The role of the health professional is constantly changing and evolving, and as areas of practice expand, this requires advanced skills. The midwife in extending her role to become professionally competent in the examination and assessment of the newborn facilitates the provision of holistic care for the woman, infant and family. This is a case study report of an infant diagnosed with an innocent heart murmur on the first neonatal examination. It explores the transitional process of a midwife extending her role in performing the neonatal examination and critically evaluating the neuro-behavioural physiological assessment of the infant and covers areas of debate including which practitioner should be performing the examination and the timing of the examination.