Tests you will be offered for your baby

In the first days after the birth, you will be offered various tests to make sure your baby is healthy. The doctor or midwife will discuss the tests with you beforehand and will be happy to answer any questions you may have. Although these tests are recommended, it’s up to you whether you decide to have them done.

Routine examinations

You will be offered two physical examinations of your baby after she is born. The first is carried out immediately after the birth. The second is called the routine examination of the newborn and usually takes place 24 hours after your baby is born – although it can be any time between 6 and 72 hours after birth.

This examination will be carried out by a children’s doctor (paediatrician), a specially trained midwife or a neonatal nurse. They will examine your baby from top to toe, and in particular will examine her head, heart, hips, eyes and genitalia.

It is important that you inform the person carrying out the examination of any problems that run in the family – both on your side, and the baby’s father’s side – such as dislocated hips as a child, heart conditions, sight or hearing defects. They also need to know about any difficulties you experienced during pregnancy or at your antenatal scans – or if your baby was lying breech. If a problem is found, your baby might need further tests, or to be seen again at an outpatients’ clinic after she has been discharged from hospital.

Heart check

If you are told your baby’s heart makes an additional sound, called a ‘murmur’, you may feel worried, but in fact the condition is very common. One estimate is that 50% of babies have a heart murmur in the first week. Within a few weeks, most murmurs are not heard any more.

Developmental dysplasia of hips

The midwife or doctor will examine each hip joint to check that the head of the thigh bone (femur) moves as it should do within the socket at the hip, and that it doesn’t slip out.

Undescended testes

For baby boys, the midwife will examine the scrotum to ensure that the testes (testicles) have travelled down from the abdomen. The testes usually move down into the scrotum two months before birth, but in some baby boys this does not happen. The ‘undescended’ testes may still descend in the first six months or up to one year after birth. If there is any concern about the testes at your baby’s 6-8 week check your health professional will arrange for your baby to be reviewed again. If you have any concerns about your baby’s testes, for example a swelling, please seek medical advice.

Tests, checks and screening

A few routine checks for minor health problems will be carried out in the days and weeks after your baby is born. These are designed to set your mind at rest and to give your baby a good start in life.

Jaundice

The usual check is just to observe the skin, which is yellowish if the baby is jaundiced – many new babies have mild jaundice. If the yellow colour of the skin doesn’t go away in a few days a blood check is done to see whether the jaundice is severe. Babies who are still jaundiced at 14 days will always be referred to a paediatrician for further investigations. There are other less common causes of jaundice which need to be ruled out. Most babies, however, are perfectly well.

Group B Streptococcus (Strep B)

This is a germ carried by up to one-third of mothers, and it usually doesn’t cause any harm. However, it can be passed to the baby during labour, and a few babies who catch it will become very sick if they are not treated. Babies who are infected will be given antibiotics to prevent them from becoming ill. In some areas, routine testing for Strep B in mothers is being considered. Ask your midwife about local policy.

Newborn hearing screening

A simple screening test will be done within the first few weeks after your baby is born, maybe even before you leave the maternity unit, to check if your baby has a hearing loss. This is important for your baby’s development and, if you need it, it means that you can get support and information at an early stage. If your baby’s hearing is not tested, ask your midwife, health visitor or public health nurse, to make an appointment.

The newborn bloodspot test

Although most babies are born healthy, a few may have problems. All babies are examined carefully after birth so that these can be picked up as early as possible. Some problems which can’t be picked up in this way, will show up in the bloodspot screening test.

The bloodspot test or ‘heel prick test’ is usually carried out when your baby is five days old. The midwife takes several spots of blood from the baby’s heel and places them on a special card which is sent to the lab for testing for three rare conditions: Phenylketonuria (PKU), Congenital Hypothyroidism (CHT) and Cystic Fibrosis (CF).

Your midwife will explain the test and ask for consent to carry it out. If you choose not to let your baby have the test, you will be asked to sign a form confirming that the reasons for testing have been explained to you, and that you understand that a delay in diagnosis of these conditions may lead to permanent damage to your baby.

Normal results are not routinely reported to each family but your midwife or health visitor or public health nurse will be able to give you this information. If the test shows up an abnormal result, a hospital appointment will be arranged and your GP will be contacted.

Phenylketonuria (PKU)

This disorder affects around one in every 8,000 babies born in Scotland. Babies with this condition cannot process a substance called phenylalanine, which is present in many foods that contain protein, such as milk, meat, fish, cheese and cereals.

If PKU is detected by the test, your baby will be seen by a paediatrician as soon as possible and further tests will be carried out before a final diagnosis is made. If PKU is diagnosed, your baby must be given a special diet which will help her to develop normally. If a baby with PKU is not screened, the condition will remain undetected. Babies who have PKU and who are not treated, will gradually develop irreversible brain damage.

Congenital Hypothyroidism (CHT)

This condition affects around one in every 3,500 babies born in Scotland. It means that a baby is born unable to produce enough of the hormone thyroxine. This hormone is vital for normal mental and physical development. It is easily treated by giving thyroxine by mouth but, if it is not detected and treated, a lack of thyroxine can lead to slower than normal growth and severe learning difficulties.

Cystic Fibrosis (CF)

This is a serious inherited condition which affects one in every 2,500 babies born in Scotland. It can affect the pancreas and the lungs. Poor digestion and absorption of foods and chest infections are common problems. The majority of affected babies will be picked up by the bloodspot test but it is necessary to carry out further tests before a final diagnosis can be made.

Early treatment for Cystic Fibrosis may help prevent the long-term complications of this disease. It will also help affected children by maintaining good nutrition, minimising chest infections and improving quality of life.