Parent's guide to newborn testing, screening, and prevention measures

February 14, 2014 Robyn K. Rogers, MD

When picturing the first days of an infant’s life, what we look forward to the most is love. We express our love in so many ways: skin-to-skin, breastfeeding, swaddling and snuggling. 
Love also means keeping them safe. 
Advances in maternal-infant health are one of the greatest success stories of the 20th century, with a drop in the death rate of 99%. But some of those dangers only stay in the past through constant vigilance. Behind every screening test and preventive measure is a careful, research-driven rationale. Here are seven newborn tests, screenings, and prevention measures you should know about:
Vitamin K injection 
Vitamin K is vital for blood to clot properly. Newborns cannot make Vitamin K and it is poorly transferred in breast milk. Without this injection, babies are at risk for spontaneous bleeding from the umbilical cord, mucus membranes, even in the brain. Giving Vitamin K has greatly reduced this "hemorrhagic disease of the newborn," but rates are increasing as more parents refuse it. Oral Vitamin K has not been shown to prevent this potentially devastating disease. 
Hepatitis B vaccine
This is an anti-cancer vaccine. Before this vaccine existed, approximately 10,000 kids under age 10 contracted hepatitis B each year. Most had no known exposure to it. Kids are more likely than adults to get very sick and to have complications. Vaccination at birth has greatly reduced rates of pediatric liver cancer due to hepatitis B. 
Antibiotic eye ointment
This prevents bacterial eye infections. Some of these infections are associated with sexually transmitted bacteria, but not all of them are. Negative testing or a monogamous relationship does not prevent these infections. The ointment does not sting, affect your baby's vision or prevent eye opening.  
Jaundice screening
Jaundice, or yellowing of the skin, is caused by a chemical called bilirubin. High levels can cause lethargy, feeding problems and dehydration. Very high levels can causes permanent brain damage. Every baby gets screened with a skin test or a blood test. 
Metabolic screening 
This two-part blood tests looks for some rare but life-threatening conditions. They are asymptomatic at birth and not detected in prenatal screening. If not treated promptly, they can cause permanent problems like seizures and developmental delay.
Congenital cyanotic heart disease screening
Even with good prenatal care, some babies have heart or blood vessel problems. Early detection can help to prevent irreversible damage to organs like the heart and lungs. Soft sensors are painlessly placed on the right hand and one foot for a few seconds. 
Hearing screening

This is also a painless test. There are two kinds of tests commonly used. One involves small sounds made through soft earphones, another places a tiny sensor just on the inside of the ear. This helps to detect hearing deficits in about 1-3/1000 babies, half of whom have no risk factors for hearing loss. Early detection provides the opportunity for early intervention and preservation of speech development.

Each year, newborn screening tests save or improve over 12,000 lives. Talk to your pediatrician. Love your baby by protecting your baby! 

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