Tommy's PregnancyHub

Tests and vaccinations for your premature baby

Your baby will have regular tests to check their progress while they are in the baby unit. They will also need vaccinations to protect them from some illnesses.

What tests does my baby need?

Your baby may have tests to see how they’re developing, to check for illnesses or to see how they’re responding to treatment. The doctor will examine your baby and may carry out tests if your baby needs them.

These may include tests to:

  • find out their blood group
  • check the amount of oxygen and carbon dioxide in the blood (this helps to check if the lungs are working properly, and whether treatment is effective in babies with breathing problems)
  • check levels of glucose, salts, calcium and other minerals to ensure your baby is getting all the nutrition they need 
  • check for infection (if your healthcare team thinks they may have an infection)
  • check their haemoglobin (red blood cell) levels to check for anaemia
  • check for yellowing of the skin (jaundice). 

You may be able to comfort your baby during or after the tests, for example, by holding them or breastfeeding.

Screening tests for premature babies

Screening tests pick up signs of illness at an early stage when treatment is most effective. The healthcare team can tell you what the screening tests involve and how they may benefit your baby. 

These are routine examinations that every newborn baby gets, regardless of when they were born. As parents, it’s your choice whether your baby has these tests.

  • Newborn physical examination. The doctor will perform a detailed examination of your baby. They will usually check your baby’s heart, eyes and hips. They also check the testes in boys. Your baby will have this examination in hospital when they’re well enough and again when they’re 6–8 weeks old.  It is important to tell the medical team if there is any history of heart, eye or hip problems in babies in your family.
  • Blood spot (heel prick) test. This test checks for rare but serious health problems. Premature babies may have this test more than once depending on their health and treatment. 
  • Newborn hearing screening test. Hearing loss is more common in premature babies. Your baby will be offered hearing tests once their health is stable. 

Some premature babies may also need to have a blood test. This may explain why they might need extra support now and what support or treatment they may need going forward.

If your baby was born before 32 weeks, they will have an additional test for congenital hypothyroidism at 28 days old or when they are discharged from hospital, whichever is sooner. 

The British Thyroid Foundation has more information about congenital hypothyroidism.

Vision test for retinopathy of prematurity (ROP)

Retinopathy of prematurity is an eye condition that affects some premature and low birth weight babies. If your baby was born before 32 weeks or weighed less than 1.5kg at birth, they may need screening for ROP. 

Find out more about your premature baby’s vision and hearing

Vaccinations for your premature baby

One of the best ways to protect your baby against diseases like measles, rubella, tetanus and meningitis is through vaccination. As well as protecting your own baby, you're also protecting other babies and children by preventing the spread of disease.   

Premature babies have a higher chance of getting infections, so it’s important that they have their vaccinations. Vaccinations are free in the UK.

It’s important that all children follow the NHS vaccination schedule so that their risk of catching certain diseases is as low as possible. Premature babies should be immunised in line with the recommended schedule from 8 weeks after birth, no matter how premature they were. This may happen whilst your baby is in hospital, you will need to discuss this with your doctor.  

The first vaccine is due at 8 weeks after the birth, so your baby may still be in the baby unit when they have it.  After you take your baby home, you will receive a letter to tell you when their next vaccine is due.

Find out more about your baby’s check-ups after they are born

 

Lab Tests Online. Blood gas tests. https://labtestsonline.org.uk/tests/blood-gas-tests (Page last reviewed: 26/7/2016.)

NICE (2010) Jaundice in newborn babies under 28 days. Clinical guideline 98. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/cg98

PHE (2017) Babies in special care units: screening tests for your baby. Public Health England https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/712824/NICU1_Babies_in_special_care_units_Screening_tests_for_you_and_your_baby.pdf
  
NICE (2017) Developmental follow-up of children and young people born preterm. NICE guideline 72. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng72/chapter/Recommendations
  
NHS. Newborn blood spot screening FAQS. https://www.nhs.uk/conditions/baby/newborn-screening/blood-spot-screening-faqs/ (Page last reviewed: 10 August 2020, Next review due: 10 August 2023)

Royal College of Paediatrics and Child Health, Royal College of Ophthalmologists British Association of Perinatal Medicine & BLISS (2008, reviewed 2013) Guideline for the Screening and Treatment of Retinopathy of Prematurity https://www.rcpch.ac.uk/sites/default/files/2018-03/guideline_for_the_screening_and_treatment_of_retinopathy_of_prematurity_2008-05.pdf

PHE (2019) A quick guide to childhood immunisations for the parents of premature babies born on or after 1 January 2020. Public Health England. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/849306/PHE_11490_premature_quickguide_Jan2020.pdf
 
PHE (2019) The routine immunisation schedule: from January 2020. Public Health England https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/849184/PHE_complete_immunisation_schedule_Jan2020.pdf