Newborn screening (heel prick, hearing, heart)

Newborn screening: what are the options?

Parents usually land on one of these 2 approaches.

1. 1. Accept all

   The baby has all the standard screening tests.

2. 2. Opt out

   You decline some or all of the tests.

Newborn screening: what does the evidence say?

Well established. Guidance and evidence agree. The real question is whether you'll follow it. (Settled (details vary by state))

Every US state runs newborn screening, built around a federal recommended list of conditions that is not law, so each state chooses which to screen: the list has about 35 core conditions and 26 secondary ones (counts differ slightly by source and date). The tests are a heel-prick blood spot, a hearing screen, and a pulse-oximeter check for critical congenital heart disease. The hearing goals are screening by 1 month, diagnosis by 3 months and early intervention by 6 months. Most states let parents refuse for religious reasons, many allow personal exemptions, and rules differ on how parents are informed and on how long blood spots are kept, so ask your hospital

Sources

• Baby's First Test
• CDC EHDI goals
• Hastings Center
• Washington DOH refusal page

What else is worth knowing?

These tests look for rare conditions that are far easier to treat when found early, often before any symptoms appear. The blood test covers dozens of conditions, depending on where you live. Ask how and when you will get the results.

Questions to ask each other

• What do we know about what these tests look for?
• Would we want to opt out of any, and why?
• Who will check that the results get to us afterward?

More in Newborn medical choices

• Vitamin K at birth
• Erythromycin eye ointment
• Hepatitis B at birth
• Circumcision
• Tongue-tie release
• First-year vaccine schedule
• Choosing the child's doctor