Your baby’s check-ups after they are born

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Your baby’s red book or personal child health record (PCHR)

Newborn physical examination

Other tests and checks for your baby

Newborn hearing screening test

Newborn blood spot (heel prick) test

Premature babies

Scans for developmental dysplasia of the hip (DDH)

Your baby’s weight

Further reviews for your baby in their first 3 months

Your baby's first vaccinations

What to expect after a vaccination

Your emotional health 

What do to about missed appointments

If you’re worried about your baby between appointments

Your baby’s red book or personal child health record (PCHR)

You'll be given a personal child health record (PCHR) for your baby. This usually has a red cover and is sometimes called the red book. These are available digitally in some areas.

Take this book with you every time you visit the baby clinic, health visitor or GP. They will use it to record your baby’s weight, height, immunisations and other important information such as test results.  

It’s also helpful to update the developmental milestones section of the book too. You can also add other information if you want, such as any illnesses, medicines or accidents.  

Newborn physical examination

Soon after your baby is born, a doctor, midwife, or nurse will check your baby is doing well. They will offer a thorough physical examination within 72 hours of your baby being born. This will usually happen before you leave the hospital but may also be done at a local clinic or home. They will usually check your baby's eyes, heart, and hips. Baby boys are checked to make sure their testicles are in the right place.  

Some parts may be a bit uncomfortable for your baby, but it will not cause them any pain.

The aim is to spot any problems early, so treatment can be started as soon as possible if necessary.  If the health professional carrying out the examination does find a possible problem, they may refer your baby for more tests. Fortunately, in most cases, nothing concerning is found.

Eyes

The health professional will check the appearance and movement of your baby's eyes. They are looking for cataracts, which is a clouding of the transparent lens inside the eye. However, this examination won’t be able to tell you how well your baby can see.  

Your baby can be referred to the hospital’s ophthalmology (eye) department if they need any more tests.  

Heart

The health professional will check your baby's heart. They will look at your baby, feel your baby’s pulse and listen to their heart with a stethoscope.

Sometimes heart murmurs are picked up in the test. This is when the heartbeat has an extra or unusual sound. These are common in babies and the heart is normal in almost all cases when a murmur is heard. But about 8 in 1,000 babies have congenital heart disease that needs treatment.

Your baby will be referred to the hospital’s cardiology (heart) department if they need more tests.

Hips

Some newborn babies have hip joints that aren’t formed properly. This is known as developmental dysplasia of the hip or DDH. If this is left untreated, it can cause difficulty walking (a limp) or joint problems.  

Only about 1 or 2 in 1,000 babies have DDH that needs to be treated with surgery. There is more information below about DDH.

Testicles 

Baby boys are checked to make sure their testicles are in the right place. During pregnancy, the testicles form inside the baby's body. They may not drop down into the scrotum until a few months after birth.

In about 1 in 25 baby boys, the testicles only descend partially or not at all. Most of these will naturally move down by the time the baby is 6 months old. However, about 1 in 100 boys will need treatment to prevent possible problems later in life, such as reduced fertility.

Other tests and checks for your baby

You'll be offered 2 screening tests for your baby:

• newborn hearing screening test
• blood spot (heel prick) test.

In the early days after the birth, the midwife will also check your baby for signs of jaundice, infection of the umbilical cord or eyes, and thrush in the mouth.

Learn more about jaundice, thrush and other common newborn conditions.

Newborn hearing screening test

The newborn hearing screening test is done soon after your baby is born. It helps identify babies who have permanent hearing loss as early as possible. This means you can get any support and advice straight away.  

If you give birth in hospital, you may be offered the test before you and your baby are discharged. Otherwise, it will usually be done within the first few weeks, though it can be done up to 3 months of age. 

If you aren't offered a hearing screening test, ask your health visitor to help you arrange an appointment.

If the screening test results do not show a clear response from 1 or both of your baby’s ears, your healthcare professional may repeat the test at a later date. Some newborns may not pass their first hearing test, even if their hearing is normal. Research has shown that this may be especially true for babies born by c-section.  

If the screening test results are still not clear, your baby will be given an appointment with a hearing specialist at an audiology clinic. Even if this happens, it does not necessarily mean your baby has permanent hearing loss.

The NHS website has more information about the newborn hearing screening test.  

Newborn blood spot (heel prick) test

The newborn blood spot test involves taking a small sample of your baby's blood to screen it for 9 rare but serious health conditions, including cystic fibrosis and sickle cell disease.

