Newborn screening

When a baby is born, he or she is entitled to a range of routine health checks and tests in the first six weeks. These include:

  • a physical examination
  • a hearing test
  • a blood test (taken from the baby's heel)

Most babies are healthy and won't have any of the conditions or problems that the screening tests are looking for. But for those babies that do have a health problem, the benefits of screening can be enormous.  Early treatment can improve the baby's health and prevent severe disability or even death.

It's a good idea for you to consent to your baby having the checks and tests, but you can decline if you wish.

The checks and tests are quick and won't harm your baby.

Physical examination

Every baby has a head-to-toe physical examination soon after birth to identify babies likely to have particular conditions that may need further monitoring, investigation or treatment.

The examination is carried out within 72 hours of birth and then again at six to eight weeks of age, as some conditions can develop later.

As well as the top-to-toe physical check, there is specific examination of the baby's:

  • eyes – this is not done to check your baby's vision, but to pick up conditions such as congenital cataracts
  • heart – a wide range of abnormalities may be detected, ranging from minor defects that may get better by themselves, to more serious conditions that need further investigation and treatment including heart surgery 
  • hips – to check their position and stability
  • testicles, in boys – to check they're in the right place

Read more about what's involved in NHS newborn physical examinations.

The hearing screening test

A hearing screening test is performed within a few weeks of your baby being born, either while you're both still in hospital, by a health visitor in your home, or at your local GP surgery or health clinic.

Two hearing screening tests may be used:

  • the Automated Otoacoustic Emission (AOAE) screening test and/or
  • the Automated Auditory Brainstem Response (AABR) test

One to two babies in every thousand are born each year with hearing loss in one or both ears. This hearing screening test enables those babies with hearing loss to be identified early. Early identification is important for the development of the child and means that parents can receive support and information as early as possible.

The hearing test is quick and painless.

The AOAE hearing screening test involves putting a small, soft-tipped earpiece in the outer part of the baby's ear. Sounds are then sent through the earpiece and into the baby's ear. The equipment measures how the baby's ears have responded.

The AABR hearing screening test also involves placing three small sensors on the baby's head. Then, headphones are put over the baby's ears and a series of clicking sounds are played. The AABR machine measures how well sounds travel along the baby's hearing nerve pathways from the ear to the brainstem.

You should be given the results at the time of the hearing screening test.

Read more about NHS newborn hearing screening tests.

Blood spot (heel prick) test

When a baby is about five days old, a midwife will collect a sample of blood by pricking the baby’s heel using a special device and squeezing out a few drops of blood on to a card. The heel prick may be uncomfortable and the baby may cry, but it's all over very quickly.

The card is sent off for analysis and parents receive the results of the blood spot test within a couple of months.

The blood spot screening test helps to identify a range of health conditions, including:

  • Sickle cell disease: an inherited blood disorder. Treating babies will help prevent serious illness.
  • Cystic fibrosis: a life-limiting inherited disorder that affects the internal organs, especially the lungs and digestive system.
  • Phenylketonuria (PKU): a very rare condition that can cause mental disability (but is treatable once diagnosed).
  • Congenital hypothyroidism: another rare condition that can lead to impaired growth and mental development. Treated babies can develop normally.
  • Medium-chain acyl Co-A dehydrogenase deficiency (MCADD): a rare, but potentially life-threatening inherited disorder, where fat cannot be broken down by the body as well as usual. Babies with MCADD develop normally, but recognising the condition early enables parents to make sure they eat regularly and avoid serious illness.

Read more about the NHS blood spot test.

In May 2014, the UK's National Screening Committee recommended screening for four additional rare, but treatable, conditions. Read all about the proposed extension to newborn heel prick test screening.

Page last reviewed: 05/01/2014

Next review due: 05/01/2016

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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Rachael36 said on 23 February 2011

My daughter was born with a Congenital Heart Defect which went undiagnosed for over 5 months. She then required open heart surgery at 6 months old.
It would be an excellent idea if the NHS introduced the mandatory screening for CHDs. By doing a simple test in the first 24 hours (a pulse oximetry test) that measures the oxygen levels in the blood can help detect some heart defects. I believe this is mandatory in some countries. I do hope that in the near future this happens for all newborns so that babies do not have to suffer like my little girl did. Thanks

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