What are the Newborn Screening Tests

Newborn screening tests are done at the hospital soon after your baby is born. These tests are done to check for any health conditions your baby was born with.

Sometimes these are rare conditions that might not show any symptoms at birth. The purpose of screening is to find and treat a problem as early as possible. Early treatment may prevent or reduce future effects of the condition.

Hospitals routinely do newborn screenings. The types of screening tests are not the same in all states. Each state has its own screening routine. All tests are usually done before your child leaves the hospital. You may decide not to do some screenings. Before you give birth, talk to your health care provider about which screening tests are right for you and your baby.

What to expect:

Apgar test

Newborn screening tests begin with your baby’s first physical exam. This is usually started within the first minute of birth. In this exam, your baby gets a score of 0 to 2 in five different areas (Apgar score). The Apgar test measures:

• Skin color.
• Heart rate.
• Reflexes.
• Muscle tone.
• Breathing.

A perfect score of 10 is unusual. An Apgar score of 7 is good. Less than 7 may mean that your baby needs some additional care. This exam is repeated after 5 minutes because most babies need a few minutes to warm up and start breathing well. This test may be repeated one more time after 10 minutes. It depends on your baby’s scores from the first two exams.

Blood test

Before leaving the hospital or birth center, your baby may have a heel stick to collect a sample of blood for testing. This blood test can be used to screen for about 60 conditions that babies can be born with, including:

• Disorders that interfere with the way your baby uses or makes important nutrients for energy (metabolic disorders).
• Disorders that interfere with important chemical messengers (hormones) in the body (endocrine disorders).
• Blood disorders.
• Other disorders, such as cystic fibrosis.

Hearing test

Within 24 hours of birth, your baby may also have a hearing test. This simple, painless test checks how your baby reacts to sound. It can be done while your baby is sleeping.

Pulse oximetry

Pulse oximetry is another test that may be done within 24 hours of birth. This is a test to measure the amount of oxygen in the blood. This painless test uses a sensor that attaches to your baby’s finger or foot. Low levels of oxygen may be caused by a heart defect that some babies are born with (critical congenital heart diseases). More testing may be needed if your baby has low oxygen.

Follow these instructions at home:

Learn as much as you can about newborn screening tests. Before you give birth is the best time to start your research. You may want to learn more about:

• Your family history and countries of origin. This information may help your health care provider decide which screenings to do.
• Genetic screening for you and your partner. This type of screening is offered to all women before or during pregnancy.
• Which routine newborn screenings are done in your state. You can get this information from your health care provider, hospital, or state health department.
• Whether your health care provider will do any screening tests if you give birth at a birthing center or at home. You may be able to have some routine newborn screening tests done at a later time at the health care provider’s office.

Questions to ask your health care provider

• What routine newborn screenings will my baby have?
• What are the benefits of these tests?
• Are there any risks associated with any of these screening tests?
• If I am concerned about a screening test for my baby, can I decide not to have it done?
• Are there any additional screening tests that you would recommend?
• Will my insurance cover screening tests?
• When will the test results come back?
• When will we discuss the results of the testing and what they may mean for my baby?

Summary

• Newborn screening tests are done to make sure your baby is healthy and to check whether your baby may have a condition that is not obvious at birth.
• Finding potential problems as early as possible means treatment can be started in time to prevent or limit the effects of the condition.
• Routine screening tests are not the same in all states.
• Your newborn may have a hearing test and pulse oximetry as well as a routine blood test to check for certain conditions.