Why Your Newborn Should Have a Blood Screening Test

Every baby is offered newborn blood spot screening, also known as the heel prick test, ideally when they’re 5 days old.

Newborn blood spot screening involves taking a blood sample to find out if your baby has one of 9 rare but serious health conditions.

Most babies won’t have any of these conditions but, for the few who do, the benefits of screening are enormous.

Early treatment can improve their health, and prevent severe disability or even death.

What does the blood spot test involve?

When your baby is 5 days old, a health professional will prick their heel and collect 4 drops of blood on a special card.

You can ease any distress for your baby by cuddling and feeding them, and making sure they’re warm and comfortable.

Occasionally, the sample may need to be taken when your baby is 6, 7 or 8 days old.

Sometimes a second blood spot sample is needed. The reason for this will be explained to you. It doesn’t necessarily mean there’s something wrong with your baby.

The test doesn’t carry any known risks for your baby.

Which conditions is the blood spot test for?

The blood spot test screens for the following 9 rare but serious conditions.

If you, your partner or a family member already has one of these conditions (or a family history of it), tell your health professional straight away.

Sickle cell disease

About 1 in 2,000 babies born in the UK** has sickle cell disease. This is a serious inherited blood disease.

Sickle cell disease affects haemoglobin, the iron-rich protein in red blood cells that carries oxygen around the body.

Babies who have this condition will need specialist care throughout their lives.

People with sickle cell disease can have attacks of severe pain and get serious, life-threatening infections. They’re usually anaemic because their blood cells have difficulty carrying oxygen.

The blood spot screening test means that babies with sickle cell disease can receive early treatment to help them live healthier lives. This may include vaccinations and antibiotics to prevent serious illnesses.

Pregnant women are also routinely tested for sickle cell disease early in pregnancy.

Read more about sickle cell disease, or download leaflets for parents whose child has sickle cell disease.

Cystic fibrosis

About 1 in 2,500 babies born in the UK** has cystic fibrosis. This inherited condition affects the digestion and lungs.

Babies with cystic fibrosis may not gain weight well and are prone to chest infections.

Babies with the condition can be treated early with a high-energy diet, medicines and physiotherapy.

Although children with cystic fibrosis may still become very ill, early treatment can help them live longer, healthier lives.

Read more about cystic fibrosis, or download a leaflet for parents whose baby has suspected cystic fibrosis.

Congenital hypothyroidism

About 1 in 3,000 babies born in the UK** has congenital hypothyroidism. Babies with congenital hypothyroidism don’t have enough of the hormone thyroxine.

Without thyroxine, babies don’t grow properly and can develop learning disabilities.

Babies who have the condition can be treated early with thyroxine tablets, and this allows them to develop normally.

See more information about congenital hypothyroidism (CHT).

Inherited metabolic diseases

It’s important to let your health professional know if you have a family history of a metabolic disease (a disease that affects your metabolism).

Babies are screened for 6 inherited metabolic diseases. These are:

About 1 in 10,000 babies born in the UK** has PKU or MCADD. The other conditions are rarer, occurring in 1 in 100,000 to 150,000 babies.

Without treatment, babies with inherited metabolic diseases can become suddenly and seriously ill. The diseases all have different symptoms.

Depending on which one affects your baby, the condition may be life threatening or cause severe developmental problems.

They can all be treated with a carefully managed diet and, in some cases, medicines as well.

Does my baby have to have the blood spot test?

It’s not compulsory, but it’s recommended because it could save your baby’s life.

You can choose to have screening for sickle cell disease, cystic fibrosis or congenital hypothyroidism individually, but you can only choose to have screening for all 6 inherited metabolic diseases or none at all.

If you don’t want your baby to be screened for any of these conditions, discuss it with your midwife.

You should be given information about the blood spot test and the diseases it screens for in advance so you can make an informed decision for your baby.

If you change your mind, babies can be screened up to the age of 12 months for all the conditions except cystic fibrosis. Cystic fibrosis can only be screened for up to 8 weeks of age.

If you have any concerns about the tests, speak to your midwife, health visitor or GP.

When will we get the results?

You should receive the results either by letter or from a health professional by the time your baby is 6 to 8 weeks old.

The results should be recorded in your baby’s personal child health record (red book)(*health records). It’s important to keep this safe and take it with you to all your baby’s appointments.

If you haven’t received your baby’s results, speak to your health visitor or GP(*physician).

You’ll be contacted sooner if your baby screens positive. This means they’re more likely to have one of the conditions tested for.

