Char-Koosta News

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Health Screening Newborn

Most states require newborn screening. Montana tests all babies because some babies might look healthy but they may have rare health conditions. If they have the conditions and are detected early and treated appropriately, it is possible to prevent serious debilitating outcomes of many of them.

When a baby is born, they get a range of routine health checks and tests within their first six weeks on the planet. These include: a physical examination, a hearing test, and a blood test.

Most babies are born healthy and won’t have any of the conditions or problems that the screening tests are looking for. But for those babies that do have a health problem, the benefits of screening can be enormous. Early treatment can improve the baby’s health and prevent severe disability or even death. The checks and tests are quick and won’t harm the baby.

It’s a good idea for parents or guardians to consent to their baby having the checks and tests. However, they have the option to decline the checks and/or tests.

Physical Examination
Every baby has a head-to-toe physical examination soon after birth to identify babies likely to have particular conditions that may need further monitoring, investigation or treatment.

The examination is carried out within 72 hours of birth and then again at six to eight weeks of age, as some conditions can develop later.

As well as the top-to-toe physical check, there is specific examination of the baby’s:
   • Eyes – this is not done to check your baby’s vision, but to pick up conditions such as congenital cataracts
   • Heart – a wide range of abnormalities may be detected, ranging from minor defects that may get better by themselves, to more serious conditions that need further investigation and treatment including heart surgery
   • Hips – to check their position and stability
   • Testicles, in boys – to check they’re in the right place

The Hearing Screening Test
A hearing screening test is performed within a few weeks of a baby being born, either while both parent and child are still in hospital, or by a community health nurse or doctor at a residence, or at a health clinic or hospital.

Two hearing screening tests may be used: the Automated Otoacoustic Emission (AOAE) screening test and/or the Automated Auditory Brainstem Response (AABR) test.

One to two babies in every thousand are born each year with hearing loss in one or both ears. This hearing screening test enables those babies with hearing loss to be identified early. Early identification is important for the development of the child and means that parents can receive support and information as early as possible. The hearing test is quick and painless.

The AOAE hearing screening test involves putting a small, soft-tipped earpiece in the outer part of the baby’s ear. Sounds are then sent through the earpiece and into the baby’s ear. The equipment measures how the baby’s ears have responded.

The AABR hearing screening test also involves placing three small sensors on the baby’s head. Then, headphones are put over the baby’s ears and a series of clicking sounds are played. The AABR machine measures how well sounds travel along the baby’s hearing nerve pathways from the ear to the brainstem.

Parents should be given the results at the time of the hearing screening test.

Blood spot (heel prick) test
When a baby is about one or two days old, a medical professional will collect a sample of blood by pricking the baby’s heel using a special device and squeezing out a few drops of blood on to a card. The heel prick may be uncomfortable and the baby may cry, but it’s all over very quickly.

The blood sample card is sent off for analysis at the Montana Public Health Laboratory in Helena and parents receive the results of the blood spot test within a couple of months. The blood sample cards are destroyed after one year.

The blood spot screening tests helps to identify a range of health conditions, including:
   • Sickle cell disease: an inherited blood disorder. Treating babies will help prevent serious illness.
   • Cystic fibrosis: a life limiting inherited disorder that affects the internal organs, especially the lungs and digestive system.
   • Phenylketonuria: a very rare condition that can cause mental disability (but is treatable once diagnosed).
   • Congenital hypothyroidism: another rare condition that can lead to impaired growth and mental development. Treated babies can develop normally.
   • Medium-chain acyl Co-A dehydrogenase deficiency: a rare but potentially life-threatening inherited disorder, where fat cannot be broken down by the body as well as usual. Babies with MCADD develop normally, but recognizing the condition early enables parents to make sure they eat regularly and avoid serious illness.

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