Examination of the NewbornIntroduction and pre-examination

Chris Kingsnorth

Before We Begin

Overview

• 4 presentations:

1. Introduction and pre-examination2. Examination part 1: Eyes, heart, hips

and testes3. Examination part 2: Top-to-toe4. Post-examination

Overview

• What is the Newborn and Infant Physical Examination programme?

• Why are Newborn Examinations performed?• Information gathering• Preparing to examine

Newborn and Infant Physical Examination (NIPE) Programme

• National screening programme• 2 examinations:• 1st (‘Newborn’): <72hrs• 2nd (‘Infant’): Ideally at 6-8wks (must be

<10wks)

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

Information Gathering

• Medical Hx• Parental concerns• Feeding• Bowels and urine

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

Information Gathering: Mum’s Medical Hx

Information Gathering: Baby’s Medical Hx

Information Gathering: Family Hx

Information Gathering: Other

• Birth-weight/ head circumference • Feeding well (tired/ breathless?)• Meconium passed?• Urine passed?

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

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

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

What Now?

• Download slides + checklist• Online MCQ: https://www.goconqr.com/en-

GB/p/3867979-Examination-of-the-Newborn--1--Introduction-and-Pre-examination-quizzes

• Request a Podcast/ ask a question• Next presentation: Examination part 1: Eyes,

heart, hips and testes

Further Information

NIPE eLearning package: http://cpd.screening.nhs.uk/nipe-elearning