You’ll be contacted:

  • the day the result is available, or the next working day, if your baby is thought to have congenital hypothyroidism (CHT) – you’ll be given an appointment to see a specialist
  • before your baby’s 4 weeks old if they’re thought to have cystic fibrosis
  • before your baby’s 6 weeks old if they’re thought to have sickle cell disease

Screening for cystic fibrosis finds some babies who may be genetic carriers of the condition. These babies may need further testing.

Screening for sickle cell disease also finds babies who are carriers of this or other red blood cell diseases.

Carriers are healthy, although they can experience problems in situations where their bodies aren’t getting much oxygen – for example, if they’re having an anaesthetic.

Parents of babies who are found to be carriers should be told by the time they’re 6 to 8 weeks old.

Read more about what being a carrier means.

What do the results mean?

Most babies will have a normal result, which means it’s unlikely that they have any of the conditions.

A small number of babies will screen positive for one of the conditions. This doesn’t mean they have the condition, but they’re more likely to have it. They’ll be referred to a specialist for more tests.

It’s important to know that screening isn’t 100% certain. A baby with a negative screening result may later turn out to have the disease screened for. This is known as a false negative.

Babies with a positive result sometimes turn out not to have the disease – what’s known as a false positive.

Occasionally, other medical conditions are picked up by blood spot test screening. For example, babies with beta thalassaemia major, a serious blood disease, will usually be detected. These babies also need to be referred for early treatment.

More information

Editor’s Notes:

*Clarification provided for our US readers

** Resources outside the U.K.

  • For the individual state test conditions and screening programs in the US visit here.
  • For more information on newborn blood screening visit the CDC bulletin here.


NHS Choices logo

From www.nhs.uk

Child Health and Safety News: 3/26 Teen Suicide Levels Soar

twitter thumbIn this week’s Child Health News: Childhood Obesity Rates Are At Their Highest Since 1999

Welcome to Pediatric Safety’s weekly “Child Health & Safety News Roundup”- a recap of the past week’s child health and safety news headlines from around the world. Each day we use social media to communicate relevant and timely health and safety information to the parents, medical professionals and caregivers who follow us. Occasionally we overlook something, but overall we think we’re doing a pretty good job of keeping you informed. Still, quite a bit happens every day – so to make sure you don’t miss anything, we offer you a recap of this week’s top 20 events & stories

PedSafe Child Health & Safety News Headline of the Week:
Teen suicide is soaring. Do spotty mental health and addiction treatment share blame?

  • Seventeen children injured when 8-year-old student uses pepper spray at school assembly 2018-3-23
  • What I Learned Arguing With an 8-Year-Old 2018-3-23
  • Hospitalization, PICU admissions increasing for pediatric opioid ingestions 2018-3-23
  • A Wrinkle in Time is Tomorrow morning at AMC: 2018-3-23
  • Can FLOTUS Address Online Hate Without Using the C-Word? 2018-3-22
  • Here Is Why Toddlers Hit Themselves (And When You Should Be Concerned) 2018-3-22
  • When your child’s first food allergy reaction takes place in the air…mid-flight?? 2018-3-22
  • Code Adam…Because You Don’t Have Eyes in the Back of Your Head – Thurs Time Capsule 02/11 2018-3-22
  • Why Staying Together for the Kids Could Hurt Your Child’s Mental Health 2018-3-21
  • What is Strep and How Can it Affect Your Family? 2018-3-21
  • Electronic device screen time may affect mental health of school-aged youths including social phobia and depressive symptoms 2018-3-21
  • New York’s only freestanding pediatric health facility completed on the Buffalo Niagara Medical Campus 2018-3-20
  • 7 Ways to Deal With Moms That Bully Other Moms 2018-3-20
  • Soaring child suicide rates sparks launch of app that controls harmful content on mobiles 2018-3-20
  • “Reach Every Mother and Child Act (S.1730) proposes the USAID target existing funding towards maternal and child health” http://bit.ly/2FNdddd 2018-3-19
  • New online resource helps military families deal with child mental health issues 2018-3-19

Nicotine Poisoning: How to Keep Your Child Safe

Congratulations, you have quit smoking. It is a huge step that can add years to your life and give you more time to spend with the ones you love. While quitting smoking is not an easy task, there is a whole industry now providing the products used to replace cigarettes called NRT or Nicotine Replacement Therapy. The most common items used to replace smoking are nicotine gum, the nicotine patch, and now the world has been introduced to the e-cigarette or vape.

