Newborn checks: the physical examination and hearing test

In the first days, your baby will be offered a full physical check and a hearing screen. Both are quick, and neither hurts. Here’s what to expect.

The newborn physical examination

The NHS says the physical examination is done within 72 hours of birth, by a specially trained midwife, nurse or doctor. If you gave birth in hospital it’s usually done before you go home, but it can also be done at home, at a GP surgery, a community clinic or a children’s centre. A second check is offered by the GP at 6 to 8 weeks. See the 6 to 8 week baby check.

The NHS says it checks your baby’s general health and, in particular:

Eyes: how they focus and move.
Heart: and pulse.
Hips: growth and movement.
Testicles, for boys: whether they have come down into the scrotum.

If something is found, the healthcare professional explains what it might mean and what happens next, and your baby may be referred to a specialist. Results are recorded in the red book. The check is recommended for all babies, but it’s your choice.

The newborn hearing screen

The NHS says hearing screening is usually offered before your baby is 4 weeks old, though it can be done up to 3 months. It takes a few minutes and you get the result straight away. It can be offered in hospital or at home, and sometimes you may be invited to a clinic appointment. It is done when your baby is settled or asleep. The NHS says it has no known risks.

First test. A small soft earpiece is placed in your baby’s ear and gentle clicking sounds are played, to check how the ear responds.
If the first result isn’t clear. The test is repeated, or your baby is offered a different one. The second test uses three small sensors on the forehead, the back of the neck and the shoulder, with soft headphones, and takes up to 15 minutes. It checks whether the hearing nerve responds to sound.

What the results mean

The NHS uses the word “clear”. If your baby has a clear result in both ears, it’s unlikely they have hearing loss. The screen doesn’t pick up all types of hearing loss, so keep an eye on your child’s hearing as they grow.

If the result isn’t clear in one or both ears, a hearing specialist appointment is arranged for a second test, which the NHS says should be within 4 weeks of the screening. A result that isn’t clear doesn’t always mean hearing loss. The specialist usually gives results at the end of the appointment.

It’s your choice if you want your baby to have the screen. If you decline, you’ll be given checklists to monitor your baby’s hearing.

Questions people ask

Do these checks hurt my baby?

The physical exam involves gentle handling, and the hearing test has no known risks. The hearing test has no known risks.

Can I be there?

Yes, the checks are usually done with you present. You can ask the person doing the check to explain what they are looking at. Arrangements can differ in other UK nations.

What if the hearing result isn’t clear?

An appointment with a hearing specialist is arranged for a second test, which the NHS says should be within 4 weeks of the first.

Is the heel prick the same thing?

No. That’s a separate screening test, usually around day 5. See the newborn blood spot test.