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Your Baby’s First Tests

What is being assessed during newborn screenings and how to make sense of your child’s results
By Debra Schwartzers, MD

The preventive care offered through newborn screenings is the first step in ensuring your baby leads a healthy, happy life, now and in the future. In the hours following birth, your medical team will perform various tests to screen for a variety of medical conditions such as hormonal irregularities, metabolic conditions and more.

As a new parent, it can be difficult to understand all the tests and screenings given to your baby. To help simplify the process, here is a guide to tests and screenings to expect, and how to make sense of your baby’s results. 

APGAR Test: The first screening performed is the APGAR test. APGAR stands for Appearance of the babies skin color, Pulse, Grimace responses (reflexes), Activity (muscle tone), and Respiration (breathing and effort). These measures help your physician determine how your baby is adjusting outside of the womb. This test will be given one minute after birth and again five minutes after birth. While this test is important for a first evaluation, it doesn’t completely determine the future health and wellness of your baby.

How Scoring Works: APGAR scores are determined based on the five categories mentioned above, with overall scores ranging from 0-10. Each category is scored from 0-2. Two is the most ideal score, and zero is the least ideal. An overall score of seven or above is considered healthy.

What if my baby’s scores are below normal?: A lower than average score is nothing to worry about. Many babies score below the recommended rating of seven and lead healthy lives. Your physician will share any concerns and the information you need to know to properly care for your baby.

Blood Test Screenings: Blood samples are used to detect a variety of disorders, such as sickle cell disease, congenital hypothyroidism and cystic fibrosis. These screenings determine your baby’s risk of developing various conditions, however, further testing is needed for diagnosis and treatment.

Hearing Tests: There are congenital causes for hearing loss and early detection allows for proper intervention. If hearing loss is found, there are options that may restore your baby’s hearing.

Physical Exams: Typically, on the second day after birth, a pediatrician will visit the hospital to give your baby a thorough physical examination. Your pediatrician will weigh your baby and measure their length and head circumference. They will also check their skin, head, neck, heart, lungs, abdomen, genitals, nervous system and reflexes. 

  • Skin: In most cases, a newborn’s skin is a blush color, while the skin on their hands has a bluish tint due to poor circulation. Dryness and peeling of the skin is common. Most rashes that newborn babies can develop, such as erythema toxicum, are harmless and disappear within a few days.
  • Head and Neck: Head-first, vaginal deliveries can result in a slightly misshapen head or bruising, which can last for the first few days after birth. Your baby’s neck will be examined for swelling growths and twisting or spasms. Their ears will also be examined to ensure that they formed properly during pregnancy. Your physician will also check your baby’s mouth for a cleft lip or palette and any growths that can lead to feeding issues.
  • Heart and Lungs: Your physician will listen to your baby’s heart and lungs to screen for heart murmurs and lung congestion. Bluish skin tone in the face or torso can also help detect a congenital heart condition or lung disease.
  • Abdomen and Genitals: Your baby’s abdomen will be examined for shape, size and position of internal organs. Your pediatrician will also ensure that their urethra is open and in the proper location.
  • Nervous System: During this evaluation, your physician will determine if your baby’s reflexes, such as rooting and sucking, are normal. He/she will also evaluate your baby’s alertness, muscle tone and ability to move limbs normally.
  • Muscles and Bones: Your pediatrician will check flexibility and mobility, as well as ensure no bones or limbs are broken or missing.

Why are screenings important?
While you are given the option to opt out of certain screenings, there are many benefits to having your newborn baby thoroughly examined. Screenings are the best way to detect abnormalities early, allowing you and your pediatrician to take the necessary steps to manage, treat and care for your baby.

To learn more about newborn screenings and what to expect after birth, or to schedule an appointment with one of our pediatricians, please visit us online at https://www.dupagemedicalgroup.com/services/pediatrics/.

Topics and Subtopics: Children's Health, Infant Care & Pregnancy

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