Newborn examination (NIPE) & screening

Overview

The Newborn and Infant Physical Examination — a systematic head-to-toe screen performed within 72 hours of birth and again at 6-8 weeks, targeting four conditions especially: the EYES (red reflex — congenital cataract/retinoblastoma), the HEART (murmurs, femoral pulses, saturations — congenital heart disease), the HIPS (Barlow/Ortolani — developmental dysplasia), and the TESTES (undescended). It is the screen that catches treatable congenital conditions early.

Recognise

• Systematic examination within 72 h and at 6-8 weeks; the four screened targets are eyes, heart, hips, testes
• Eyes: RED REFLEX (absent → congenital cataract/retinoblastoma — urgent); Heart: murmur, FEMORAL pulses, pre/post-ductal saturations (CHD/coarctation)
• Hips: Barlow (dislocate) + Ortolani (relocate) for developmental dysplasia; Testes: bilateral descent (cryptorchidism)

Differentials & how to tell them apart

Investigations

Clinical examination; pulse oximetry screening; hip ultrasound for risk factors/abnormal exam (breech, family history); plus the separate newborn blood-spot (heel-prick) and hearing screens.

Management

Systematic NIPE (eyes/heart/hips/testes) + pulse oximetry; refer abnormal findings

1. 1Perform the systematic NIPE within 72 h and at 6-8 weeks, focusing on eyes (red reflex), heart (murmur/femoral pulses/saturations), hips (Barlow/Ortolani) and testes; add pulse oximetry and the blood-spot/hearing screens.Gate: An ABSENT RED REFLEX (cataract/retinoblastoma) and ABSENT FEMORAL PULSES (coarctation/duct-dependent CHD) are the two not-to-miss findings — each triggers urgent referral; risk factors/abnormal hip exam → hip ultrasound
2. 2Specific referrals: ophthalmology (red reflex), cardiology (heart/pulses/saturations), hip ultrasound (DDH), surgery/urology (undescended testis); the 6-8-week check repeats the screen.

Monitor & prognosis

Repeat at 6-8 weeks; track referrals.

Excellent — early detection of treatable conditions.