1. Examination of the Newborn Introduction and pre-examination
Chris Kingsnorth

2. Before We Begin

3. Overview 4 presentations: Introduction and pre-examination
Examination part 1: Eyes, heart, hips and testes
Examination part 2: Top-to-toe
Post-examination

4. Overview
What is the Newborn and Infant Physical Examination programme?
Why are Newborn Examinations performed?
Information gathering
Preparing to examine

5. Newborn and Infant Physical Examination (NIPE) Programme
National screening programme
2 examinations:
1st (‘Newborn’): <72hrs
2nd (‘Infant’): Ideally at 6-8wks (must be <10wks)

6. Newborn and Infant Physical Examination (NIPE) Programme
Head-to-toe check
Aim = to identify problems requiring timely intervention (i.e. within wks)
Main focus = heart, hips, eyes +/- testes
Chance to document birthmarks

7. Information Gathering
Medical Hx
Parental concerns
Feeding
Bowels and urine

8. Information Gathering: Medical Hx
Mum: Prepartum/ intrapartum/ postpartum
Child: Antenatal/ perinatal/ postnatal
Family: 1st degree relatives (i.e. siblings and parents)/ others
Check antenatal (‘handheld’) notes and perinatal documentation

9. Information Gathering: Mum’s Medical Hx
Conditions existing prior to pregnancy
Conditions acquired during or continuing into pregnancy (infections/ (pre)eclampsia/ gestational diabetes/
Risk factors in perinatal period (PROM/ maternal pyrexia/ intrapartum Abx/ Emergency C-section or assisted delivery/ meconium stained liquor)
Health since giving birth (blood loss, infections, psychological status)

10. Information Gathering: Baby’s Medical Hx

11. Information Gathering: Family Hx

12. Information Gathering: Other
Birth-weight/ head circumference
Feeding well (tired/ breathless?)
Meconium passed?
Urine passed?
(if male ?nature of urine stream)

13. Explanation and Parental Concerns
Briefly explain reason for examination and what it involves
Explain that not all abnormalities present at birth and others may be picked up at 6-8 week check
Address any parental concerns
Ask permission to examine
Have you noticed anything that worries you?
Have you noticed any birthmarks?

14. Preparing to Examine Remember your ophthalmoscope Turn on the light
Mum and baby’s privacy is important
Keep baby as warm as possible
Firm flat surface must be available for hip examination

15. Summary
NIPE newborn check = head to toe screening examination at <72hrs to identify problems requiring timely intervention
Review notes thoroughly prior to examination
Address parental concerns
Proper preparation and explanation will save you and the parents time and hassle

16. What Now? Download slides + checklist
Online MCQ:
Request a Podcast/ ask a question
Next presentation: Examination part 1: Eyes, heart, hips and testes

17. NIPE eLearning package: http://cpd.screening.nhs.uk/nipe-elearning
Further Information
NIPE eLearning package:
Briefly covers newborn and infant examinations