What labs are done during a newborn visit?

From the Guidelines

For a newborn visit, the recommended labs typically include newborn metabolic screening, hearing screening, and pulse oximetry screenings, as these are crucial for detecting potential genetic, metabolic, and congenital disorders, and should be performed within the first few days of life, usually before discharge from the hospital or at the first outpatient visit, as stated in the 2015 Pediatrics study 1. The newborn metabolic screening is mandatory in most regions and screens for various genetic and metabolic disorders. Additional tests may be ordered based on risk factors or physical exam findings, such as:

• Complete blood count (CBC) to assess for anemia, infection, or other blood disorders
• Blood type and Rh factor to check for potential future transfusions and Rh incompatibility
• Bilirubin level to monitor for jaundice, which is common in newborns
• Thyroid function tests if not included in metabolic screening It's also important to note that maternal and infant laboratory tests, including maternal syphilis, hepatitis B surface antigen, and HIV status, as well as umbilical cord or newborn blood type and direct Coombs test result, if clinically indicated, should be reviewed, as mentioned in the 2015 Pediatrics study 1. These tests should be performed in accordance with local or state policy, and a system for repeating the test during the follow-up visit must be in place if screening metabolic tests were performed before 24 hours of milk feeding, as stated in the 2015 Pediatrics study 1. Parents should be educated on the purpose of these tests and when to expect results, and follow-up appointments should be scheduled as needed based on the findings.

From the Research

Newborn Screening Tests

The following tests are typically done during a newborn visit:

• Newborn screening (NBS) for certain genetic and metabolic conditions through a heel prick 3 to 5 days after birth 2
• Screening for disorders such as biotinidase deficiency, congenital adrenal hyperplasia, congenital hearing loss, congenital hypothyroidism, cystic fibrosis, galactosemia, homocystinuria, maple syrup urine disease, medium-chain acyl-coenzyme A dehydrogenase deficiency, phenylketonuria, sickle cell disease and other hemoglobinopathies, and tyrosinemia 3
• Dried blood spot screening (NBS) to identify infants with certain genetic, metabolic, and endocrine disorders 4
• Comprehensive screening system capable of detecting over 50 different conditions 5

Timing and Procedure

• Screening is typically performed in the first few days of life through blood testing 4
• Several drops of blood are taken from the baby's heel and placed on a filter paper card 4
• The dried blood is sent to the state health department laboratory or a commercial partner for analysis 4
• Screening may be repeated as needed, especially in neonatal intensive care units (NICUs) where interventions may affect screening results 2