Most babies won’t have any of these conditions. However early screening and treatment means that if they do, they can start to be monitored and treated sooner. This test is not compulsory, but it is recommended because it could be life-saving. 

When your baby is 5 to 8 days old, a healthcare professional will collect the blood sample by pricking your baby's heel, which is why it is sometimes called the heel prick test. They’ll collect a few drops of blood onto a blood spot card and send it for testing.  

This may be uncomfortable, and your baby may cry, but it is very quick. You can help soothe your baby by cuddling and feeding them, and making sure they are warm and comfortable.  

Try not to worry if you are contacted to do the test again. Sometimes the test will need to be repeated, for example if there wasn’t enough blood taken the first time.

You should receive the results by the time your baby is 6 to 8 weeks old. If you haven't received your baby's results, speak to your health visitor or GP.

You'll be contacted sooner if your baby screens positive for any of the conditions. This doesn't mean they have the condition, but they're more likely to have it. They will be referred to a specialist for more tests31. 

The NHS website has detailed information about the heel prick test and the possible results.

Premature babies

If your baby was born before 37 weeks, they may need extra tests and checks in the neonatal unit. If they were born before 32 weeks, they will have an additional test for congenital hypothyroidism at 28 days old or when they are discharged from hospital, whichever is sooner.

Learn more about extra tests and checks for premature babies.

Scans for developmental dysplasia of the hip (DDH)

If your health professional thinks your baby’s hips feel unstable during their newborn physical examination, they should offer an ultrasound scan of their hip between 4 and 6 weeks old.

This is to check for developmental dysplasia of the hip (DDH), which is where the ball and socket joint of the hip doesn’t form properly. DDH can’t be prevented and it’s nobody's fault.

With early diagnosis and treatment, many babies are able to develop normally and have a full range of movement in their hip.

Babies should also have an ultrasound scan of their hip before they're 6 weeks old if:

• there have been childhood hip problems in your family
• your baby was in the breech position (feet or bottom downwards) after 28 weeks of pregnancy.
• If you have had twins or multiple babies and 1 of the babies was breech, each baby should have an ultrasound scan of their hips by the time they're 6 weeks old.

Even if your baby’s hip stabilises before the scan is due, they should still be checked to make sure.  

If your baby is diagnosed with DDH, they will usually be treated with a fabric splint called a Pavlik harness. This secures both of your baby's hips in a stable position and allows them to develop normally. Your hospital team will provide instructions on how to look after your baby if they are wearing a harness.  

Late-stage signs of DDH

Sometimes, hip problems can develop after these checks. Contact your GP as soon as possible if your child has any of the following symptoms:

• restricted movement in 1 leg when you change their nappy
• 1 leg dragging when they crawl
• 1 leg appearing longer than the other
• A limp or ‘waddling’ walk.

The charity Steps offers information and support if your baby has been diagnosed with DDH.  

Your baby’s weight

It's normal for babies to lose some weight in the first few days after birth. Putting on weight steadily after this is a sign your baby is healthy and feeding well.

Your baby will be weighed during their first 2 weeks to make sure they're regaining their birthweight. Most babies are at, or above, their birthweight by 3 weeks.

Your midwife or health visitor can help you if your baby loses a large amount of weight or doesn’t regain their birthweight by 3 weeks. They will ask you how feeding is going and look at your baby’s health in general. They may ask to watch you breastfeed, if you’re breastfeeding.  

How often should my baby be weighed? 

After the first 2 weeks, your baby should be weighed no more than:

• once a month up to 6 months of age
• once every 2 months from 6-12 months
• once every 3 months over 12 months.  

Speak to your health visitor or GP if you have any concerns about your baby’s weight. 

Further reviews for your baby in their first 3 months

When your baby is 1 to 2 weeks 

Your health visitor will do a new baby review around 10 to 14 days after the birth. 

They can talk to you about:

• safe sleeping for your baby
• vaccinations for your baby
• feeding your baby  
• adjusting to life as a new parent
• your baby's development.

Your health visitor will see you for more scheduled visits at various stages during your baby's early years. 

We have more information about how your health visitor can support you.  

When your baby is 6 to 8 weeks

Your baby will be invited for a thorough physical examination. This is usually done by a GP.

The GP will check your baby's eyes, heart, hips and – for boys – testicles. They'll also usually measure their weight, length and head circumference.

