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Having a baby can be an exciting time. It also can be hectic and overwhelming. In particular, there is a lot going on in the first hours and days of your baby’s life. Your newborn will go through several types of screening tests at the hospital. The purpose of newborn screening is to find and treat certain health issues that aren’t always visible at birth. Early detection can help prevent or reduce the effects of these conditions.
Path to improved health
Before delivery, you should learn all the facts of newborn screening.
The first test your newborn will receive is the Apgar test. The doctor or nurse will complete this in the delivery room at the hospital.
The Apgar test is named after Virgina Apgar, who created it in the 1950s. It also is an acronym for the test’s measures. Your doctor or nurse will check 5 areas of your newborn baby’s health. They will score each area based on a scale of 0 to 2. A score of 2 is the highest and a score of 0 is the lowest. The 5 areas and ranges are:
- A Your baby’s skin color can range from pink to bluish-gray.
- P Your baby’s heart rate can be above 100 beats per minute (strong), below 100 beats per minute (fair), or absent.
- G This checks your baby’s facial and physical reflexes.
- A This checks your baby’s muscle tone.
- R This checks your baby’s breathing. The rate and effort can range from normal to slow to absent.
The total possible Apgar score is 10. It’s very uncommon to get 10, at least on the first try. It takes most babies several minutes to warm up, regulate their breathing, and adjust to their new settings. A score of 7 or more is good. A score less than 7 means your baby might require additional care. They might need simple oxygen or heat. Most babies are healthy after Apgar testing.
Premature babies can have lower Apgar scores. If your baby still scores low after several tests, hospital staff will begin treatment. They will monitor your baby closely for changes. Your healthcare provider may order testing to identify possible health conditions or disorders.
Screening for metabolic disorders
Babies can be born with metabolic disorders. These affect their ability to create and process nutrients and energy. These types of genetic disorders can range from mild or moderate to severe. The effects can cause physical and mental issues, possibly even death.
Babies in the Maritime provinces are screened for several metabolic, blood, endocrine, and immune disorders, as well as cystic fibrosis. A complete list of disorders can be found here: https://www.iwk.nshealth.ca/newbornscreening
Metabolic disorders typically aren’t visible upon birth. PKU was the first metabolic disorder that healthcare providers screened for. PKU can be life threatening and treatment is proven effective. Although PKU can be tested separately, it now is done as part of a larger blood test.
Hospital staff will perform the blood test when your baby is about 24-48 hours old. They will prick your baby’s heel to collect a few drops of blood. The blood gets sent to a lab to screen for metabolic disorders.
If your baby is diagnosed with a metabolic disorder, talk to your healthcare provider about options. Some disorders have proven treatment programs to help prevent or reduce symptoms. These can include restricted diets, supplements, and lifestyle changes. Another option is to monitor your baby’s condition for symptoms and changes.
Screening for hearing issues
This common test detects genetic hearing loss before symptoms begin. It can also detect hearing loss that can occur due to issues such as infections during pregnancy or childbirth. Early detection and treatment can reduce effects of hearing loss and improve outcomes. The newborn hearing screening is proven to be accurate and valuable. It’s quick and painless, and often done when your baby is sleeping. Babies are usually tested before they leave the hospital after birth.
The type of treatment depends on the severity of hearing loss. Your healthcare provider might decide to monitor your baby. Your child can have regular tests with an ear doctor (audiologist). This can keep track of your child’s hearing ability and watch if their hearing improves or declines.
Treatment also can include a hearing device, such as an aid or implant, or surgery. Hearing loss can cause other health issues with speech, reaction, and social skills. Your child could need therapy, counseling, or other medical care to treat these symptoms. Babies with certain health conditions, head trauma, or a family history of hearing loss are at higher risk.
Things to consider
In general, screening is recommended for health issues where early detection and treatment have proven health outcomes.
Some screening can cause needless worry or concern. Keep in mind that screening is only the first stage of diagnosis. Try not to panic if initial results aren’t “normal.” It’s common to ask for repeat testing. This can identify false positive tests (show positive but actually be negative) and false negative tests (show negative but actually be positive). Further testing will be done to confirm a disorder or condition. Talk to your healthcare provider about all options.
When to see your doctor
After leaving the hospital, observe your baby for any signs of health issues. If at any point your child shows symptoms (listed below), contact your healthcare provider right away. Babies also have physical and mental milestones as they grow. Check with your healthcare provider to ensure your child is meeting these.
Signs of metabolic disorders include:
- Vomiting or poor appetite
- Shortness of breath
- Difficulty gaining weight or weight loss
- Sudden lack of movement, energy, or alertness
Even if your baby passed the initial hearing screen, they still could develop hearing problems. This is known as acquired or progressive loss. Symptoms of hearing loss as your baby gets older include:
- Doesn’t respond to loud noises
- Responds to sight but not sound
- Hears some sound tones but not others
- Doesn’t talk or make much noise
- Slurred or mumbled speech
- Hard time following directions
- Asks you to repeat often
- Listens to noise at a high volume
FOR MORE INFORMATION
Maritime Newborn Screening Program