Helping Infants off to a good start-September is Newborn Screening Awareness Month
Despite all that is going on in the world these days, most of us can agree that there is no greater blessing than a new baby! As an internal medicine/pediatric physician who cares for both adults and children, it is certainly a highlight of my day when I see newborns in clinic. There is speculation that with the current pandemic and wide-spread stay at home orders, there may be a baby boom this winter and spring. Time will tell! With September being Newborn Screening Awareness Month, it seems like a good uplifting topic to discuss.
If you have not had a newborn recently, you may not be aware of the screening that is routinely done on newborns. Guidelines change over the years too, so as a physician it is helpful to review what the current standards are. The screening is done in the hospital prior to the infant being discharged home, but not all the results are available immediately. When we see them back in clinic, it is important to be sure all those results are reviewed and any needed follow-up arranged.
All newborns in the United States undergo a 3 stage screening in the hours or days after birth. The reasons for these 3 particular areas of screening are to identify conditions which require urgent interventions to avoid complications.
These tests are:
- Pulse oximetry. This consists of non-invasive measurements of oxygen levels in the infant’s arms and legs and can detect some types of congenital heart disease. These results are available immediately and can be acted upon if needed.
- Hearing screening. This is not as urgent as congenital heart disease might be. However, early detection can improve long-term outcomes in regards to language development. 1 in 300 babies born in Minnesota have hearing loss that can be detected. The 2 types of initial screening are Otoacoustic Emissions (OAE) and Automated Auditory Brainstem Response (AABR.) OAE consists of a soft rubber tip placed in each ear which delivers soft tones and measures an echo that occurs when the ear is functioning normally. AABR consists of earphones which deliver test sounds, and sensors placed on the baby’s head and neck measure the baby’s internal response to these sounds. These results are known immediately and recommendations made if abnormal. Usually initial recommendation is to repeat the test in the near future. However if that result is still abnormal, further referrals are recommended.
- Blood test. This involves a small amount of blood obtained from the baby’s heel, which is then sent to the state laboratory. The conditions tested for vary a bit from state to state. Currently in Minnesota, screening is done for more than 50 rare but treatable disorders. Many of these are metabolic disorders which can be treated with dietary restrictions or supplements. Some of the other conditions that you may be more familiar with include cystic fibrosis, sickle cell anemia and other blood disorders, hypothyroidism and spinal muscular atrophy. The complete list can be found on the Minnesota Department of Health website. Information is generally given to the parents at the time of testing.
My colleagues at Gateway Clinic who care for women throughout pregnancy and delivery try to discuss these screenings with the parents in the 3rd trimester but will usually discuss again at the time of delivery.
The results from the blood test are typically available in 1-2 weeks and if normal, are sent to the delivering physician. The report is then sent out to the patients with any explanation needed. We keep those reports on file in their chart and can discuss at subsequent visits if any questions or concerns arise.
Any abnormal results are communicated more urgently to the physician and patient by the Minnesota Department of Health. That department is then able to assist with appropriate referrals.
Be sure to discuss any questions with your physician during a pre-natal or well child visit. More information can be found at:
www.health.state. mn.us/newbornscreening
Bridget Dewey , MD
Internal medicine/pediatric physician
Gateway Clinic
