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 tests performed on newborns. If you haven’t already selected a regular doctor for your baby, choose a pediatrician here.
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.
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 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)
Maple syrup urine disease (MSUD)
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)
Biotinidase deficiency (BIOT)
Congenital adrenal hyperplasia (CAH)
Congenital hypothyroidism (CH)
Cystic fibrosis (CF)
Learn more about newborn screening tests.
APGAR Tests for newborns – A quick test performed at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score assesses how well the newborn is adapting to the new environment. The rating is based on a total score of 1 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 1 and 2 months of age and the third at 6 months of age.