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Newborn Screenings
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 There
are a number of screenings during the first few days of life to identify any
problems. These include newborn screenings, hearing screenings, and in some
situations, car seat trials.
Newborn screening are simple blood tests that can identify certain rare
life-threatening metabolic illnesses. “Metabolic” has to do with chemical
changes which take place inside living cells.
A
baby with one of these illnesses may appear perfectly healthy at birth, but by
the time symptoms appear, the baby may suffer physical problems, mental
retardation, or even death.
Fortunately, most babies receive a clean bill of health when screened. Chances
of a baby screening positive for one of the disorders is about 1 in 1,500.
Screening in the first few days of life allows early identification and
treatment of babies with these disorders.
Early treatment can make the difference between lifelong disability or death and
healthy development. All states require screening for certain disorders,
although the requirements vary from state to state. Private organizations offer
screenings, for an additional fee, that are not included in state programs. With
the most complete newborn screening currently available, nearly 40 disorders can
be detected.
Talk with your physician if you have questions about additional screening tests.
Before leaving the hospital, a few drops of blood are obtained by pricking the
baby’s heel and the blood is sent for testing. Hospitals in Missouri previously
screened newborns for five disorders: phenylketonuria (PKU), congenital
hypothyroidism, galactosemia, hemogloginopathies (sickle cell anemia), and
congenital adrenal hyperplasia (CAH).
As of Jan. 1, 2005, the use of tandem mass spectrometry has expanded Missouri’s
state screening to include more than 20 metabolic disorders. These include
disorders of amino acid and organic acid metabolism, as well as fatty acid
oxidation disorders.
Hearing loss is one of the most common birth defects, occurring in about three
or four for every 1,000 newborns. Because language and communication develop so
rapidly during the first three years of life, an undetected hearing loss will
interfere with a child’s speech and communication with others. Early detection
of hearing loss allows the baby to be fitted with hearing aids before six months
of age to decrease serious speech and language problems.
Screening takes 10 to 30 minutes and is done in the Newborn Nursery while the
baby is quiet and sleeping. Tiny soft earphones are placed in the baby’s ears
and the baby’s response to sounds is measured. If a baby does not pass the
hearing screening, a referral is made to a hearing specialist for further
testing.
About 5 percent of babies will fail the initial screening, but only about one in
10 of these babies will actually have hearing loss.
It is important to have a seat that fits your baby. Some small (less than 5
pounds) or premature (less than 37 weeks gestation) babies may have breathing
problems when sitting in a regular infant car seat. The American Academy of
Pediatrics (AAP) recommends that these babies receive a “car seat trial” before
being discharged from the hospital.
The trial is done using the baby’s own car seat. The baby is positioned in the
car seat and heart rate, breathing, and oxygen levels are monitored for a period
of time. If the trial shows that the baby does not tolerate sitting in the car
seat, a car bed will be needed until your physician decides the baby can sit up
safely. If you choose not to purchase a car bed, St. John’s has car beds
available to borrow, for a refundable deposit, for babies who need them.
With the wide variety of child restraint systems (car seats), belt systems, and
passenger vehicles, choosing and installing a car seat and securing your child
in it correctly can be challenging. St. John’s has partnered with the Traffic
Safety Alliance (891-1514) and the Safety Council of the Ozarks (869-2121) to
provide education and information about car seat use. Parents are encouraged to
contact one of these agencies before your baby is born for a FREE car seat
installation check.
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