In the nursery, how many times do you have to exam the well newborn?

We exam the baby twice: in first 24 hours and before discharge.

I have been told that only one exam is needed. Any reference?

This is how we do it (not why...)

* infants >24 h postnatal age - one examination before discharge from maternity

* infants discharged home before 24 h postnatal age - one examination before discharge and one examination at the follow-up visit at 48-72 h postnatal age

We do (not yet) perform pulse saturation screening.

I know there are references (in ADC I'm sure) - will see if I can find these later!

Pulse oximetry screening...yes definitely promising

http://www.bmj.com/cgi/reprint/338/jan08_2/a3037?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=%22Impact+of+pulse+oximetry+screening+on+the+detection+of+duct+dependent+congenital+heart+disease%3A+a+Swedish+prospective+screening+study+in+39+821+newborns%22&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT

(free article)

http://www.ncbi.nlm.nih.gov/pubmed/17344253?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=5&log$=relatedreviews&logdbfrom=pubmed

This was the article I was thinking about... also published as a Leading Article at 99nicu!

http://www.99nicu.org/forum/showthread.php?t=14351

Some Swedish experience: http://www.ncbi.nlm.nih.gov/pubmed/18394103

Thank you for your responses. Now I will consider if we should change...

We exam the baby every day (health newborn baby discharge on 4th day after delivery).

Once before discharge is what we practice. We make sure we examine them thoroughly according to policy. But before that a 48 hour check is helpful since midwives and mother`s might not come up with subtle problems all the time. Apart from that I think daily check is really not needed.