Eyes, heart, hips and testes (physical examination)
Updated 11 August 2025
Applies to England
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This short video explains screening for eyes, heart, hips and testicles 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. The tests check whether your baby has a suspected problem with their eyes, heart, hips and, in boys, their testicles. If a problem is suspected, babies benefit from early investigation and possible treatment.
The screening tests are carried out again when your baby is between 6 and 8 weeks of age, usually at your GP practice. This is because some conditions do not develop or cannot be identified until then.
2. About the conditions
Each part of the physical examination is looking for different conditions.
2.1 Eyes
In England, about 2 to 3 babies in every 10,000 are born with cataracts. This is when the transparent lens inside the eye is clouded. In over 50% of cases, both eyes will be affected.
The main reason for screening is to identify this condition. The examination checks the appearance of your baby’s eyes, but it cannot tell how well your baby can see.
2.2 Heart
Congenital heart disease (CHD) is a term for heart conditions that are present at birth. These conditions affect the heart’s structure, function and rhythm.
CHD is one of the most common conditions that babies are born with in the UK. About 8 in 1,000 babies will have a heart or circulatory condition.
The main reason for screening is to identify early signs and symptoms of CHD. 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, but 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 3 to 5 newborns in every 1,000 may need treatment with a harness.
About 1 to 2 newborns in every 1,000 may need surgery.
2.4 Testicles
Baby boys are checked to make sure their testicles are in the right place. This is because sometimes one or both testicles fail to drop down (descend) into the scrotum (the sac that holds the testicles).
There are 2 types of undescended testicles:
- where one or both testicles can be felt but they are in the wrong place (palpable)
- where one or both testicles cannot be felt at all (impalpable)
It can take several months for testicles to descend.
About 4 in 100 baby boys (4%) are born with this condition. Being born prematurely (before the 37th week of pregnancy), having a low birth weight and a family history of undescended testicles may increase the chances of a boy being born with the condition.
3. The screening test
A trained healthcare professional will carry out a physical examination of your baby. They will 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 healthcare professional will:
- look into your baby’s eyes to checktheir appearance
- listen to your baby’s heart to detect heart sounds
- examine your baby’s hips to ensure the joints have developed and are working properly
- examine baby boys to check if their testicles are in the right place
4. Safety of the test
There are no risks associated with having this test.
5. Screening is your choice
You can decide to have your baby examined and screened for any or all of the conditions. The examination is intended to identify any of the conditions early, so that treatment can be started as soon as possible. Screening is recommended for your baby.
6. Not having the test
If you choose not to have the screening test, or have any concerns, you should speak with your midwife and the healthcare professional who offers the examination.
7. Possible results
If a condition or problem is suspected, your baby will be referred for further assessment and tests if appropriate. This may include referral for a hip ultrasound scan, or referral to specialist teams that look at the baby’s heart, eyes or testicles.
8. Getting my results
The healthcare professional carrying out the examination will give you the screening 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 medical record and personal child health record (‘red book’). You will need to keep the red book safe. Make sure it is available whenever your baby sees a healthcare professional.