The most common way children are exposed to nicotine and experience a reaction is direct exposure to nicotine they find around the house.

It goes without saying that anything left out, the kids will find, and that holds true in this case too. Kids will find a pack of gum and chew it or they will find a patch and use their bare hands to remove it from its applicator absorbing the nicotine through their skin. In a growing number of cases now, children are finding the liquid that is put into the vaporizers or e-cigarettes and drinking it because it looks like juice. In all of these examples the child gets exposed to nicotine and can have a reaction.

Nicotine poisoning tends to produce symptoms that follow a pattern. Nicotine poisoning symptoms are caused by extreme stimulation of nicotine in the central and autonomous system and the neuromuscular junction. At lower doses, nicotine causes stimulating effects on the receptors present there but at higher doses or more sustained exposure, the effects are inhibitory and can lead to neuromuscular problems.

The first symptoms are usually the result of the stimulating nature of nicotine. These include:

  • vomiting
  • hypertension
  • headaches
  • excessive salivation
  • seizures

After the first phase of symptoms, other symptoms caused by the depressor effects of nicotine follows. These include:

  • muscular weakness
  • central nervous system depression
  • paralysis
  • coma
  • labored breathing
  • respiratory failure

Exposure to electronic cigarettes and liquid nicotine is also quickly becoming a major issue. In 2014, more than 50 percent of nicotine poisoning cases occurred in children under the age of 6. Children and toddlers who come in contact with e-cigarettes and liquid nicotine become very ill very quickly and they exhibit all the symptoms. It is harmful to them and adults should be extremely careful where they keep or place these products.

According to Medline, nicotine overdose may present many potential symptoms. These can include:

  • Nausea and abdominal pain
  • Cramping
  • Restlessness or agitation
  • Irregular breathing – either rapid breathing or difficulty breathing
  • Convulsions
  • Confusion
  • Drooling
  • Burning sensation in the mouth
  • Weakness
  • Vomiting
  • Headache
  • Fainting

In severe cases, the person may stop breathing. Seizures and coma have also been reported.

If you find your child with any of these symptoms and believe they have ingested nicotine please take them to the emergency room right away or call 911 and get professional help. In the case that your child presents with irregular breathing or any type of altered mental status, please call 911 first.

While we all congratulate you for taking the steps to quit smoking, please be cognizant of the new items that you are using, where you keep those items, and the risk they can pose to your family.

Thank you and please be safe.


Tomb Raider is Sensory Friendly Tuesday Night at AMC

AMC Entertainment (AMC) has expanded their Sensory Friendly Films program in partnership with the Autism Society. This Tuesday evening, families affected by autism or other special needs have the opportunity to view a sensory friendly screening of Tomb Raider, a film that may appeal to older audiences on the autism spectrum.

As always, the movie auditoriums will have their lights turned up and the sound turned down. Families will be able to bring in snacks to match their child’s dietary needs (i.e. gluten-free, casein-free, etc.), there are no advertisements or previews before the movie and it’s totally acceptable to get up and dance, walk, shout, talk to each other…and even sing – in other words, AMC’s “Silence is Golden®” policy will not be enforced during movie screenings unless the safety of the audience is questioned.

Does it make a difference? Absolutely! Imagine …no need to shhhhh your child. No angry stares from other movie goers. Many parents think twice before bringing a child to a movie theater. Add to that your child’s special needs and it can easily become cause for parental panic. tomb raider movie posterBut on this one day a month, for this one screening, everyone is there to relax and have a good time, everyone expects to be surrounded by kids – with and without special needs – and the movie theater policy becomes “Tolerance is Golden“.

AMC and the Autism Society will be showing Tomb Raider sensory friendly tomorrow, Tuesday, March 27th at 7pm (local time). Tickets can be as low as $4 to $6 depending on the location. To find a theatre near you, here is a list of AMC theatres nationwide participating in this fabulous program (note: to access full list, please scroll to the bottom of the page).

Coming in April: Ready Player One (Tues 4/10); Sherlock Gnomes (Sat. 4/13); Rampage (Tues 4/24)


Editor’s note: Tomb Raider has been chosen by AMC and the Autism Society for a Tuesday Sensory Friendly “Mature Audience” screening. Parents should be advised that it is rated PG-13 by the Motion Picture Association of America for sequences of violence and action, and for some language. As always, please check the IMDB Parents Guide for a more detailed description of this film to determine if it is right for you and your family.

What I Learned Arguing With an 8-Year-Old

My step-son and I spent some time alone a couple of weeks ago. My grandmother-in-law passed away and my husband and I went to help his mother. When we got up there, my husband drove his mom on some errands and I was left to play with my newly 8 years-old step-son.

