Although the purpose of the first examination of the newborn is to confirm normality, there are some potentially life-threatening conditions, such as some forms of congenital heart disease, that are not evident in the first 24 hours of the baby’s life and which therefore would not be detected. It is estimated that approximately 50 per cent of affected infants leave hospital without being diagnosed (Singh et al. 2015). When the practitioner performing this clinical examination of the baby is new to the role, it is likely that she will have some concerns about the risk of litigation in the event of an abnormality being missed. For example, what is the legal position of a practitioner who does not detect a congenital condition in a baby during the first examination of the newborn? It is therefore essential that this examination is performed with competence and an appreciation of the practitioner’s accountability.