Expansion
A head to toe screen performed within 72 hours of birth
Expansion
Performed within 72 hours and again at 6 to 8 weeks. Four conditions are specifically screened for: eyes, heart, hips and testes.
Head to toe
- Head: fontanelles, sutures, moulding, caput and cephalhaematoma, occipitofrontal circumference
- Eyes: red reflex in both eyes, to exclude congenital cataract and retinoblastoma
- Mouth: palate inspected and palpated for cleft
- Chest: respiratory rate and effort, heart sounds, murmurs
- Abdomen: masses, organomegaly, umbilicus
- Femoral pulses: absent or delayed suggests coarctation
- Hips: Barlow (dislocates) and Ortolani (relocates) tests for developmental dysplasia
- Genitalia: testes descended, patent anus, ambiguity
- Spine: midline defects, sacral dimples
- Limbs: digits, talipes, tone and posture
- Reflexes: Moro, grasp, rooting, sucking
Risk factors for hip dysplasia: breech, family history, female, first born, oligohydramnios. These prompt ultrasound regardless of examination findings.
Ask about antenatal history, feeding, urine and meconium passage, and check the newborn blood spot and hearing screen have been arranged.