DEAR EDITOR, Cutaneous infantile haemangioma (IH) occurs in 5–10% of neonates, with multiple IH (> 1) in 30% of those. 1 Expert opinion currently recommends routine liver ultrasound (USS) for five or more (5+) IH, 2, 3 and if hepatic haemangiomas (HH) are identified, to test thyroid function3 even if neonatal thyroid screening occurred. Supportive data from one cohort demonstrate associations between 5+ IH and HH, 1 and between HH and adverse clinical outcomes (cardiac failure/hypothyroidism). 4–6 However, there are no data relating number of cutaneous IH, USS screening or thyroid testing to frequency of adverse clinical outcomes, as per the principles of any screening programme. 7 One study suggesting validation of screening USS in infants with multiple cutaneous IH, while important in describing a HH cohort, in fact compared clinical outcomes in infants presenting spontaneously (in whom we would expect more severe disease) with those diagnosed on screening. 4 In addition, the study lacked control groups without USS and without HH.