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Newborn bloodspot test

Heel prick test

Mothers of all newborn babies are offered testing for certain rare but serious health conditions by testing blood taken from the baby's heel. This is the blood spot screening programme and it is also known as the heel prick test.

At a glance

  • The newborn blood spot test is also known as the heel prick test.

  • The test is usually done when your baby is 5 days old and involves taking a small blood sample from their heel.

  • It screens for several rare but serious inherited conditions like sickle cell disease and cystic fibrosis.

  • Early diagnosis and treatment of these conditions can improve a baby's outcome.

  • Inform your healthcare professional if you or your family have any of the tested conditions.

  • You can opt out of the test or specific parts of it by informing your doctor or midwife.

Continue reading below

How is the blood test done?

This is usually done by a health professional (usually a midwife or health visitor) during a home visit when your baby is 5 days old. A very small sample of blood is collected by pricking your baby's heel, using a special device and squeezing out a few drops of blood on to a blood spot card. Although this test may be uncomfortable, it is over very quickly. The sample is sent away for testing, and you will receive the results by letter or phone in due course.

It is important that you tell your healthcare professional if you, your partner or a member of your family have been diagnosed with one of the conditions below.

Conditions which the heel prick test can screen for are as follows:

  • Sickle cell disease (SCD) - this is an inherited blood disorder. Treatment started early in life, can prevent complications. This may include taking regular antibiotics and having extra vaccinations.

  • Cystic fibrosis (CF) - this is an inherited disorder that affects the internal organs, especially the lungs and digestive system. The heel prick test detects a chemical called immunoreactive trypsinogen. This is high in babies with cystic fibrosis. If it is high then a sweat test and genetic test are usually done to confirm the diagnosis. The earlier the diagnosis is made, the sooner treatment can begin which improves the outlook (prognosis).

  • Phenylketonuria - this is a very rare condition in which the body is unable to break down a substance called phenylalanine, which builds up in the blood and brain. It is really important for this to be picked up early. Early treatment significantly reduces the risk of brain problems and complications in the future.

  • Congenital hypothyroidism - this is a rare condition which can lead to impaired growth and mental development. However, treated babies can develop normally so it is important for it to be diagnosed early. If your baby was born prematurely (under 32 weeks) then your baby will need a repeat test when they are 28 days old.

  • Medium-chain acyl-Co-A dehydrogenase deficiency (MCADD)- this is a very rare, but potentially life-threatening, inherited disorder, where fat cannot be broken down by the body as well as usual. Babies with this condition develop normally, but recognising the condition early enables parents to make sure their babies and children with this condition eat regularly. When people with this condition go for a long period of time without eating there is a build-up of medium-chain fats inside the body, which can have a poisonous effect. Also, a sudden and severe drop in blood sugar levels can occur.

  • All four devolved nations of the United Kingdom now offer screening for four other serious, but treatable, inherited metabolic diseases. These are:

    • Homocystinuria (HCU).

    • Maple syrup urine disease (MSUD).

    • Glutaric aciduria type 1 (GA1).

    • Isovaleric acidaemia (IVA).

If you do not want your baby to have some or all of these conditions tested for in the heel prick test then you should inform your doctor or midwife.

Frequently asked questions

What is a heel prick test for babies?

The heel prick test is a screening procedure for newborns that uses a small blood sample collected from the baby's heel to check for several rare but serious conditions. Early detection and treatment of these conditions can prevent complications and improve the baby's long-term health.

How long does it take for the heel prick test results to come back?

After the blood sample is collected, it is sent for testing. You will receive the results by letter or phone, but the article does not specify an exact timeframe for how long this will take.

Should I be concerned if my baby was born prematurely regarding this test?

Yes, if your baby was born prematurely (before 32 weeks), they will need a repeat heel prick test when they are 28 days old, specifically for congenital hypothyroidism.

What should I do if a family member has one of the conditions screened for?

It is important that you inform your healthcare professional (such as the midwife or health visitor performing the test) if you, your partner, or any family member has been diagnosed with one of the conditions that the heel prick test screens for.

Can I refuse to have my baby tested for certain conditions?

Yes, if you do not wish for your baby to be screened for some or all of the conditions covered by the heel prick test, you should inform your doctor or midwife.

What are the potential complications of some of the conditions tested for if not caught early?

If not detected and treated early, conditions like sickle cell disease can lead to complications, phenylketonuria can cause brain problems, congenital hypothyroidism can impair growth and mental development, and MCADD can lead to a build-up of poisonous substances or severe drops in blood sugar if feeding is irregular.

Further reading and references

Continue reading below

About the authorView full bio

Author image

Dr Hayley Willacy, FRCGP

General Practitioner, Medical Author

MBChB (1992), DRCOG, DFFP, MRCOG (Part 1) MRCGP (2007), DFSRH (2013), MSc - medical education (2020)

Dr Hayley Willacy was an NHS GP working in northwest England, who retired from clinical practice in 2022 after 30 years. 

About the reviewerView full bio

Author image

Dr Colin Tidy, MRCGP

General Practitioner, Medical Author

MBBS, MRCGP, MRCP (Paediatrics), DCH

Dr Colin Tidy is an NHS Doctor, based in Oxfordshire.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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