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Is it safe? · Pregnancy Smart

Newborn blood-spot screening: the heel-prick test

Assigned clinical reviewerMichael Yuzefovich· MD, FACOGDraft · pending clinical reviewUpdated

What does the evidence say about newborn blood-spot screening?

  1. NICHD describes dried blood-spot screening as one part of the newborn screening program. Early identification can allow care to begin before serious effects are apparent. A baby looking healthy is therefore not a reason to assume screening is unnecessary. The program targets selected conditions rather than providing a complete test of every aspect of newborn health. 1
  2. Staff record identifying and timing information on a screening card, collect drops of blood from the heel onto the designated absorbent areas, and send the card to a laboratory. Accurate contact and clinician details matter because the laboratory process continues after the sample is collected. Parents should know which team will communicate results and follow-up needs. 2
  3. The usual first collection is 24 to 48 hours after birth. Some conditions cannot be screened reliably from blood taken too early, and some state programs request a second sample. Ask the birth team about the actual schedule for your baby, including early discharge or neonatal care, instead of assuming that one heel prick always finishes the process. 2
  4. Hearing screening and screening for critical heart problems use different methods from the blood-spot card. Completing one does not show that the others were performed. A useful discharge review checks the status of each assessment separately and identifies where the results and any next appointment will be recorded. 1

Frequently asked questions

Does the heel-prick screen check for every inherited condition?

No. Newborn screening looks for a selected group of conditions and cannot establish that every genetic or other health condition is absent. Ask the pediatric team what the local program includes and what any particular result means for your baby.

Why might a second blood sample be needed?

Some programs routinely request another screen, and sample timing can affect what the first screen can show. A request for another sample needs clarification from the screening or pediatric team. Ask why it is needed, how soon to arrange it, and where to go.

Can the sample be taken immediately after delivery?

The usual collection window is 24 to 48 hours because taking blood before 24 hours can be too early for reliable screening of some conditions. If an earlier sample is collected or discharge occurs early, ask whether another sample is required and make that plan before leaving.

Does my baby still need screening if pregnancy tests were normal?

Newborn screening has a different purpose and timing from prenatal testing. Normal pregnancy results do not establish that the newborn blood-spot targets have all been assessed. Discuss the screening plan with the birth or pediatric team rather than assuming the earlier tests replace it.

Will the hospital have every result before we go home?

The blood-spot card goes to a laboratory, so results may still be pending at discharge. Ask how they will be communicated and when to call if you have not heard. Keep your contact information current and identify the clinician who will review the results.

Is a screening result the final answer about a condition?

Screening identifies findings that may need a more specific medical assessment. Ask the pediatric or screening team to explain the result and the next steps, including timing. Do not try to interpret a laboratory label without that context or postpone a requested follow-up because the baby seems well.

Is hearing screening included in the blood sample?

No. Hearing tests use sound responses, while pulse oximetry uses a skin sensor to estimate oxygen. The blood-spot card is a separate laboratory test. Ask for the status of all three parts of newborn screening so a completed blood draw is not mistaken for a complete discharge checklist.

Who should I contact if I do not know the result?

Start with the baby’s pediatric clinician or the birth facility and ask which newborn screening results have been received. Provide the birth date, birth location, and current contact information. Request a specific follow-up plan for any missing result rather than assuming that no message means everything was reviewed.

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References

  1. Newborn Screening

    NIH NICHD · https://www.nichd.nih.gov/health/topics/newborn

  2. How is newborn screening done?

    NIH NICHD · https://www.nichd.nih.gov/health/topics/newborn/conditioninfo/how-done

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.