Exams to the newborn: medical checks in the first days
What tests does the newborn baby undergo, in the first days of life in the hospital, on discharge and at the first visit after returning home, to verify its growth, general state of health and normal neuro-behavioral development?
All hospitals subject the newborn to a series of more or less thorough checks. At birth, all newborns receive a sort of score through the Apgar index , which takes into consideration the vitality and efficiency of the primary vital functions. It is based on the assessment of heart rate, respiration, color, muscle tone and reflexes.
But this is only the first of a series of tests, some of which are very important for early therapeutic intervention, such as metabolic screening.
Below we have listed the checks that the Birth Point of Humanitas San Pio X regularly performs on its newborns. All the information is also contained in the discharge diary which is delivered to all new parents during their hospitalisation.
Checkups at the hospital
All the newborns of our birth point undergo a series of checks including the determination of bilirubinemia by transcutaneous route, monitoring of pre- and post-ductal arterial saturation and heart rate, as a predictive tool of congenital heart disease or rhythm disturbances cardiac.
Metabolic screening
In the first hours of life, all newborns in all hospitals undergo a very small blood sample. The sample taken is used to carry out the metabolic screening extended to 40 rare genetic diseases . The timely diagnosis of one of these pathologies is essential to intervene in time before they can cause damage to the body of the newborn, and therefore guarantee normal development.
Extended metabolic screening is performed between 48 and 72 hours of age and the sample taken will be kept in the laboratory for the first two years as a precaution.
If the screening is negative the parents will not receive any communication. If the test results in doubt or the sample taken is not sufficient, the child will be checked again. If the diagnosis is confirmed, the parents will be contacted by the hospital nursery pediatrician.
The red reflection
Before being discharged, newborns from the Humanitas San Pio X Birth Center undergo a red reflex test.
This is an exam to check for visual problems. It is a non-invasive and short-term test, which is performed using the transmission of light from an ophthalmoscope.
The result of the examination is reported in the discharge folder. If the examination gives a doubtful outcome or identifies a problem, a specialist check-up at the Ophthalmology Service is scheduled as soon as possible.
Lo screening audiologico
1 in 1000 newborns is born with congenital deafness. Even in this case, early diagnosis allows excellent chances of recovery of hearing function.
The newborn undergoes a test called Evoked Acoustic Otoemissions (OEA). This is a non-invasive test that does not bother the child.
The exam consists in inserting a soft probe into the outermost part of the ear canal, and sending a sound stimulus. In response to this stimulus, the innermost part of the auditory canal (the cochlea) responds with a sort of “echo” that is recorded by the device.
The presence of an adequate acoustic response is a sign that the cochlea is functioning well and therefore of normal hearing ability.
Osteopathic treatments and neurological evaluation
All those born in Humanitas San Pio X, if necessary, undergo osteopathic evaluation and treatment from the first days of life. Clinical attention is particularly directed to neonates with plagiocephaly or myogenic torticollis , neonates born with vacuum extractors, preterm or low birth weight neonates, neonates with paresis or paralysis following birth trauma (fracture of the clavicle , obstetric paralysis of the brachial plexus, etc) and to newborns who present at birth with mild neurological anomalies (mild hypertonicity or hypotonicity). For cases that require more attention, classification and care will also be shared with the neonatal neurologist who is part of the Neonatology medical team .
The interview with the parents will be essential to explain, right away, how to help your child recover as quickly as possible, teaching them the preferred postures and the exercises to do at home.
Checks with the pediatrician
On discharge
Upon discharge, the newborn undergoes a check-up visit with the pediatrician in the presence of the mother. This moment is important not only to evaluate the growth, nutritional status, neuro-behavioral development of the child, but also for the mother who has the opportunity to ask questions and clarify any doubts.
The checks of the first month
The first check-up at the birth center clinic is carried out 2-3 days after discharge and then after a week or in any case 7-10 days of life.
These check-ups are important to assess the child’s growth and general health, but also for parents to ask the pediatrician a few questions about the child’s first days of life.
A thorough clinical evaluation of developmental dysplasia of the hip is also performed.
Our newborns are all subjected to careful clinical evaluation by the pediatrician, while the indication for ultrasound investigation around the 1st month of life is reserved for those with risk factors.
The birth center clinic
Given the importance of support and advice to mothers in the first days of life, also for a correct start of breastfeeding, the nursing clinic of the San Pio X Birth Center is available to mothers for information and advice on breastfeeding, weight control, bilirubin assessment and the most common childcare maneuvers.
During the first month of life, parents can always refer to the Birth Point clinic, after which the newborn will be entrusted to the pediatrician of their choice.
Other recommended exams
Between the 25th and 40th day of life all newborns should undergo an electrocardiogram to check for any cardiovascular pathologies.
Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.
Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.