Newborn screenings: what to expect in hospital right after birth

For those of you who are expecting new babies, congratulations! In addition to getting to know your newborn and learning to care for her, there are many things that happen in the hospital after a baby is born that you should be aware of.

It may seem like a lot of poking and prodding around your perfect new baby, but each test is done for a very specific and important reason. All are designed to make sure your baby is healthy and has the best start in life.

You can talk to your baby’s future health care provider about these topics to learn more.

Vitamin K

All babies are born with a low vitamin K level, which is an important factor in helping a baby’s blood clot. That’s why we give all newborns a vitamin K injection shortly after delivery. The vitamin K shot helps prevent a type of bleeding called vitamin-K deficient bleeding (hemorrhagic disease of the newborn). This rare but serious condition can range from bruising of the skin to bleeding inside the baby’s brain. Unfortunately, there’s no way to tell who will be affected and vitamin K is not found in breastmilk or infant formula (Pediatrics).

Bilirubin

It’s normal for almost all babies to look a little yellow, or jaundiced, after birth. A blood or skin test  measures the baby’s amount of jaundice (bilirubin) after birth. Infants with very high levels of bilirubin are at risk for neurologic problems. This test can detect severe jaundice early, so that it can be treated right away, often with simple light therapy (Healthline).

Erythromycin

Newborn’s eyes are treated with erythromycin ointment, an antibiotic to prevent the development of bacterial conjunctivitis (eye infection). This preventive treatment is safe, easy and effective in preventing sight-threatening eye infections (Healthfamilies.org, American Academy of Pediatrics).

Hepatitis B

Vaccination of all newborns with hepatitis B vaccine, regardless of mom’s hepatitis B status, is recommended. The earlier a baby receives the first hepatitis B vaccine, the better protected she is in cases of unknown maternal infection or accidental exposure (Aboutaids.org, U.S. Dept. of Health and Human Services).

Newborn screen

Here in Oregon, babies receive the first newborn screen in the first day of life and the second one around two weeks of age. A few drops of blood from a heel prick are sent to the state public health lab. You and your baby’s provider will be contacted if anything abnormal is found (Oregon.gov, Oregon Health Authority).

Hearing screen

Hearing loss is the most common congenital condition in the United States. We screen all newborns in the hospital soon after birth to identify infants with hearing loss as early as possible. Early identification has been shown to improve outcomes (Healthchildren.org, American Academy of Pediatrics).

Heart disease screen

A pulse oximetry probe, which looks like a piece of tape, is placed on an infant’s hand or foot to measure the amount of oxygen in the blood. This test is not painful and can detect certain types of congenital heart disease in infants. Without screening, some newborns with heart defects might be missed because the symptoms may not be evident before they go home (Centers for Disease Control and Prevention).

Lauren Harris, M.D.
Second-Year Resident in Pediatrics
OHSU Doernbecher Children’s Hospital

Carrie Phillipi, M.D., Ph.D.
Associate Professor of Pediatrics
OHSU Doernbecher Children’s Hospital
Director, Mother-Baby Unit
OHSU Hospital