Expectant parents are usually very focused on the prenatal health of their babies. Making those obstetrician appointments routinely and timely can help your provider ensure the best outcome for your infant. As the due date comes closer, the focus will shift to the labor and delivery phase. The anticipation and excitement of delivery is soon followed by the joy and sometimes exhaustion of delivery.
Newborns are most often whisked off from exhausted moms, quickly followed by nervous and jubilant dads, with camera and video recorders in hands. But what exactly are they doing “back there” in the nursery? Your obstetrician and pediatrician are evaluating and assessing your newborn’s medical well being. A trip to the nursery will also include several screenings, which are state mandated and vary depending on the state in which you live.
In the Commonwealth of Virginia, the Virginia Department of Health has deemed three separate areas important enough to require screening before a child is discharged from a hospital after birth. These include screening for newborn hearing, more prevalent heritable disorders and genetic diseases, and critical congenital heart disease. Every hospital nursery in the Commonwealth is required to administer these screening tests before an infant is discharged. The only infants not tested are those whose parents have opted out for religious reasons.
The Virginia Early Hearing Detection and Intervention Program’s mission is to “minimize or eliminate communication disorders resulting from hearing loss.” Its goal is to identify early congenital hearing loss in children before three months of age and assure enrollment in early intervention services before the age of six months. The Commonwealth of Virginia recognizes that early intervention is critically important when it comes to infant’s communication and development skills.
Usually within a few hours of birth, an infant is given a hearing screening by a newborn screener. Depending on the facility where a child is born, either an Otoacoustic Emission (OAE) test or an Auditory Brainstem Response (ABR) test will be given. The OAE test is administered by measuring the sounds produced by the cochlea within the ear. Small probes are placed in the infants’ ear. One probe delivers and sound and the other probe is a microphone, which measures the cochlea response. A properly functioning cochlea will send a measurable response. This test is generally very good at testing for congenital deafness.
ABR screening involves placing a few electrode on an infant’s head to measure the electrical response of the brain to a series of “clicking” sounds presented to the infant though small earphones placed in the infant’s ears. Both of these tests are painless and take just a few minutes to administer.
The second battery of state-mandated screenings involves a blood screening from a prick of an infant’s heel. A few drops of blood are collected and dried and sent to Division of Consolidated Laboratory Services to test for 28 rare but serious genetic disorders, some of which may be only be detected with a blood test and many of which will benefit from early medical interventions to prevent intellectual or developmental problems. These disorders are recognized by both the American Academy of Pediatrics and The March of Dimes. (For a complete list of the 28 disorders, see website below.).
Phenylketouria or PKU, Sickle Cell Anemia, and Cystic Fibrosis are just a few of the 28, which may be recognizable to many. The Virginia Department of Health will notify you in writing about the results of these tests. Individuals who do not deliver their infants in a hospital are encouraged to get these important tests done within days of birth.
The third screening of infants involves screening infants for Critical Congenital Heart Defects or CCHD. Again the screening is simple and non-invasive and involves measuring the oxygen level in an infant’s bloodstream. Generally done between 24 to 48 hours after birth, a pulse oximeter is placed around the baby’s ankle to measure the oxygen level. Infants with CCHD usually have lower oxygen levels in their blood. This simple, painless test can be a tool to let health care providers know whether additional testing needs to be done to rule out any cardiac problems an infant might have.
These three screenings have been deemed by the Commonwealth of Virginia to be worthwhile to ensure that every baby gets the best chance at a happy and healthy start. So before all the excitement begins, take some time to find out more about these important newborn screenings and consult with your obstetrician or pediatricians if you have any questions or concerns.
For a complete list of the 28 genetic disorders detected by newborn screening, visit www.virginiahospitalcenter.com/healthinformation/newborn_tests_and_treatments.aspx
Dr. Hardy practices obstetrics and gynecology at Atlantic Ob/Gyn with locations in Va. Beach and Chesapeake. Please call 757-463-1234 or visit www.atlanticobgyn.com.