The Red Book Explained: Baby Development Checks in the UK

If you're a parent in England (and Wales and Northern Ireland — Scotland has a slightly different version), you'll have been handed a red book shortly after your baby was born. Here's everything you need to know about it and the checks inside.

What is the red book?

Officially called the Personal Child Health Record (PCHR), the red book is a document held by parents (not the NHS) that records your child's health and development from birth through childhood. It's yours to keep and bring to every health appointment.

It contains:

Your baby's measurements and growth charts
Record of vaccinations
Notes from development checks and health visitor appointments
Feeding records (in the early weeks)
Space for your own notes

Bring it to every appointment — GP, health visitor, A&E, hospital. It's the most complete picture of your child's health history.

Development checks — the schedule

The NHS offers a structured programme of checks in the first years. Here's when they happen:

Newborn checks (first 72 hours)

The newborn and infant physical examination (NIPE) happens within 72 hours of birth (often in hospital before you leave). It includes:

Eyes (red reflex check for cataracts)
Heart (listening for murmurs)
Hips (developmental dysplasia check)
Testes (in boys)
Overall physical examination

This check happens again at 6–8 weeks (the "6-week check") with your GP.

6–8 week check

Done by your GP. Key things assessed:

Weight, length, head circumference
Heart, hips, eyes again
Social development — is baby smiling? Responding to faces?
Feeding and feeding support
Your emotional wellbeing as a parent (the Edinburgh Postnatal Depression Scale is often used here)
Baby's first vaccinations are usually due now

9–12 month review

A health visitor appointment. Checks include:

Physical development — sitting, movement, cruising
Social and communication development — responding to name, pointing, waving, babbling
Hearing check if not already done (hearing is screened at birth but this is a follow-up)
Safety advice for the age (crawling, choking hazards)
Introduction of family foods, cup use

2–2.5 year review

Beyond the first year — a significant developmental check assessing language, physical development, and behaviour.

School entry (4–5 years)

Height, weight, vision, and a developmental screen.

The newborn hearing screening

This is separate from the red book checks but important to know: newborn hearing screening is offered to all babies in England, usually in hospital within a few days of birth or at home within a few weeks. It uses non-invasive sounds and sensors and takes around 20 minutes. If results are unclear, you'll be referred for a more detailed test — this doesn't mean your baby definitely has a hearing impairment.

The newborn bloodspot screening (heel prick test)

Done at 5 days old, this screens for 9 conditions including:

Congenital hypothyroidism
Cystic fibrosis
Sickle cell disease
Phenylketonuria (PKU)
And others

A small sample of blood is taken from the heel. Results come within 6–8 weeks — you'll be contacted if further investigation is needed.

Vaccinations — the UK schedule

The full NHS vaccination schedule is in your red book. Key dates:

8 weeks: 6-in-1, Rotavirus, MenB
12 weeks: 6-in-1 (2nd), Rotavirus (2nd), Pneumococcal
16 weeks: 6-in-1 (3rd), MenB (2nd)
12–13 months: Hib/MenC, MMR, Pneumococcal booster, MenB booster

All are free on the NHS. Your GP surgery or health visitor team will invite you for appointments.

What if I miss a check?

Contact your health visitor to rearrange. Checks don't expire — they can happen a little later if needed. The important thing is that they happen.

Using your red book well

Write things in it yourself. Note the date your baby first smiled, rolled, sat up, walked. Many parents regret not recording these in the moment. Your red book is a lasting record — and unlike a phone that can be lost or broken, it's a paper document you'll likely have forever.

The TinyYears app is a great digital companion — log milestones with photos and notes alongside your red book records.