Women & Infant Health:
Newborn Tests & Treatments
HealthReach, Fall 2012 | Page 12
It’s almost time for your baby to be born at Virginia Hospital Center. In preparation for your stay on the Mother-Baby Unit, we want to fill you in about common tests and treatments your newborn may have before going home. Sawsan Talib, MD, Chair, Department of Pediatrics, along with Dena McCoy, RN, Mother-Baby Unit Patient Care Director, and Susan Mayhugh, RN, NICU Patient Care Director, provided this snapshot of what to expect.
Physical by a Pediatrician
All babies are medically assessed at birth. In addition, they must have a physical by a pediatrician within the first 24 hours of life. Pediatric residents and neonatologists are on staff at the Hospital around the clock to address any issues that may arise during the baby’s stay.
Newborn Metabolic Screening
All babies are required to have the Newborn Metabolic Screening, a blood test that screens for more than 50 metabolic diseases, genetic disorders and anemias. It is done once the baby is at least 24 hours old and has been through at least one feeding. A lab technician will prick the baby’s heel to draw blood, which can either be done at your bedside or in the nursery. The results will be available in two weeks and are sent to your pediatrician.
After birth, the level of bilirubin in the baby’s blood increases over the first few days. In normal circumstances, the level will then decrease as bilirubin is secreted in urine and stool. High bilirubin levels result in jaundice. If the bilirubin is allowed to get too high, it can make the baby very sick. “This is why we test all babies,” Dr. Talib explains. “We have the ability to easily treat this condition before it gets to dangerous levels.”
A noninvasive test to measure bilirubin level is done within the first 36-40 hours after birth by placing a light on the baby’s forehead that looks through the skin. If the bilirubin level is too high, then a blood test is done. You and your baby’s condition may prompt earlier testing; premature babies, for example, are monitored more frequently because their livers aren’t as mature, which can result in higher bilirubin levels.
The typical treatment for jaundice is phototherapy; the baby lies on a blanket with ultraviolet (UV) lights wearing only a diaper and a mask placed over the eyes for protection. Overhead UV lights may be used as well. The need for treatment is common; 33 to 50 percent of newborns are jaundiced and half of those will need treatment. High bilirubin levels may extend your baby’s Hospital stay.
Every baby is required to have a hearing screening. Typically done the day after birth, the screening is performed by placing soft earpieces over the baby’s ears and hooking up sensors to measure the brain’s response to sound. It takes 10 to 15 minutes and can be done at your bedside or in the nursery.
It’s important to know that babies don’t always pass the test the first time. “After birth, some babies may still have some amniotic fluid or vernix wax in the ear canal,” Dr. Talib says. “It takes a while for that to evaporate, so, when necessary, we will repeat the test.”
Other Blood Tests
Depending on your prenatal history, your doctor may order other blood tests for your baby, such as blood sugar or complete blood counts (CBC). Those tests are done if they are clinically indicated for the baby’s health. A blood sugar test can be done as early as one hour after birth; CBC is done at 12 hours after birth.
Hepatitis B Vaccine
Recommended by the American Academy of Pediatrics, this three-shot series is not mandatory. If parents consent, the first shot is given at the Hospital; the two follow-up shots are done at your pediatrician’s office. The vaccine can be given at any point during the Hospital stay.
Circumcision is offered at Virginia Hospital Center at the request of the parents and is performed by, and scheduled with, the mother's obstetrician.
Virginia Child ID Program
At birth, parents have the option of having the Hospital collect a sample of their newborn’s blood. The sample is preserved and given to the parents for storage and safekeeping to be used for future child identification purposes. This is a free, optional service offered by Virginia Hospital Center.
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