8 Common Questions About Newborn Screening Tests

Nearly every newborn baby gets a series of screening tests soon after birth. But many parents-to-be aren’t aware of the details about these potentially lifesaving tests.

Screenings usually happen during the first 24 to 48 hours after birth, and you don’t have to ask for them to be done. Newborn screening is a normal part of the post-birth process in the United States.

Here are common questions I hear from parents about these tests, and the answers I share with them.

1. Why do we test?

Even though most babies are healthy at birth, there’s a very small group that appear healthy but may have serious medical conditions. About 1 in every 300 babies are found to have a health condition identified by newborn screening. That’s about 13,000 babies each year. These babies usually come from families without a history of the disorder.

If we find these conditions early, we often can treat babies right away to prevent serious illness and keep your baby healthy.

2. What tests are done?

There are three ways that your baby will be tested. A few drops of blood will be taken from your baby’s heel before you leave the hospital or birthing center. The blood sample will be sent to a lab that screens for dozens of conditions. Your baby’s hearing will also be tested. And finally, your baby’s blood oxygen levels will be measured by a painless sensor on the skin. Low oxygen levels can be a sign of a heart condition.

3. What conditions do the tests look for?

Newborn screening is a public health service. Each state has its own newborn screening program, so the list of conditions varies by state. But all states screen for the same basic panel of about 30 conditions. You can find your state’s list of conditions on the Baby’s First Test website. Every baby is screened for the disorders on your state’s list.

4. What are the most common conditions found in screening?

Remember, most test results are normal. Babies who are found to have a health condition after screening most commonly have

• hearing loss

• low thyroid levels

• cystic fibrosis, a disorder that causes problems with breathing and digestion

• sickle cell disease or other red blood cell disorders

• MCAD deficiency, a disorder that affects how the body breaks down fats

5. What happens if the screening detects a concern in my baby?

If your baby has a positive screening test, it doesn’t mean your baby has the condition. It means there is a possible problem, and more tests will be needed to confirm whether your baby is affected. If you are notified of this, following up is very important.

If tests confirm that the baby has the disorder, treatment options are discussed. Treatment may keep babies healthy or prevent an existing disorder from getting worse. Even very serious conditions may have treatment options that can improve your baby’s life.

When a disorder is found at birth, rather than a few years later, you have more time to learn about it, understand it, and manage it. Your baby’s doctor may connect you with a genetic counselor or other resources to help you learn and plan for the future. Knowing this information about your baby may also affect the genetic tests you choose in another pregnancy.

6. Is screening ever delayed?

If a baby is born very early, has a low birth weight, or is sick, screening may not be done in the first 48 hours. If a baby has a blood transfusion, screening may also be delayed.

7. Will my baby be screened if I don’t have insurance?

Yes. These tests are for everyone. Fees are different for every state, and all babies receive newborn screening regardless of their health insurance status.

8. Where can I find more information?

You can ask your ob-gyn or your baby’s doctor if you have any questions. Be sure to review the test results with your baby’s doctor. Genetic counselors can also help if your baby is found to have a genetic disorder. These websites offer helpful resources too:

• Baby’s First Test

• Newborn Screening Information Center, from the Health Resources & Services Administration

• Find a Genetic Clinic, a directory of genetic counselors and clinics

Screenings save lives

Nearly 4 million babies get screened in the U.S. every year. Remember, the reason why is simple: Screening tests can give you a head start on your baby’s health. The goal is to prevent or improve serious health problems.

Copyright 2023 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.