Seeing new parents bond with their babies is one of the best parts of my practice. At Temple, we ensure parents have the time and support they need throughout those first hours and days. While you’re getting to know your baby, your care team is there to focus on your newborn’s health. That includes collecting screening tests to check for rare but serious disorders that may affect your baby's heart, hormones, or hearing.
Performing screening tests is a quick and easy way to detect these conditions right away so they can be treated quickly. That's why every newborn in the U.S. gets checked — including those who appear perfectly healthy. If your baby is born at the hospital, there's nothing you need to do to prepare for these tests. The nurses will take care of everything during your stay. If your baby is born at home, their pediatrician should screen them within a few days of birth.
Still, it can be helpful to familiarize yourself with these tests before your baby arrives. That way, you'll know what to expect and have an idea of the next steps if a screening reveals a potential problem. So, let's look at the newborn screenings your baby will receive and why they matter.
1. Hearing screening
Hearing screenings check your baby for hearing loss in one or both ears. This test is quick and painless and can be done anytime after your child is 12 hours old. A healthcare provider will place a pair of tiny earphones in your baby's ears and measure how they respond to a series of soft sounds. You’ll typically get the results of this screening right away. If the screening detects a potential problem, your baby will be tested again in the hospital. If your baby does not pass the hearing screening test multiple times, two things will happen: your child will be tested for cytomegalovirus (CMV) infection and referred to repeat the hearing test in 1-2 weeks with an outpatient hearing specialist called an audiologist. If caught early, CMV infection in newborns is a leading cause of hearing loss that may be prevented with an early antiviral medication. Testing for CMV infection is usually done on a newborn’s saliva, urine, or blood before the baby goes home from the hospital.
That said, an abnormal hearing test doesn’t always indicate a problem. Hearing tests work best when your baby is calm, and the room is quiet. Your infant might have trouble responding to the test sounds if they're crying or there's a lot of background noise.
2. Newborn screening
You might also hear this called a heel stick test. That’s because, instead of drawing blood from the arm, we take just a few drops of blood from your baby’s heel, usually within 24 to 48 hours of their birth. The blood is collected on a special card and sent to a lab for testing.
That small blood sample is used to test for a number of possible disorders, including:
- Blood disorders, such as cystic fibrosis and sickle cell disease
- Endocrine disorders – which affect the hormones in the body – such as primary congenital hypothyroidism or congenital adrenal hyperplasia
- Metabolic disorders that affect how your baby's body converts food into energy, such as phenylketonuria (PKU) or “maple syrup urine disease.”
Your baby's pediatrician will notify you of the screening results within five to seven days. You can also ask about the results at your baby’s first well-child visits.
The pinprick on your baby’s heel is small but will make them slightly uncomfortable, so some crying is normal. You can comfort your newborn during the test by holding them skin-to-skin or nursing them. Wrapping them tightly in a blanket can also be soothing.
3. Heart screening
Heart screening tests check your baby for a group of heart conditions called critical congenital heart defects. These conditions cause a low level of oxygen in the blood, so the test works by measuring the amount of oxygen in your baby's blood. This test can also be used to detect certain infections and lung issues.
Checking your baby's blood oxygen level is fast, simple, and painless. A healthcare provider will place soft sensors on your baby's right hand and one of their feet for about a minute. The sensor is attached to an oximeter machine, which measures how much oxygen is in your baby's bloodstream.
The results of this screening are typically ready immediately, as soon as the screening is done. If a potential heart problem is detected, your baby’s care team will conduct more tests.
4. Jaundice screening
Jaundice is when the skin, whites of the eyes, or sometimes inside of the mouth look yellow. Jaundice is caused by the buildup of a substance called bilirubin in the blood. Mild bilirubin buildup can be common and not dangerous in newborns. Mild bilirubin buildup is usually due to the changes in a newborn’s blood after being born, so your baby may look a little yellow.
We monitor newborns’ jaundice levels in the hospital to prevent medical complications. Rarely, a newborn may have more severe jaundice due to other dangerous illnesses. One of the main reasons that these complications are so rare is that we monitor all our babies for jaundice and treat it as soon as possible.
Your baby’s jaundice levels will be monitored by using a machine called a bilirubinometer that is gently pressed on your baby’s skin every 12 hours or so while in the hospital. If jaundice levels are higher, a blood test to measure bilirubin will be collected. The most common treatment and prevention for worsening jaundice is to feed your baby whenever your baby is hungry because that will help your baby to get rid of the extra bilirubin in their stool.
Making sense of your baby’s results
It's normal to feel a little uneasy while your baby is having a screening test. I remind my patients that the disorders these tests screen for are rare, and most newborns have perfectly normal results.
It’s also important to know that abnormal results don't automatically mean your baby has a serious health problem. If your baby's results fall outside the normal range for a certain screening test, their healthcare provider will recommend a second diagnostic test.
Very often, diagnostic tests don't find a problem. If the second test suggests that your baby does have a health condition, your baby's provider will help you understand the results and decide on the next steps to support your baby's health.
Baby on the way?
At Temple, your newborn will have access to specialized care and experienced experts — and we’ll be here to support your family every step of the way.
To learn more about what to expect when you deliver your baby at Temple, take a virtual tour or call 800-TEMPLE-MED (800-836-7536). You can also request an appointment online.
Helpful Resources
Looking for more information?