Over the first few years of their life, your baby will be given a series of tests, assessments and opportunities to see health professionals as part of the new Healthy Child Programme.
Your baby’s eyesight
Babies are born with the ability to see, although their vision may not be completely focused.
Their eyesight develops gradually over the next few months.
By the time of their first review (at around 14 days), you’ll have noticed whether or not your baby's eyes can follow your face or a colourful object held about 20cm (eight inches) away. If they can't, mention it at the review. At birth, a baby’s eyes may roll away from each other occasionally, which is normal. If your baby squints often or all the time, tell your health visitor and GP.
They can refer you to an orthoptist or ophthalmologist who specialises in children’s eyes.
It’s important that any problems with your child’s eyesight are identified as soon as possible as they can affect social and educational development.
Children may not realise that there’s anything wrong with their sight. Eye examinations are available free of charge to all children under 16. They don’t have to be able to read to have one. Ask your health visitor or school nurse for further advice or book an appointment with an optometrist directly.
Your baby’s hearing
In the first few weeks of your baby's life, they will be given a routine hearing screening test. The test uses the latest technology and can be carried out almost immediately after birth. It is completely safe and comfortable for babies.
You’ll be given a leaflet about the tests and how they work, either before or shortly after your baby is born.
After the test, you’ll be given two checklists (Reaction to Sounds and Making Sounds), which list the sounds your baby should respond to and make as they grow. There's information about hearing in your red book (PCHR or personal child health record).
If test results show that there could be a problem with your child’s hearing, you’ll be invited to a follow-up assessment. Sometimes, a cold or other infection can temporarily affect hearing.
You can also ask for another appointment if the results show that there’s no problem but you’re still concerned about your child’s hearing. If your child doesn’t seem to hear properly at the second appointment or you’re still worried, ask for a referral to a specialist paediatrician.
If your child's hearing problems are relatively minor, they may simply need some extra support to learn to talk. If the problems are more serious, they may need to learn other ways of communicating. The earlier that hearing problems are discovered, the greater the chance that something can be done.
Your baby’s weight and height
Steady weight gain is a sign that feeding is going well and your baby is healthy. In the early days after birth, it's normal for a baby to lose some weight. Your baby will be weighed to make sure that they regain their birth weight.
Four out of five healthy babies are at or above their birth weight by 14 days. If your baby loses a large amount of weight, your health visitor will talk to you about how feeding is going, and they'll look at your baby’s health in general. After this, your baby will only be weighed during routine reviews unless there’s cause for concern. Your health visitor may ask you to bring your baby more often if they think they need more regular monitoring.
Generally, you don’t need to weigh your baby too often: no more than once a month up to six months of age, once every two months from six to 12 months of age, and once every three months over the age of one.
A baby’s length is measured by trained staff using appropriate equipment. By age two, your child’s height can be measured when they're standing up.
Understanding your child’s chart
Your child’s growth will be recorded on a centile chart. This allows you to see how their height and weight compare to other children of the same age. Boys and girls have different charts because boys are on average heavier and taller and their growth pattern is slightly different.
Since May 2009, the centile charts in your PCHR or red book have been based on measurements taken by the World Health Organization from healthy, breastfed children with non-smoking parents from a range of countries.
They represent the pattern of growth that healthy children should follow, whether they're breastfed or formula fed. They are suitable for children from all ethnic backgrounds.
The curves on the chart, or centile lines, show the range of weights and heights (or lengths) of most children. If your child’s height is on the 25th centile, for example, this means that if you lined up 100 children of the same age in order from the shortest to the tallest, your child would be number 25 and 75 children would be taller.
It is normal for a child’s weight or height to be anywhere within the centile lines on the chart.
The centile lines show roughly the pattern of growth expected in weight and length, but these don't usually follow one centile line exactly. Weight usually stays within one centile space (the space between two centile lines).
All babies are different, and your baby’s growth chart won’t look exactly the same as another baby’s (even their brother's or sister's).
Usually, weight gain is quickest in the first six to nine months. It gradually slows down as children move into the toddler years.
If your baby is ill, weight gain may slow down for a while. Toddlers may lose weight when they're ill. When they recover, their weight will usually return to normal within two to three weeks. If your baby drops two or more centile spaces from their normal position, ask your health visitor to check them and measure their length.
You child’s height after the age of two can give some indication of how tall they will be when they grow up. Use the adult height predictor on the height page of your red book. It’s normal for your child to be on different centiles for weight and height/length, but the two are usually similar.
If there’s a big difference or if your health visitor is concerned about your child’s weight, they will calculate their Body Mass Index (BMI) centile. This will show if your child is overweight or underweight. If this is the case, talk to your health visitor about your child’s diet and physical activity levels. They can help you plan any changes needed.
You can also use our BMI calculator to check your child's BMI (as long as they are two years old or over) and find helpful information and advice.
For more information about any of these tests or if you’re worried about your baby's or child’s development, contact your health visitor or GP. You can ask them to refer you to a paediatrician (children's health specialist).
Your baby's screening timeline
One day to one month: newborn hearing
This is a test to check whether your baby’s hearing is normal. It can be done either before you go home from hospital or by a health visitor in your home or at the clinic.
One to three days: newborn physical examination
This includes screening of your baby’s heart, hips and eyes (and testes in boys), plus a general physical examination. The test can be carried out by a baby specialist or a specially trained midwife. It doesn’t have to be done before you leave hospital.
Five to eight days: newborn bloodspot
This is a heel-prick blood test for phenylketonuria, congenital hypothyroidism, cystic fibrosis and sickle cell disorders. In some areas, the test also includes MCADD, a metabolic disorder.
Six to eight weeks: physical examination
This involves screening of your baby’s heart, hips and eyes (and testes in boys). Your baby will be weighed and given a general physical examination. You’ll be asked whether your baby is being breastfed or bottle fed.
Eight weeks onwards: vaccinations
Vaccinations are routinely offered at 8, 12 and 16 weeks; 12 and 13 months, and three years and four months.
Read more about child vaccinations.
Six to eight months: hearing assessment
An infant distraction test is offered if your baby didn’t have the newborn hearing test.
Between 8 and 36 months: general reviews
You may be offered a general review of your child’s wellbeing between 8 and 12 months, and again at around two to two-and-a-half years.
Between four and five years: school entry screening
This includes vision screening, a height and weight check and a hearing test. Your child may also be given a general health review.