A guide to newborn screening and tests

A guide to newborn screening and tests

Keep reading for must-know information on newborn screening.

Many tests are performed on babies in the first few days of their lives—including newborn screening—starting as soon as immediately after they are born. You may wonder: What are these tests? What are the doctors looking for? Are such tests needed?

Your concerns are as valid as the tests are necessary.  But rest assured that these tests cause little pain, if any at all, to your precious little one. Such tests are routine and are essential in ensuring your baby is well and healthy.

Newborn screening can help detect any abnormalities that may not apparent just by looking at the baby.

newborn screening

Newborn screening tests will be done both in your hospital room and in the nursery.

Tests done immediately after birth

Apgar scoring
In the first minute after your baby is born he will do the first grading test of his life! In the Apgar score test, five factors are used to evaluate the baby’s condition. The five factors are:

1. Appearance (skin color)
2. Pulse (heart rate)
3. Grimace response (reflexes)
4. Activity (muscle tone)
5. Respiration (breathing rate and effort)

Each factor is given a score on a scale of 0 to 2, with 2 being the best score. The scores for each of the 5 areas are then combined to obtain a total grading out of a possible score of 10. A perfect score of 10 is possible but rare.

Five minutes later, the Apgar test is repeated. Babies usually get a higher score in the second test because their overall condition tends to improve.

Quick physical examination
Within an hour of your baby’s birth the midwife will also perform a quick physical examination. She will check your baby’s weight, length, and head circumference. These figures will go into your baby’s health booklet which will be updated at subsequent check-ups.

newborn screening

The moment your baby is born, their vital signs will be checked through a quick physical examination.

Thorough physical examination
The pediatrician will perform a detailed head-to-toe examination within the first 24 hours of your baby’s life.This will include checking your baby’s heart, reflexes and breathing. The doctor will also do a physical check for Jaundice symptoms and how breastfeeding is going.

newborn screening

You baby will receive a vitamin K injection when she is born.

Besides the general tests and checks done closer to the baby’s birth, there are other specific tests and injections necessary for the baby:

Routine blood test
A routine blood test will be done on your newborn by the means of a quick prick on his foot. The blood sample will be used to check for Phenylketonuria (PKU) (PKU). This is a rare genetic disorder in which the body cannot break down acid called phenylalanine, which is a part of protein that is found in breast milk, many types of baby formula, and most foods -especially those with a lot of protein.

If PKU is not treated, phenylalanine can build up in the blood and lead to intellectual disability and issues with the central nervous system.

newborn screening

A hearing test is part of the routine newborn screening

Although in certain instances this test is done right away, some specialists recommend that this is done 24 to 48 hours after birth and breastfeeding is established.

In addition to checking for PKU, the routine blood test also checks for blood sugar.

Bilirubin test

This too is a routine test that measures the amount of bilirubin in a blood sample taken from your baby. Bilirubin is a yellowish-brown substance found in bile, which is a by-product made after the breakdown of red blood cells.

Newborns, especially those who are born prematurely, develop a condition called jaundice because their immature livers are slow to produce bilirubin.

While it is not a problem for a baby to have mild jaundice, too much bilirubin in a newborn baby may cause brain damage and other serious issues. Therefore this test is very important to determine if your baby needs to be treated for jaundice with the help of phototherapy.

newborn screening

You baby’s doctor will also perform a thorough physical examination on your baby to make sure everything is in order.

G6PD (Glucose-6-Phosphate Dehydrogenase) test

G6PD (Glucose-6-Phosphate Dehydrogenase) is an enzyme helps red blood cells function normally. A G6PD deficiency is an inherited condition where a baby doesn’t have enough G6PD which could cause a condition called  hemolytic anemia, which is a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is over. Therefore testing your baby for G6PD will be done routinely.

TSH (Thyroid Stimulating Hormone) test

The Thyroid Stimulating Hormone (TSH) test will help evaluate if your baby’s thyroid and pituitary glands are functioning normally. This test also helps to diagnose and monitor a thyroid disorder, if present.

Vaccinations and injections

Vitamin K injection

Vitamin K is a routine injection given to help your baby’s blot clot and prevent hemorrhaging, especially in instances where forceps or suction has been used to aid delivery.

BCG and Hepatitis B vaccinations

The BCG vaccination which protects your child against tuberculosis and the first dose of the hepatitis B vaccines are given shortly after your baby is born. This has proven highly effective in preventing serious forms of childhood tuberculosis such as tuberculosis TB meningitis (occurs when the tuberculosis bacteria invade the membranes and fluid surrounding the brain and spinal cord) and disseminated tuberculosis (a contagious bacterial infection in which TB bacteria has spread from the lungs to other parts of the body through the blood or lymph system).

As the name suggests, the hepatitis B vaccine protects your baby from serious viral liver infections such as hepatitis B. Your baby will get the 2nd dose of the hepatitis B vaccine one month after the first dose and the 3rd dose 5 months after the 2nd dose.

Other optional tests

Some other optional tests that your pediatrician may request for include a newborn screening hearing test and metabolic screening test.

The hearing test can be done easily and doesn’t cause any pain to your baby. Hearing in infants can be tested using two different methods: the auditory brainstem response (ABR) evaluations or the otoacoustic emission (OAE) measures. Both tests are accurate, noninvasive, automated, and do not require any observable response from the infant. It is important to detect hearing impairment early on so that treatment can be prescribed if needed.

The metabolic screening can also done between the 2nd to the 5th postnatal day. Over 25 different health problems such as phenylketonuria (PKU), cystic fibrosis, and congenital hypothyroidism can be detected through a metabolic screening test.


Mums and mums-to-be, we hope this information about newborn screening was insightful to you. If you wish to share your views on this article, please leave a message below. 










Also read: Breastfeeding your newborn 101: One hour, one week, three months

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Minoli Almeida

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