We had a wonderful time. He is currently obsessed with the lego show Ninjago and we played with legos, making up storylines and dancing to the pop punk theme songs of the show. This was my first time spending a significant amount of time alone with him and it was interesting. I learned some things about 8 year-olds, for instance, “poop” is the new word that he finds hilarious and children have their own logic.

We had transitioned from playing with legos to playing outside and were each playing with swords and some other toys. I was playing with a flower and he wanted it, so, he looked at me and said “Give me that.” Now, he and I do not have a particularly formal relationship. We play and talk about this and that and are generally very relaxed with each other. However, this demand had a very specific tone, parents, I’m sure you know the tone I’m talking about. It’s the one that says “I don’t know my boundaries with you and I’m gonna see if I can tell you what to do.”

This was new to me, I just recently reached a point in my life where I handle conflict well with adults, now I was being tested by an 8 year-old. Since we were still playing, I kept the mood light. I have no interest in being an authoritarian with him and I prefer to talk to him like he’s just a smaller human instead of a less intelligent one, so my response was quite simply to pause and say “no.” The result of this wasn’t a temper tantrum (though he did sulk briefly) but a back and forth conversation lasting about half an hour. We argued for a bit, him trying to grab it from me, me holding it over my head, neither of us actually angry, more just testing the relationship we have.

I told him early on that all he had to do to get the toy from me was say please. This caused a burst of annoyance and the logic eventually came out that “big boys don’t have to say please.” This was an interesting turn to me, so we talked about it. “Your dad says please,” I responded. He nodded and said “daddy’s an adult.” Okay, I thought, so “big boys” and “adults” are not the same. He elaborated further, “only little kids say please.”

This is where I learned that children will make up their own rationalizations for how the world works in order to get what they want. There is something very important about this. Adults do this too. In relationships, in parenting, in politics, in religion, we all choose a worldview that pleases us and takes us in what we consider to be the “right” direction.

Our conversation continued where I explained that people didn’t respond very well when they had things demanded of them. That it made them feel like they don’t have a choice, that they have to do what you want. He thought about this and looked at me a little shyly and asked if he could have the toy “please.” I grinned at him and tossed him the toy. We kept playing until my husband got home at which point my step-son immediately ran up to him and said “daddy, Clara and I got into a fight.” My husband smiled and his mother asked “who won?” And winked knowingly at me.

And that was that. There were no tears, no yelling, I didn’t focus on the “right” or “wrong” of the situation. I focused on the expression itself. I choose to be a guide and a sounding board, I choose to be less concerned with exerting my will over him and more concerned with how his world view is developing.

Many children are highly intelligent and are more than capable of having well thought out conversations about their thoughts, emotions, and choices.

By being curious and taking the time to listen to his explanation and talk things through I was able to create an understanding between our perspectives.

Shouldn’t that be the point of all communication?

I’d love to hear stories from you guys. What’s the strangest thing you’ve ever “argued” with your little one about? What conclusions did you reach?

What is Strep and How Can it Affect Your Family?


There are many different types of Streptococci bacteria, and infections vary in severity from mild throat infections to life-threatening infections of the blood or organs. Most streptococcal infections can be treated with antibiotics.

Streptococci are divided into two key groups:

  • alpha-haemolytic – made up of two groups, including Streptococcus pneumoniae
  • beta-haemolytic – made up of several groups, including Group A and Group B streptococci

This topic focuses on Group A and Group B beta-haemolytic streptococci. Read about pneumococcal infections for information on infections caused by Streptococcus pneumoniae.

Group A strep

Group A strep (strep A) are often found on the surface of the skin and inside the throat. They are a common cause of infection in adults and children.

They can be spread in droplets in the coughs or sneezes of someone with an infection, or through direct contact with an infected person or contaminated object.

Minor strep A infections

Most infections caused by strep A are unpleasant, but don’t pose a serious threat to your health. These include:

  • throat infections (pharyngitis or “strep throat”) and tonsillitis – which can cause a sore throat, swollen glands and discomfort when swallowing
  • impetigo – a skin infection that can cause sores, blisters and crusts to develop on the skin
  • cellulitis – an infection of the deeper layers of the skin, which can cause affected areas to quickly become red, painful, swollen and hot
  • a middle ear infection – which often causes earache, a high temperature (fever) and some temporary hearing loss
  • sinusitis – an infection of the small cavities behind the forehead and cheekbones, which causes a blocked or runny nose and a throbbing pain in your face
  • scarlet fever – an infection that causes a widespread, fine pink-red rash that feels like sandpaper to touch

Click on the links above for more information on these conditions.

