Ensuring your baby receives their scheduled health checks is one of the most important steps in early parenthood.
In the UK, these assessments are part of the Newborn and Infant Physical Examination (NIPE) programme, designed to screen for specific conditions that aren’t always obvious at birth.
Here is a comprehensive guide on when your newborn should be examined, what happens during these checks, and why they are vital for your baby’s development.
Immediately after birth, the midwife or doctor attending your delivery will perform a rapid assessment.
When: Within the first minutes of life.
What is checked: This is a general “head-to-toe” visual inspection. They check the baby’s color, breathing, muscle tone, and heart rate (often referred to as the Apgar Score).
Goal: To ensure the baby has transitioned well to life outside the womb and does not need immediate medical intervention.
The first formal, in-depth physical examination must take place very shortly after birth. This is a detailed screening to identify any issues that may require early specialist review.
When: Between 6 and 72 hours after birth.
Who performs it: A specially trained midwife, neonatal nurse, or paediatrician.
Where: Usually on the postnatal ward before you go home, or at home/a community clinic if you had a home birth or early discharge.
What does the NIPE look for?
The examiner focuses on four key areas where early detection significantly improves outcomes:
Eyes: Using an ophthalmoscope to check for the “red reflex” to rule out cataracts or other rare conditions.
Heart: Listening to the heart rhythm and sounds to screen for congenital heart defects.
Hips: Performing specific manual maneuvers (the Ortolani and Barlow tests) to check for Developmental Dysplasia of the Hip (DDH).
Testicles (for boys): Checking that both testes have descended into the scrotum.
The second formal NIPE check occurs once your baby’s body has had time to grow and “settle” into its environment. Some conditions, like certain heart murmurs or hip issues, may only become apparent at this stage.
When: Between 6 and 8 weeks of age.
Who performs it: Usually your General Practitioner (GP).
Where: At your local GP surgery.
Why is this check different?
While it repeats the core screens (eyes, heart, hips, and testes), the GP will also look at:
Growth: Measuring weight, length, and head circumference.
Development: Checking for social smiling, head control, and response to sounds.
General Wellbeing: Discussing feeding, sleeping, and bowel habits.
Pro Tip: This appointment is often booked alongside your own 6-week postnatal maternal check. However, ensure the surgery allows enough time for both. Your health and recovery are just as important as the baby’s!
Your baby will be issued a Personal Child Health Record, famously known as the “Red Book.” * Keep it safe: This is a legal and clinical record of your child’s health.
Bring it to every appointment: The results of the 72-hour check and the 6-week check must be recorded here.
Digital Version: Many areas now offer a digital Red Book, but the physical copy remains the gold standard for quick reference by health visitors and GPs.
| Examination | Timing | Primary Focus |
| Initial Check | 0–1 Hour | Immediate safety and Apgar score |
| NIPE (First) | 6–72 Hours | Eyes, Heart, Hips, Testes (scoping for defects) |
| NIPE (Second) | 6–8 Weeks | Developmental milestones and physical growth |
| Hearing Screen | Birth–5 Weeks | Automated test for permanent hearing loss |
When to seek help between checks
You do not need to wait for a scheduled examination if you have concerns. Contact your midwife, health visitor, or GP immediately if you notice:
Jaundice: Yellowing of the skin or whites of the eyes.
Feeding issues: Dehydration signs (fewer than 6 wet diapers in 24 hours).
High Temperature: Anything over 38°C in a baby under 3 months is a medical priority.
Lethargy: If the baby is excessively sleepy or difficult to wake for feeds.
Do you have your 6-week appointment booked yet, or are you still in those early first few days at home?
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