A GP or health visitor will also discuss your baby's vaccinations with you. These are offered at 8 weeks, 12 weeks, 16 weeks and 12 months old, and before your child starts school.

They'll also ask you how you've been feeling emotionally and physically since the birth of your baby. They may offer to check your stitches if you had an episiotomy or c-section.

This is your chance to ask any questions and talk to a healthcare professional about anything that’s worrying you. You may find it helpful to write a list of questions before you go.

Your baby's first vaccinations

The best way to protect your baby against diseases like measles, rubella, tetanus and meningitis is through vaccination. As well as protecting your own baby, you're also protecting other babies and children by preventing the spread of disease.

Vaccinations are free in the UK. You just need to book your appointments with your GP.  

Your baby needs their first injections at 8 weeks, then 12 weeks, 16 weeks and 1 year. Your GP or health visitor can talk to you about vaccinations, including what to expect and how you can comfort your baby.

During your baby’s first 3 months, they will need 2 sets of vaccinations:

At 8 weeks old

• 6-in-1 vaccine
• RV (rotavirus) vaccine
• MenB vaccine
• At 12 weeks old
• 6-in-1 vaccine – 2nd dose
• PCV (pneumococcal) vaccine
• RV (rotavirus) vaccine – 2nd dose
• At 16 weeks old
• 6-in-1 vaccine – 3rd dose
• MenB vaccine – 2nd dose

What to expect after a vaccination

Your baby may be a little upset after a vaccination, but they should feel better after a cuddle or a feed.

Sometimes the area where the needle goes in can be sore and red for 2 to 3 days. This should go away on its own.

Some babies may also develop a high temperature for a day or two. A normal temperature in babies and children is about 36.4C, but this can vary slightly from child to child. A high temperature is usually considered to be 38C or more.  

If your baby has a temperature they might:

• feel hotter than usual when you touch their back or chest
• feel sweaty or clammy
• have flushed cheeks
• look or feel unwell.

You can help ease a high temperature by:

• making sure they're not wearing too many layers of clothes or blankets
• offering them feeds to avoid dehydration
• giving them infant paracetamol if they’re distressed or uncomfortable.

It's recommended that you give your baby infant paracetamol after the MenB vaccine to reduce the risk of a high temperature. This vaccine is given at 8 weeks, 16 weeks and 1 year old.

Make sure you follow the instructions that come with the medicine. If you're unsure, ask a pharmacist for advice. If your baby was premature they may need a dose prescribed for them by the GP.

A high temperature after a vaccination should go away quite quickly by itself.  

Always contact a GP or call 111 if:

• your child has other signs of illness, such as a rash, as well as a high temperature
• your baby's temperature is 38C or higher if they're under 3 months old
• your baby's temperature is 39C or higher if they're 3 to 6 months old.

You may find it useful to buy a digital thermometer to check your baby’s temperature accurately. Ideally, use an armpit thermometer, as these give the most accurate results for children under 5 years. You can buy these at any supermarket or pharmacy.  

You can read more about your baby’s vaccinations on the NHS website.

Your emotional health

Watching your newborn have all these tests and check-ups can cause some anxiety. For example, you may worry that the tests will find a problem, that something will happen to the baby, or that you will do something wrong.

Having anxious thoughts and worries now and again are natural, particularly in the early weeks after having a baby.  

Talk to your midwife or health visitor if you have any questions or concerns about your baby’s tests or the results. You can also talk to them about how you’re feeling. If your anxiety is constant and affecting your daily life, you may need some help. Find out more about postnatal anxiety.

What do to about missed appointments

If you’re worried that your baby has missed any of the recommended tests, checks or other appointments, speak to your midwife, health visitor or GP. Most tests, checks and vaccinations can be done later if necessary.

If you’re struggling to make it to appointments, let your healthcare provider know. They may be able to help you, for example by offering you extra reminders, or helping you with transport costs.

Even if your baby seems fine, it’s always best for them to have all their recommended checks, just to be on the safe side.

If you’re worried about your baby between appointments

If you have any concerns about your baby’s health, contact your midwife, health visitor or GP as soon as possible. There’s no need to wait for your next appointment.

If you can’t get hold of your regular healthcare professionals, and want health advice right away, call NHS 111. Always trust your instincts and seek help if you’re worried.

If you want more general advice, reassurance or support, you can also contact Tommy’s midwives on 0800 0147 800 (9-5 Monday to Friday), or email: [email protected]