12 newborn screening tests your baby will have in hospital

Your baby will be whisked away after birth for his health checks, so it’s good to know what to expect. By Lynne Gidish

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After finally meeting, holding and feeding your precious newborn baby, he will be taken from you, in order to perform some vital routine health checks. These are to make sure that your little one is healthy, and to determine whether there are any underlying problems.

Cape Town-based paediatrician Dr Kathy Krige and Dr Gary Reubenson, a paediatrician at the Rahima Moosa Mother and Child Hospital in Joburg, explain what will be done.

ALSO SEE: 12 important things you should know about your newborn

Weight

When: Right after birth.

What they’re doing: Weighing your baby, which is very important. Babies under 2.5kg at birth are called ‘low- birth-weight’, while those over 4 kg are considered big. This is still ‘normal’ for that particular baby, but babies at the low- or high-end may have problems with low blood sugar or temperature control, and may need extra monitoring and sometimes extra support. Usually, the head circumference and body length are also checked to obtain a serial measurement that is then used to monitor your baby’s growth and development.

The Apgar test

When: Within one minute, then at five minutes, and again at 10 minutes after birth.

What they’re doing: Looking at 5 specific things to check how well your baby is adapting to the outside world: his colour, heart rate, breathing, and response to stimulation and posture. Each is equally rated, and within 10 minutes, most babies score 9/10. It’s the routine way of picking up problems.

Eye check

When: Within 72 hours

What they’re doing: Assessing the health of your baby’s eyes and looking for any abnormalities of the eyeball, cornea and retina. They’re also checking for the ‘red reflex’ – a reflection from the retina when a light from an ophthalmoscope is shone into the eyes. Any other colours may require a referral to an ophthalmologist.

ALSO SEE: Track your baby’s vision development with our eyesight check list

Heart and lungs

When: Within minutes of delivery, once stabilised, and every time your baby is seen by a professional afterwards.

What they’re doing: Making sure there’s no fluid in his lungs while monitoring his breathing pattern. They’re also measuring the amount of oxygen in his blood via a non-invasive probe.

Reflexes check

When: Within 72 hours

What they’re doing: Checking her bones, joints, muscles, nerves, brain function, sucking, rooting and swallowing reflexes, ability to grasp, and his Moro reflex (his reaction when his head is gently ‘dropped’ downwards). The normal response is a ‘startled’ one, with arms and legs moving outwards and brought back in again.

ALSO SEE: 8 newborn reflexes and why your little one has them

Hearing

When: Within the first few days after delivery.

What they’re doing: Testing the cochlear function, the part of the inner ear that receives and processes sound. A good screening test is the OAE (oto-acoustic emissions) where a miniature earphone and microphone are placed in the ear. Sounds are then played and the response is measured.

Skin check

When: At birth

What they’re doing: Looking for birthmarks, usually benign, like Mongolian spots (blueish marks usually on the spine and butt), stork bites (on the back of the neck) and angel kisses (red marks on the forehead or nose), are common and fade. Strawberry birthmarks are blood vessels under the skin and are usually not dangerous unless they bleed or are close to the mouth.

ALSO SEE: Are birthmarks dangerous?

Heel prick

When: Prior to discharge, as the result becomes more reliable the longer your baby has been out of the womb and has been fed.

What they’re doing: Taking blood from your newborn child for metabolic screening such as blood glucose, and to look for evidence of a genetic problem such as phenylketonuria (PKU) and congenital hypothyroidism especially if there’s a family history.

Vitamin k

When: after delivery

What they’re doing: Making sure that your baby has enough of this very important vitamin via an intra-muscular injection that helps the blood to clot. Newborns lack this vital vitamin and a deficiency may lead to bleeding, especially from the umbilical cord. This may lead to severe blood loss, which can be dangerous for him.

Spine check

When: Immediately after birth

What they’re doing: Ensuring that your baby’s spine is symmetrically aligned and normal, and that he doesn’t have spina bifida, which is fortunately becoming very rare. It’s also checked for little indentations that may indicate an underlying problem when a spinal ultrasound or MRI may be requested.

Hip check

When: After delivery

What they’re doing: Two tests are done to ensure that your baby’s hips are moving smoothly without any clicks or clunks, and that the ball of the hip is neatly aligned in the socket. If not, he may have congenital hip dysplasia which, if picked up early, is treatable and your child will be able to walk normally. If it’s missed and left untreated, he may struggle with walking and with his hips for the rest of his life. Babies who are breech, or twins and triplets, are at an increased risk of hip displasia.

ALSO SEE: 5 common baby genital health problems

Genital check

When: After delivery

What they’re doing: Checking to see whether your baby is a boy or girl, for starters! With boys, it’s important to check that the penis is straight and that the urethra is on the tip of the penis, not along the shaft. If not, the little boy may need surgery in the first year or two of life to correct this. A little white mucousy discharge or a few drops of blood from the vagina is normal in little girls. Very rarely, the genitalia are not clearly male or female, which is when further tests need to be done.

More about the experts:

Dr Kathy Krige graduated from Stellenbosch University and did part of her community service year at the paediatric ward of Helderberg Hospital in Somerset-West. She completed her studies at Cape Town’s Red Cross War Memorial Children’s Hospital and the University of Cape Town. She was admitted as a Fellow of the College of Paediatricians in 2006 and has been in private practice at Thriving Kids since 2007. Read more about Dr Kathy Krige here.

Dr Gary Reubenson is currently the head of the Clinical Unit at the Rahima Moosa Mother and Child Hospital in Joburg. He is an infectious diseases paediatrician who has been full-time employed at Rahima Moosa Mother and Child Hospital since 2004. Read more about Dr Gary Reubenson here.

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