 in 100 baby boys have problems with undescended testes that need treatment to reduce the risk of problems later in life, such as reduced fertility.
3. The screening test
A trained health professional will carry out a physical examination of your baby and ask you questions about your baby’s general wellbeing.
Your baby will need to be undressed for part of the examination. During the examination the health professional will:
- look into your baby’s eyes focusing on how their eyes look and move
- listen to their heart using a stethoscope to detect heart sounds
- examine their hips to ensure the joints are working properly
- examine baby boys to check if their testes are in the right place
These screening tests are carried out within 72 hours of birth and again when your baby is between 6 and 8 weeks of age.
4. Safety of the test
There are no risks associated with having this test.
5. Screening is your choice
The examination is intended to identify any of the problems early so that treatment can be started as soon as possible.
The general physical examination including this screening is therefore recommended for your baby.
6. Not having the test
You can decide to have your baby examined and screened for any or all of the conditions. If you have any concerns you should discuss them with your midwife and the health professional who offers the examination.
7. Possible results
Usually there will be nothing of concern found. If the health professional finds a possible problem, your baby will be referred for further assessment and tests if appropriate.
8. Getting my results
The health professional carrying out the examination will give you the results straight away. If a referral for further assessment is needed, this will also be discussed with you at the time of the examination.
The results will be recorded in your baby’s case notes and personal child health record (‘red book’). You will need to keep this record safe and make sure it is available whenever your baby sees a health professional.