When a baby is born, there will be a string of tests carried out by a paediatrician or trained midwife to determine if there are any health or medical issues that warrant immediate attention. If you know beforehand what these tests are about, it might put your mind at ease when they’re being carried out…
APGAR
Your baby will have several checks and examinations in the first few hours of his life. You may or may not be present during these examinations. The examiner may ask you questions about your family’s medical history and it’s a good idea to mention any childhood problems within your family.
The first is the APGAR test, which is given at one minute, and again at five minutes after birth. This test checks whether your baby has any immediate problems that need medical support. Most babies will check out fine in this test. Where intervention is needed, it often just involves providing more oxygen or clearing out the airways to help the infant breathe.
Lungs
Examining a newborn’s lungs is extremely important to determine any serious breathing problems. This will be carried out using a stethoscope. The examiner will be listening for clear, equal air entry into both lungs.
Hips
A newborn infant’s hips will be manipulated to check the stability of those tiny hip joints. The movements include opening the legs wide and then bending and unbending them. If the examiner detects any instability or clicky hips, a further test will have to be carried out.
Skin
Your baby’s skin will be checked for birthmarks. These include stork marks (reddish or purple V-shaped marks on the back of the neck); strawberry marks (raised red areas) and Mongolian spots (a bluish patch of darker pigment, most commonly over the buttocks).
Genitals & Anus
Your baby’s genitals may appear swollen due to being exposed to maternal hormones before birth. These same hormones may also cause your baby to have engorged breasts, regardless of the sex of the little one and for girls to have a clear, white, or slightly bloody vaginal discharge for the first few weeks.
In boys, the scrotum is checked to see if the testes have descended fully. The penis will be checked to ensure the opening is at the tip of the penis, and not on the underside. The examiner will check your baby’s anus to ensure it is normal and will probably ask you if your baby has passed urine and the first stool, called meconium.
The heel-prick test
In some cases, the Guthrie Test’, also known as the heel prick test is carried out before the baby is a week old. In this test, a tiny amount of blood is taken from the infant’s heel and tested for Inborn Errors of Metabolism, which can be enzyme deficiencies (phenylketonuria), thyroid deficiencies, or cystic fibrosis. These disorders are rare in Asians and this heel-prick test is not routinely carried out in Malaysia unless one of the parents is of European descent.
Spine
A newborn’s spine will be assessed for straightness. It is quite common for babies to have a tiny dimple at the base of the spine called a sacral dimple. In most cases, this will cause no problems but in some cases, a deep sacral dimple may indicate a problem with the lower part of the spinal cord. This could affect nerve function in this area so if a deep sacral dimple is detected, the infant will be checked for other symptoms such as leg weakness, cold and blue feet, and urinary incontinence.
Hands and feet
An infant’s limbs will be checked for abnormalities. Fingers and toes will be counted and examined for any webbing.
Baby’s palms will be checked for two palmar creases. Single palmar creases are less common. This is sometimes associated with Down’s syndrome but not necessarily so.
The examiner will observe the resting position of the newborn’s feet and ankles, to check for talipes, or club foot, where the front half of the foot turns in and down. Many cases of talipes will already have been detected before birth via ultrasound scans.
Heart
A newborn baby’s heart will be examined with a stethoscope to exclude abnormalities such as extra heartbeats or heart murmurs. These are not uncommon in the first few days as your baby’s pattern of circulation undergoes a major change at birth.
In the womb, the two sides of the heartbeat together. When a newborn breathes for the first time, the two sides begin to function separately. Heart murmurs may require a second opinion and further investigation or they may be checked at future examinations but they will probably disappear on their own.
A further test for a heart condition is to feel for the presence of a pulse in your baby’s groin (the femoral pulse).
Mouth
The doctor will put a finger in your baby’s mouth to check for the condition called cleft palate, which is a gap in the palate. Such a condition would require correctional surgery. The infant’s tongue will also be checked for the condition known as tongue-tie, where the tongue remains more anchored to the bottom of the mouth than it should be, restricting movement and making feeding troublesome. A minor surgical procedure will quickly remedy tongue tie.
Eyes and ears
A newborn’s eyes will be examined to check for any optical issues. During the medical examination, light from an ophthalmoscope will be shone into the baby’s eyes to look for a red reflex and check for cataracts. A hearing test is also carried out at some hospitals before the infant and new mum is discharged.
Head examination
The shape of a newborn baby’s head will have to be observed. Issues are uncommon, but, if there are problems, the examiner will explain them to the parents. Bruises on the head due to the use of forceps are normal and should clear up within 48 hours. So will the appearance of a slightly misshapen head brought about by the tight squeeze out of the birth canal.
Reflexes
Your newborn baby has several reflexes such as sucking, rooting, and grasping. The most commonly tested reflex during the examination is the Moro reflex. This reflex is elicited by gently allowing your baby’s head to safely fall a short distance. Your baby will respond by flinging out both arms with his fingers spread and stretching out his legs. He may also cry a little.
What happens after these tests?
If any issues are detected, further tests and investigations might be in order before determining the next course of action. Most babies pass their newborn examinations with flying colours and most problems found tend to resolve themselves without any treatment at all.
However, if you as a parent have any concerns about your baby, then you should not hesitate to mention them to your doctor as soon as possible.
Featured image source: www.indian-babynames.com
