Know the score on your baby's first tests
Tests of one sort or another are an important part of a young person's life - even from day one. Before they leave the hospital, all babies born at Allegheny General undergo certain examinations to help make sure they are healthy and ready to begin their new lives.
A pediatrician does an assessment of the baby within 24 hours of delivery. In addition, each baby admitted to the newborn nursery goes through an extensive check by the nurse. If a problem is detected, the baby's pediatrician or in-house neonatologist is immediately contacted. Along with these, every baby's stay at the hospital includes a battery of standard tests to detect genetic metabolic diseases such as phenylketonuria.
With any blood sample screenings, if abnormalities are detected, another sample is taken and the blood retested. It is very important for the parents to bring the baby back to the hospital to be retested. Certain situations, such as the baby's age, illness or antibiotics taken, can affect results.
Every baby is evaluated to determine if screenings other than the standards are needed. These tests may include a blood test for sugar in newborns who weigh more than 8 pounds, 14 ounces, or less than 5 pounds, 8 ounces, or whose mothers have diabetes; a complete blood count for possible infections when the baby may have been exposed to bacteria in the birth canal.
Every baby is screened for jaundice using a non-invasive transcutaneous bilirubin measurement. This is a small manometer which is pressed against the baby's forehead and gives a reading within seconds. It may be followed by a blood test if the results are elevated.
Infants also have their hearing checked before discharge. Sounds are transmitted through soft ear muffs to the baby. Readings are then taken through electrodes (sticky pads similar to EKG leads) attached to the baby's forehead, shoulders and back of the neck.
How and why it's done
Apgar Test
A quick assessment to make sure the baby is progressing normally in the first minutes of life. A nurse or physician checks the baby's color, muscle tone, reflex irritability, breathing and heart rate and gives a 0 to 2 score for each area.
What it tells us: Indicates the baby's condition at one and five minutes. A total score of 7 or above at 5 minutes indicates the baby is doing fine on his own. At 1 minute, some babies need supplemental help, and the score tells the health care providers if the baby needs extra attention. In the past, the Apgar score was thought to have greater long-term significance than it has today.
Newborn screening blood tests
Mandated by Pennsylvania law and performed within 48 hours of birth. The baby's heel is pricked, and the blood sample sent to the state laboratory to test for hypothyroidism, phenylketonuria (PKU), sickle cell disease and other abnormal hemoglobins, and maple syrup urine disease.
What it tells us: Babies with hypothyroidism can develop mental retardation if not treated within the first few weeks of life. If PKU, a blood abnormality, is detected early, the child can be placed on a special diet to avoid mental retardation and seizures. If sickle cell disease, a disorder of the red blood cells, is found, health-care providers can decrease side effects with penicillin. The test also detects sickle-cell trait. Maple syrup urine disease, in which the urine smells like maple syrup, can cause mental retardation and early death if not treated shortly after birth.
Supplemental newborn screening
Screens newborns for more than 20 other hereditary conditions using a blood sample from the baby's heel. Blood is drawn from a needle inserted in the placenta side of the cord, and the sample is stored in the blood bank for one to two weeks. This blood is available for checking a baby's blood type or testing for certain types of infection if necessary.
What it tells us: Checks for inborn errors of metabolism, including cystic fibrosis, a disorder of the sweat glands that can cause serious lung and intestinal problems. The test may be performed to check for incompatibility between the mother's blood and baby's blood. In other cases, a blood gas test may be done or tests may be performed if a significant problem arises in the baby's first few weeks of life.
Last Updated: September 28, 2009