Congenital heart disease screening
Some serious heart defects have no symptoms until a baby is several days old and the circulation has changed from the fetal pattern to the normal newborn pattern. Most of these defects can be detected by simply testing the oxygen level in the baby’s arms and legs. The test is done by shining a red light through the skin (called pulse oximetry: you have probably seen this done before) on the fingers and toes. Most hospitals have started performing this test prior to discharge.
If the test is abnormal, it will be repeated several times. If it is still abnormal, a pediatric heart specialist (pediatric cardiologist) will come to see your baby before discharge. Your baby will also have an echocardiogram (ultrasound of the heart as it moves) and possibly an ECG (EKG).
Hearing Screening
Hearing is essential to normal language development, and the first two years of life is the critical window for language development in the brain. Often, a hearing problem is not detected until language development is noticeably delayed, and earlier intervention can help to ensure normal language development. The sooner hearing loss is detected and treated, the better the outcome. As a result, there has been a major public health movement for screening the hearing of all babies. Between 3-4 out of every 1,000 newborns has serious hearing loss, making it among the most common birth defects.
The screening is done in the hospital after delivery and is painless and has no side effects. All hospitals in Georgia now perform hearing tests on all babies. If, after several attempts, the test is abnormal (usually because a good reading cannot be obtained on one ear), then the baby will have further testing done in the first few months of life. Abnormal results are not uncommon; the repeat test us usually normal. It is crucial that you go for your baby’s follow-up test if it is needed. Treating hearing loss at the earliest age possible has better outcomes because the speech and language centers of the brain are developing. Be sure to bring the test results to your baby’s doctor at the first visit.
Newborn genetic/metabolic screening
There are many diseases that are treatable if detected early, usually through a special diet. Sickle cell disease, hypothyroidism, and cystic fibrosis also need to be treated immediately. A few drops of your baby’s blood will be sent to the state lab to be tested for over 30 different diseases. The results will be available in about 2 weeks and will be sent to the hospital and to the doctor who saw your baby in the hospital. If you have a different pediatrician, they should also check the results. It is vitally important; treating an abnormal result may save your child’s life. If something critical is abnormal, it is likely that multiple people will try to contact you. You must make sure the hospital and your baby’s hospital doctor have your correct address and phone number. Check with your pediatrician for the results.
For more information, visit the Georgia Newborn Screening Program at dph.georgia.gov/NBS. More resources are listed at the end of this booklet.
Jaundice risk screening
Jaundice refers to yellow skin caused by increased levels of bilirubin in the blood. Babies are prone to get jaundice. It is usually mild and has no side effects;. However, if the bilirubin level goes too high it can be harmful. The screening test in the hospital is used to predict your baby’s risk for developing a harmful level. The initial test is usually done by shining a light through the skin; sometimes a blood test is needed. If your baby’s risk level is elevated, it may need to be rechecked for a few days.
Depending on your baby’s risk, you may need to follow-up the day after going home, and the level may need to be measured again. Bilirubin levels usually peak around day 4 then start to decrease. This is one of the main reasons you have to have a follow-up plan for your baby and go to the doctor within 1-3 days after discharge.