Newborn Baby Tests and Care

We understand you have a lot to remember and a lot to do after having a baby. Below is useful information about initial newborn screening tests performed at all Franciscan Family Birth Centers. If you haven’t already selected a regular doctor for your baby, choose a pediatrician here.

Hearing tests

After your baby is born, he or she will be given a newborn hearing test. This will involve a health care provider using an instrument called an otoscope to see inside your baby’s ears to check the eardrum and look for signs of problems related to hearing, and is painless for your baby.

Two common tests are used to screen newborn infants for hearing loss:

  • the auditory brain stem response (ABR) test uses patches, called electrodes, to determine how the auditory nerve reacts to sound
  • the otoacoustic emissions (OAE) test involves placing microphones into the baby’s ears to detect nearby sounds

Critical Congenital Heart Defects (CCHD)

As a part of our routine newborn care, your baby will receive a pulse oximetry screening for CCHD. This is a pain-free, non invasive screening which measures oxygen saturation of hemoglobin in the blood. Small lights called “probes,” are placed on your infant’s hand and foot, which attach to a monitor to provide a reading for a trained clinician. It usually takes less than five minutes. According to the American Academy of Pediatrics, 18 out of every 10,000 babies are born with CCHD. When the condition is discovered in the first days after birth, babies can receive treatment to prevent death or disability in the first weeks of life. If you have questions about this screening, please talk with your doctor, certified nurse midwife or nurse.

Newborn screening tests

Newborn screening tests look for serious developmental, genetic and metabolic disorders. Although these disorders are extremely rare, it is important to test for them right away so that action can be taken immediately before complications develop. Washington State law requires all babies born in the state to be tested for congenital disorders before they are discharged from the hospital. The tests are performed by pricking the baby’s heel once to obtain a few drops of blood.

It is important to note that screening tests do not diagnose illnesses. They identify which babies need additional testing to confirm or rule out illnesses. Good screening tests have a low false-negative rate (if the test is normal, the child should be healthy), but may have a high false-positive rate (as many affected children as possible should test positive, even if this means many healthy children also test positive).

In the United States, individual states regulate newborn screening, so the diseases being screened vary considerably from state to state. In Washington State, newborns must be tested for the following disorders:

Amino Acid Disorders

Argininosuccinic acidemia (ASA)
Citrullinemia (CIT)
Homocystinuria (HCY)
Maple syrup urine disease (MSUD)
Phenylketonuria (PKU)
Tyrosinemia type I (TYR-I)

Fatty Acid Disorders

Carnitine uptake deficiency (CUD)
Long-chain L-3-hydroxy acyl-CoA (LCHAD) deficiency
Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency
Trifunctional protein (TFP) deficiency
Very-long chain acyl-CoA dehydrogenase (VLCAD) deficiency

Organic Acid Disorders

3-hydroxy-3-methylglutaric aciduria (HMG)
Beta-ketothiolase deficiency (BKT)
Glutaric acidemia type I (GA-I)
Isovaleric acidemia (IVA)
Methylmalonic acidemias (CblA,B and MUT)
Multiple carboxylase deficiency (MCD)
Propionic acidemia (PROP)

Other disorders

Biotinidase deficiency (BIOT)
Congenital adrenal hyperplasia (CAH)
Congenital hypothyroidism (CH)
Cystic fibrosis (CF)
Galactosemia (GALT)
Hemoglobinopathies (Hb)

Learn more about newborn screening tests.

Additional care

APGAR tests for newborns – A quick test performed at one and five minutes after birth. The one minute score determines how well the baby tolerated the birthing process. The five minute score assesses how well the newborn is adapting to the new environment. The rating is based on a total score of one to 10, with 10 suggesting the healthiest infant in the categories of breathing effort, heart rate, muscle tone, grimace response and skin color.

First bath – After birth, babies can be given either a sponge bath or a tub bath. Most babies actually prefer a tub bath because it is warmer than a wet cloth. Babies who receive a tub bath should be placed in warm (not hot) water and can be washed with a mild soap.

Vitamin K injection – In the United States, Canada, Great Britain and many other countries, all newborns receive vitamin K injections to prevent the possibility of hemorrhage (particularly in the brain) just after delivery. Babies are born without any bacteria in their intestines and do not get enough vitamin K from breast milk to tide them over until their bodies are able to make it. Even though vitamin K deficiency in newborns is very rare, it is dangerous enough to warrant these measures.

Hepatitis B vaccine – The hepatitis B vaccine is given to children as a series of three injections, with the first given to infants before leaving the hospital, the second between one and two months of age and the third at sixth months of age.