09/10/18

Advocacy for Newborn Screening | OBHG

Heel StickIt may seem like the pinprick heard round the world. If your newborn screams, don’t be dismayed. Your baby is more startled by the prick than anything else. The pain is gone almost before it begins. And you’re doing the right thing by letting hospital staff draw a few drops of blood from your newborn’s heel.

September is Newborn Screening Awareness Month. Parents must be advocates for their children by ensuring that their hospital completes a full health screening of their newborn. There are several types of newborn screening, including basic physical exam, hearing screening, blood spot testing, and pulse oximetry testing for heart defects.

These screenings are critical in identifying diseases or abnormalities long before a child experiences symptoms. Early detection and treatment can prevent disability, permanent damage, or even death. These screenings usually are routine in the hospital, but if for any reason a baby is not properly screened at the hospital, or if a baby is born outside of a hospital, they should be screened within a few days of birth at an appropriate medical facility.

The first screening your newborn should receive is a routine physical examination (often by a pediatrician) to measure weight, length, and head circumference. The doctor then examines the baby’s skin, head and neck, heart and lungs, and abdomen and genitals. In addition, the baby’s nervous system and reflexes are checked.

Newborns also should have their hearing checked. Newborn screenings for hearing are quick and painless. Experts recommend they be conducted no later than 1 month of age and preferably before leaving the hospital. These screenings are so subtle that they often can be conducted while the baby is asleep. If hearing loss is detected, an audiologist and otolaryngologist (ear, nose, and throat physician) will determine the level of loss and whether treatment is warranted. If the hearing loss is permanent, hearing aids and speech/language services usually are recommended.

The newborn blood screening can detect such disorders as sickle cell disease, cystic fibrosis, and phenylketonuria (PKU, a condition that can cause nervous system problems, brain damage, and mental disability). Every state has its own newborn screening program and may test for different conditions. Some states have more comprehensive screening lists than others.

Many hospitals routinely screen newborns for Critical Congenital Heart Defects (CCHDs) using a method called pulse oximetry, which gauges the amount of oxygen in the blood and measures pulse rate. Pulse oximetry can detect CCHDs in some infants before they have any symptoms. If a defect is found, the infant can be evaluated by a cardiologist and receive special care to prevent disability or premature death. Some hospitals routinely administer pulse oximetry screening, but it is not routinely conducted in all states, so parents might wish to inquire about it.

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