Newborn screening test

What is meant by newborn screening tests?

In the UK, there is a screening programme for newborn babies to check they are well. This is one of many screening programmes.

Screening is when tests are offered to everybody to rule out certain common conditions. They are offered to people in the age group where these conditions are most often picked up. The idea is to pick up conditions which can be treated early to avoid them causing possibly bigger problems later.

In newborns, the programme involves check-ups in the first few weeks of life to rule out certain problems. Specifically, the tests are:

• A physical examination within three days of the baby's birth (the newborn baby check).

• A physical examination when the baby is 6 weeks old (the six-week check).

• A blood test done by pricking the baby's heel.

• A hearing test.

Screening tests for adults

Other screening programmes (for adults) in the UK include the cervical smear test, the breast screening programme and the aortic aneurysm screening programme. See the separate leaflet called NHS screening programme for more information.

Is it the same everywhere?

No. Each country chooses which checks should be carried out on all newborn babies. This leaflet refers only to screening in the UK. Even in the four nations of the UK, there are some small differences in the tests. Broadly the system is the same, but the heel prick blood test checks for more conditions in England, Scotland and Wales than it does in Northern Ireland.

Currently, programmes are frequently reviewed and revised to make sure they are working effectively.

Types of newborn baby screening tests

Physical checks

The physical examination is done soon after your baby is born, usually by a doctor. This is repeated when your baby is 6-8 weeks old, usually by your doctor. Your baby is checked all over. In particular, the doctor will look at your baby's eyes, listen to their heart and check their hips. If your baby is a boy, the doctor will also check their testicles have descended into the scrotum. In addition, the doctor will be checking your baby's development, to see whether they have reached the milestones. This continues as infant screening when health professionals such as health visitors check the progress expected in their first year.

Your baby will also be weighed and measured, and you will be advised when you need to bring them back for regular weighing. How often this is needed will depend on how their weight is progressing compared to the rates of weight gain seen for other babies. Our separate leaflet on Newborn physical examinations gives more details of what your team will be checking for.

Immunisations

Your baby will usually be offered the first of their childhood immunisations when they are 8 weeks old. This means they may be offered immunisation at the same time as their 6 to 8 week check (if they are 8 weeks old) or you may be asked to bring them back to a separate appointment when they are 8 weeks old for their first immunisations.

Hearing checks

If you have your baby in hospital, the hearing test is often done before you leave after your baby is born. If not, your health visitor will arrange it within the first few weeks. The usual first test takes only a few minutes and involves a soft probe being placed in your baby's ears. The response is then measured. A further test can be done if the result is not clear. Neither test is in any way distressing to your baby, and you get a result straightaway. See the separate leaflet called Newborn hearing test.

Heelprick blood test

The blood test is done by a heel prick. This produces a spot of blood - hence its name: the 'bloodspot' test. This is usually done five days after your baby is born. Mostly this will be done by a midwife visiting you at home. See the separate leaflet called Newborn bloodspot test (Heel prick test).

Why are the tests done?

The tests are trying to identify babies that have certain conditions which, if picked up early, can be remedied to avoid problems later. You can read more about these conditions in the sections linked to the various tests as above. For example, if your baby is found to have a condition where their hip joint is not stable (developmental dysplasia of the hip), the joint can be stabilised by putting them in a harness or a plaster cast for a while. Although this can be tricky to deal with at the time, it stops them from getting severe wear and tear (arthritis) and pain in their hip joint at a young age.