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Examination of child after birth

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Examination of child after birth

What different tests can you arrange for your child?

Examinations after birth: everything you need to know about your baby's first check-ups

The first few hours after the birth are special for you and your baby. In addition to getting to know each other for the first time, there are also important examinations to ensure that your baby is healthy and has a good start in life. So that you feel well prepared, we explain all the important check-ups that are carried out immediately after the birth and in the first few days of life. This way, you can make informed decisions and know exactly what to expect.

The first examination: the Apgar test

Immediately after the birth, the so-called Apgar test is carried out. Midwives or doctors check how well your baby is adapting to the world outside the womb. The test is carried out three times: after 1, 5 and 10 minutes. Five parameters are checked:

  • Breathing
  • Heart rate
  • Muscle tone
  • Reflexes
  • Skin colour

Each parameter receives up to 2 points, so a maximum of 10 points is possible. But don't worry, it doesn't have to be perfect! Your baby can lie relaxed on your tummy without being taken away from you.

Umbilical cord blood examination

In many clinics, the umbilical cord blood is also analysed to check the oxygen supply during the birth. The pH value and the base excess (a measure of the acid-base balance) are measured. This examination can provide valuable information, especially after a strenuous labour.

Physical examination: from head to toe

Your baby will be thoroughly examined shortly after birth:

  • Weight measurementBirth weight is an important baseline, as babies can lose up to 10 % of their weight in the first few days after birth.
  • Head circumferenceThis is measured because the head shape can still adapt after birth.
  • Body lengthThis is often not exactly measurable, as newborns usually tighten their legs.

Vitamin K administration: For blood clotting

Immediately after birth, your baby will be given vitamin K, an essential vitamin for blood clotting. It is administered as drops and repeated later at U2 and U3. This prophylaxis protects your baby from dangerous bleeding, as breast milk contains very little vitamin K.

Pulse oximetry measurement: recognising heart defects at an early stage

Pulse oximetry is carried out between 4 and 24 hours after birth. A small clip on your baby's foot measures the oxygen saturation. Values above 96 % are considered normal. This examination is completely painless and only takes a few seconds - your baby can remain in your arms.

Extended newborn screening: recognising rare diseases

Blood is taken from your baby's heel between the 36th and 72nd hour of life. This so-called dry blood sample is analysed for rare metabolic and hormonal disorders as well as cystic fibrosis. Important: You must agree to this genetic test in writing. Your doctor must and will inform you in detail beforehand.

The diseases tested include, among many others:

  • Hypothyroidism (underactive thyroid)
  • Phenylketonuria
  • Adrenogenital syndrome (hormone production disorder)

Even though these diseases are very rare, it is crucial to recognise and treat them at an early stage.

Hearing screening: Good hearing for development

Hearing screening is also one of the first examinations. A small sound impulse is used to test whether your baby can hear. If the result is inconclusive due to cheese smears or amniotic fluid, the examination is repeated later. Hearing is important for speech and cognitive development, which is why this examination is recommended.

Vitamin D and fluoride: protection for bones and teeth

For the time at home, your baby will be given vitamin D, often in combination with fluoride. Vitamin D is important for healthy bone growth, as babies are exposed to little sunlight. The use of fluoride to strengthen teeth is controversial - it's best to talk to your dentist about whether it's a good idea for your baby.

Hip ultrasound: early diagnosis of hip dysplasia

The hip ultrasound is usually carried out as part of the U3 scan. If there are risk factors, such as breech presentation or a family history, it can already be carried out at U2. If recognised early, hip dysplasia can be treated effectively.

New from 2024: the RSV vaccination

An important innovation is the RSV vaccination, which is offered from U2 onwards. This antibody vaccination protects newborns against severe courses of respiratory syncytial virus, a common infection in infants.

Why are these examinations important?

All examinations and prophylactics serve to protect your baby from avoidable risks and ensure that it grows up healthy. Of course, the decision is up to you - you will also find detailed video material on postnatal examinations in the antenatal course. Make sure you watch these lessons so that you can make the best choice for your baby with confidence.

Take a birth preparation course now

Extended newborn screening: recognising rare diseases at an early stage

One of the most important examinations in the first few days of life is the extended newborn screening. Between the 36th and 72nd hour of life, a small amount of blood is taken from your baby's heel. This is dripped onto a dry blood card and sent to a specialised laboratory, which tests the sample for numerous rare metabolic and hormonal disorders.

Why is screening so important?

Although these diseases are rare, they are treatable. Early diagnosis enables therapies that help your baby to develop healthily.

Which diseases are tested?

Here is an overview of the diseases that are recorded as part of newborn screening:

  1. Hypothyroidism (underactive thyroid)
    → Leads to growth and development retardation if left untreated.
  2. Phenylketonuria (PKU)
    → Metabolic disorder in which phenylalanine from food is not broken down. Without therapy, there is a risk of mental developmental disorders.
  3. Adrenogenital syndrome (AGS)
    → A disorder of hormone production that can lead to dangerous salt loss.
  4. Biotinidase deficiency
    → This disease impairs the utilisation of biotin, an important vitamin for metabolic processes. If left untreated, it can trigger seizures and developmental disorders.
  5. Galactosaemia
    → Affected babies cannot break down milk sugar (galactose). If left untreated, this can lead to liver damage and visual impairment.
  6. Maple syrup disease (MSUD)
    → A rare metabolic disorder in which certain amino acids cannot be broken down.
  7. Cystic fibrosis (cystic fibrosis)
    → Leads to problems with the lungs and digestion. Early diagnosis significantly improves treatment options.
  8. Glutaric aciduria type 1 (GA1)
    → This disease leads to an accumulation of metabolic products that can cause brain damage if left untreated.
  9. MCAD deficiency
    → A fat metabolism disorder in which the body cannot obtain energy from fat during periods of fasting. If left untreated, this can be life-threatening.
  10. LCHAD deficiency
    → Similar to MCAD deficiency, this disease affects the breakdown of fatty acids and can lead to serious complications if left untreated.
  11. Isovaleric acidemia (IVA)
    → A metabolic disorder in which the body cannot break down the amino acid leucine properly.
  12. Holocarboxylase synthetase deficiency
    → Leads to metabolic disorders, seizures and developmental problems if left untreated.
  13. Carnitine cycle defects
    → Diseases in which the body cannot properly convert fat into energy.
  14. Tyrosinaemia type 1
    → A metabolic disorder in which the amino acid tyrosine is not broken down correctly and can damage the liver.
  15. Ketoacidosis diseases (e.g. methylmalonic acidemia, propionic acidemia)
    → Rare diseases in which metabolic products are not broken down properly and accumulate in the body.
  16. Cystinosis
    → A rare metabolic disorder that leads to the accumulation of cystine in the cells and causes kidney problems.
  17. Urea cycle defects
    → Diseases in which ammonia is not broken down correctly, which can lead to poisoning in the body.

Procedure for newborn screening

  • Blood is taken from the baby's heel.
  • The dried blood sample is sent to a specialised laboratory.
  • The results are available within a few days.

The screening only takes place with your written consent. Beforehand, your doctor will explain to you exactly which diseases will be tested and why this is important.

Additional information for parents

If your baby was born at home or on an outpatient basis, the newborn screening can also be carried out by your midwife - provided you have received the paediatric information beforehand.

If recognised early, many of these rare diseases can be treated well. Even if your baby is completely healthy, screening gives you additional peace of mind.

Do you have any questions about newborn screening?

Watch the corresponding lessons in the antenatal class and get advice from your paediatrician before the birth of your baby.

Take a birth preparation course now

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