You should see your GP(*physician) if you have persistent or severe symptoms of a strep A infection, as they may recommend a short course of antibiotics.

Most people with a minor strep A infection will make a full recovery and experience no long-term problems, although there is a very small risk the infection could spread further into the body or lead to complications such as rheumatic fever if left untreated.

Invasive strep A infections

In rare cases, strep A bacteria can penetrate deeper inside the tissues and organs of the body, and become what’s known as an invasive infection.

These infections are much rarer and usually affect certain groups of people, including babies, elderly people, people with diabetes, and people with weak immune systems (for example, because of cancer treatment or HIV).

Examples of invasive infections include:

  • pneumonia – an infection of the lungs that causes persistent coughing, breathing difficulties and chest pain
  • sepsis – an infection of the blood that causes a fever, rapid heartbeat and rapid breathing
  • meningitis – an infection of the protective outer layer of the brain that causes a severe headache, vomiting, stiff neck, sensitivity to light and a distinctive blotchy red rash
  • toxic shock syndrome – where bacteria release toxins into the blood, which can cause a sudden high fever, nausea and vomiting, diarrhoea, fainting, dizziness and confusion
  • necrotising fasciitis – an infection of the deeper layers of the skin, fat and covering of the muscle (fascia), which can cause severe pain, swelling and redness of the affected area that can spread very quickly

Click on the links above for more information on these conditions.

You should seek immediate medical advice if you think you may have an invasive strep A infection, as you will need to be treated with antibiotics as soon as possible.

Although pneumonia is sometimes relatively mild, the overall outlook for more serious invasive strep A infections is poor. It’s estimated up to one in every four people who develop an invasive strep A infection will die from it.

Group B strep

Group B strep (strep B) usually live harmlessly inside the digestive system and in the vagina.

Strep B can sometimes cause urinary tract infections (UTIs), skin infections, bone infections, blood infections and pneumonia, particularly in vulnerable people, such as the elderly and those with diabetes.

Strep B in pregnancy

It’s estimated around one in every four pregnant women have strep B bacteria in their vagina or digestive system.

The bacteria can sometimes be passed on to the baby through the amniotic fluid (a clear liquid that surrounds and protects the unborn baby in the womb) or as the baby passes through the birth canal during labour.

Most babies exposed to strep B will be unaffected, but in around 1 in every 2,000 cases they can become infected.

A strep B infection during pregnancy can also cause miscarriage or stillbirth, but this is rare.

Strep B in newborn babies

As newborn babies have a poorly developed immune system, strep B bacteria can quickly spread through their body, causing serious infections such as meningitis and pneumonia.

The symptoms of a strep B infection in a newborn baby usually develop within the first few hours or days of giving birth, and include:

  • being floppy and unresponsive
  • poor feeding
  • grunting when breathing
  • irritability
  • an unusually high or low temperature
  • unusually fast or slow breathing
  • an unusually fast or slow heart rate

In some cases, a baby can pick up a strep B infection a few weeks or months after birth. It’s not known exactly why this happens, but it’s not related to infection during birth. Symptoms of a late-onset group B strep infection can include a fever, poor feeding, vomiting and reduced consciousness.

You should seek immediate medical advice if you think your baby may have a group B strep infection.

Preventing and treating strep B infections in babies

It’s possible to reduce the chances of a baby becoming infected with strep B by identifying cases where there is a risk of the bacteria being passed from a mother to their child and giving the mother antibiotics directly into a vein (intravenously) during labour.

Known risk factors that may mean you need intravenous antibiotics during labour include:

  • you have previously given birth to a baby with a strep B infection
  • strep B is found in your urine during tests carried out for other purposes
  • strep B is found during vaginal and rectal swabs carried out for other purposes
  • you have a fever during labour
  • you go into labour prematurely (before 37 weeks of pregnancy)

If your baby develops symptoms of a strep B infection after they’re born, they will have tests to confirm the diagnosis and will be given intravenous antibiotics as soon as possible.

Most babies who become infected can be treated successfully and will make a full recovery, although there is chance they could die as a result of complications such as meningitis. Some babies who survive are left with permanent problems, such as hearing loss, vision loss, and problems with memory and concentration.

Further information:

Editor’s Note: *clarification provided for our US readers.

NHS Choices logo

From www.nhs.uk