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Newborn Screening: What Is It and Why Is It Important?

Dianna Graveman |10, July 2012


According to the Health Resource and Service Administration (HRSA), "Newborn screening is a state public health service that reaches each of the more than 4 million babies born in the United States every year." Babies are tested for serious but treatable conditions through processes that include a heel stick, a hearing test, and pulse oximetry. The purpose is to allow doctors to begin treating babies with a serious condition very soon after birth before additional complications can occur.

Every year, according to the HRSA, more than five thousand babies are born with one of the conditions included in a screening panel, even though the babies may look healthy at birth and have no family history of the condition. Newborns are screened for different conditions, depending on the state in which they're born.

Newborn screening was first introduced in the 1960s, and today scientists have developed tests to screen babies for more than sixty disorders or conditions. Some of these conditions can lead to severe health problems or death, if not treated.

Most or all states require the following screenings, although testing for additional conditions may also be performed, and testing varies by state.

Blood test: Your baby's heel is pricked to obtain a small blood sample. The blood drops are collected on a special piece of paper that is sent to the state for analysis. This test is usually done when the baby is between 24 and 48 hours old. Some conditions may not be detected if the blood is drawn before 24 hours after birth, but after 48 hours, a risk exists if there is a condition present that could and should have been treated immediately. Some states also require a second newborn blood screening at two weeks.

Hearing Test: Two different tests are used for newborns. Your baby may experience one or both. A tiny earphone or an earphone and mic are placed in your baby's ear, and sounds are played. One test detects the echo that is reflected back into the ear canal of a baby who has normal hearing. The other measures your baby's response to sound, through brain waves. It is best if the hearing screen is performed before the baby leaves the hospital so that it does not get postponed or overlooked in the first months of life.

The third test is the pulse oximetry screen. This non-invasive test determines how much oxygen is in your baby's blood. A pulse oximeter is used for the test, and a painless sensor is placed on the baby's skin. This screening is very important because it can help identify babies how have Critical Congenital Heart Disease so that they can receive medical intervention quickly after birth. This test is generally done within 24 hours after birth.

Newborn screening does not have to be requested by the parents, and it is performed even if the parents have no medical insurance. Most states charge a fee for testing, but if the family does have medical insurance, the newborn screenings are usually all or mostly covered. Parents sign a form giving permission to perform the tests, but most states will allow parents to refuse some or all of the tests for religious reasons. However, it is important to remember that these tests are a free public health service provided to protect and ensure the future health of a newborn.

Although each state has its own newborn screening requirements, the HRSA recommends screening for thirty specific conditions known as a "core panel" to encourage consistent and comprehensive testing throughout the United States. States are not required to use this core panel, however.

For your state's newborn screening requirements, visit the HRSA page, "Conditions Screened by State," and click on your state on the map. (

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