Declining a Newborn Infant Physical Examination

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This leaflet aims to provide parents with information about the Newborn Infant Physical Examination and the risks of declining.

What is a NIPE?

The Newborn Infant Physical Examination is one of the 11 NHS screening programmes.

Within 72 hours of giving birth, you will be offered a top-to-toe physical examination for your baby. This will include 4 specific screening tests using medical equipment to find out whether your baby has a suspected problem with their eyes, heart, hips or, in boys, their testes which would benefit from early investigation and possible treatment.

The screening tests are carried out again between 6 and 8 weeks of age as some conditions do not develop or become apparent until then.

What happens if you decline?

Screening is your choice, the NIPE is however a national recommendation for your baby. You can choose to have the full examination or partial.

If you choose to decline, advice will be provided for concerning features to look out for.

Your GP will make an appointment to see you at 6- 8 weeks where an examination will be offered again.

What to do if you have any concerns regarding your infant

If you have any concerns regarding your baby please seek medical advice from your midwife, health visitor, GP or A+E

About 3 in 10,000 babies have problems with their eyes that need treatment. Not having an eye examination using an ophthalmoscope, risks not diagnosing conditions which could lead to visual impairment long term.

Things to look out for include:

Appearance of eyes
How they focus
Any squint
Cloudiness
Any discharge that is continuous

Around 8 per 1,000 babies will have a heart problem or condition. This could range from a heart murmur to a problem needing specialist care or treatment. If a heart examination is not performed using a stethoscope and pulse oximeter a life-threatening condition missed, this could be fatal.

Things to look out for include:

Colour – if your baby has any blue episodes or appears pale
Lethargy
Work of breathing
Poor feeding
Pallor
Unusual sweating or puffiness

Babies can be born with hip joints that are not formed properly and if untreated this can lead to a limp and to joint/ mobility problems. About 1 or 2 in 1,000 babies have hip problems that need treatment.

Things to look out for include

Difference in leg length
Not using/ moving both legs the same
Difficulties crawling, walking

Baby boys are checked to make sure their testes are in the right place. It can take several months for testes to drop down (descend) into the scrotum. About 1 in 100 baby boys have problems with undescended testes that need treatment to reduce the risk of problems later in life, such as reduced fertility.

Things to look out for:

Are the testes descended?
Colour- any darkness, bruising or swelling may require urgent attention

Safety of the test

The examination is safe and does not have any side effects

What to do if you change your mind?

Not having the NIPE puts your baby at risk of missing potentially fatal conditions. You can change your mind at any point, please inform your midwife or GP who will organise for your baby to be seen. You can choose to have a partial screen.

For more information, please visit the following:

http://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby/eyes-heart-hips-and-testes-physical-examination