Baby's first weeks: Newborn check-ups

Photo of a newborn being examined

Three tests are offered for newborn babies by the time they reach the age of five weeks. In Germany these are part of a series of standard check-ups referred to in German as “U-Untersuchungen.” They are done to check that the baby is healthy and developing normally.

At each check-up, the child is measured and weighed, and the doctor gives them a thorough physical examination. The goal of these check-ups is to detect any illnesses or developmental disorders in order to treat them in time. The check-up results are recorded in a special booklet, referred to as the gelbe Heft or “yellow booklet” because of its color.

Illustration: The “yellow booklet” for recording check-up results

The first check-up (U1) is done right after the baby is born, so usually right at the hospital. If no doctor is present, for example after a home birth, a midwife examines the baby.

If the mother is still in the hospital when it's time for the second check-up (U2), it can also be done there. The U3 check-up takes place at a pediatrician's office. It's best to start looking for a pediatrician even before the child is born.

U1 (within 30 minutes of childbirth)

  • The baby’s heartbeat, complexion, reflexes, muscle tension and breathing are checked.
  • The baby is checked for visible deformities and any injuries possibly due to the delivery process.
  • Blood is taken from the umbilical cord. The pH level is checked to determine whether there’s enough oxygen in the baby’s blood.
  • With the parents' consent, the baby is given a vitamin K shot to prevent bleeding. Newborn babies have not yet stored enough vitamin K, which is important for blood clotting.

U2 (between the third and tenth day after birth)

  • The physical examination is used mostly to look for any congenital diseases or deformities.
  • The baby's diet is also considered: Is the breastfeeding or bottle-feeding working out? Does the baby have any trouble drinking or swallowing? What does their pee and poo look like?
  • The baby’s hip is examined. If the doctor finds risk factors for deformity of the hip, a special examination is recommended.
  • With the parents’ consent, the baby is given another dose of vitamin K.
  • The parents are offered the option of having expanded check-ups. Those also test the baby’s blood for various metabolic diseases, hormonal imbalances and some other illnesses. This usually involves taking a few drops of blood from the baby’s heel.
  • The sample can also be used for a series of tests for cystic fibrosis.
  • A special hearing test is carried out so that any hearing problems can be detected at an early stage.
  • A test method known as pulse oximetry is used to identify certain types of heart defect that the baby might already have.
  • The parents are given additional information about feeding the baby, preventing sudden infant death syndrome, and the use of vitamin D and .

U3 (in the fourth to fifth week after birth)

  • The physical examination is used mostly to look for any abnormalities in the baby's development
  • With the parents’ consent, the baby is given another dose of vitamin K.
  • The doctor asks about the baby’s diet, pee and poo, and whether the baby generally cries too much.
  • Gross and fine motor skill tests are done. For instance, the doctor will check to see whether the baby can hold their head up briefly while lying on their stomach and whether they can open their hand spontaneously.
  • Perceptual skills are tested. For instance, can the baby track an object with their eyes? Do they look at familiar people when approached?
  • Does someone close to the baby rocking, singing or talking have a calming effect? Does the baby react appropriately to loud noises, bright light and touch?
  • An ultrasound scan is done to check whether the baby’s hip joints are correctly positioned.
  • The doctor asks about any unusual stress in the family.
  • They will also provide information about vaccinations for the first time.
  • The parents are given additional information about feeding the baby, preventing sudden infant death syndrome, coping with excessive crying and the use of vitamin D and .

Each check-up is also an opportunity to ask for advice and to get information on local services such as parent-child classes, advice centers and “family midwifes” (who provide support for the baby, mother and family through pregnancy and the child’s first year at home).

There are a total of 12 standard check-ups by the time the child reaches the age of ten years. All but U10 and U11 are covered by statutory health insurers in Germany.

Gemeinsamer Bundesausschuss (G-BA). Mutterschafts-Richtlinien.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

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Updated on May 27, 2024

Next planned update: 2027


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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