Blood Spot Screening FAQs
What is Newborn Screening?
Newborn screening is a state public health service that reaches each of the nearly 4 million babies born in the United States each year. It ensures that all babies are screened for certain rare, but serious health conditions at birth. For babies identified with a health condition, early detection allows providers to start treatment before the baby becomes symptomatic and harmful effects happen.
For more information visit Expecting Health.
How is my baby tested?
A few drops of blood are taken from your baby’s heel and placed on a newborn screening card. This card is transported to the laboratory for immediate processing. If an out-of-range result is detected, your baby’s health provider will be notified immediately and they will reach out to you with next steps.
My baby looks healthy. Is newborn screening really necessary?
Most infants with conditions identified through newborn screening do not appear to be sick until damage has already occurred. In each of the conditions there is an "invisible" problem in one of the many chemicals that are produced naturally in the baby's body. Special laboratory tests are used to identify these imbalances right away to alert the doctor that additional testing needs to occur.
What is the chance my baby has a condition found by screening?
The conditions identified through screening are rare, but serious and can happen in families with no history of disease. Babies with these conditions may appear to be healthy, but can still have a condition. Early detection, diagnosis and treatment can be life saving!
How are results reported and how will I be notified if my baby needs treatment?
The newborn screening results will be reported to the hospital where your baby was born. Ask your provider for your baby's newborn screening results at the first newborn visit. If your baby's results are abnormal, further testing will be done to confirm or rule out a condition. Your provider must have good contact information to reach you in the case that urgent follow-up is needed.
Your baby needs a repeat newborn screening. What is next?
This does not necessarily mean that your newborn has a condition. Some reasons why repeat screenings are needed include:
- Borderline results - the results were slightly out of range
- Early collection - the specimen was collected before 24 hours of age
- Treatment/Medication Interference - some can interfere with the results
- Quality of the sample - there may have been improper handling of the specimen that caused it to not be testable.
Contact your baby's health care provider as soon as possible to schedule a repeat screening.
Can I refuse newborn blood spot screening?
In North Dakota, newborn screening is mandatory; however, parents/guardians may refuse. If you are considering refusing the screening, please discuss your concerns with your baby's health care provider.
To refuse the screening, the parents/guardians must have read and received written information about newborn screening. A signed refusal form must be sent to the Newborn Screening program. Access the newborn screening refusal form here.
What if my baby is not born in a hospital?
It is very important that babies born outside of hospitals are tested between 24 to 48 hours after birth. Parents should arrange with a doctor, hospital or midwife to have the screening done. Visit the main page to find a birthing facility near you.
My child is playing an NCAA sport, how can I obtain their sickle cell status?
The NCAA requires a physical exam for athletes and this should include a sickle solubility test (SST). The North Dakota Newborn Screening program does not conduct SST through newborn screening. Please contact your health care provider to see if your child has already had sickle cell trait testing or to request a sickle solubility test to obtain your child’s sickle cell trait status.
FAQs Parents have about Hearing Screening
FAQs about Heart Screening
Why is screening for CCHD important?
Most babies are born with healthy hearts and have enough oxygen in their blood. A few are born with CCHS. Although babies are checked very carefully by a doctor after they are born, some babies with CCHD may not have symptoms until later. Screening can help find babies with CCHD before they go home from the hospital.
How is screening for CCHD done?
Pulse oximetry is used to screen babies for CCHD. Pulse oximetry is fast, easy and does not hurt. A small sensor is placed on a baby's right hand and one foot to measure the oxygen level in the blood. Your baby's doctor or nurse will discuss low pulse oximetry readings with you. Screening for CCHD is done for well newborns at about 24 hours of age or before discharge. Screening is done while a baby is warm and quiet. If a baby is crying, moving, fussing or cold, then screening will take longer. It may need to be repeated.
What if my baby has a low pulse oximetry reading?
Healthy babies may have a low oxygen reading. Babies with low oxygen levels in their blood may have CCHD. Other conditions like breathing problems or infections may also cause a low blood oxygen level. The doctor will check the baby carefully. An ultrasound of the heart (also called "echocardiogram" and "heart echo") may be done to look for CCHD. The heart echo may need to be done in a different hospital or doctor's office. It is ready by a children's heart doctor (pediatric cardiologist). If the heart echo shows problems, then a baby's medical team will discuss next steps with parents.
What if my baby did not pass the pulse oximetry screening?
It means that the screen detected low oxygen levels in your baby's blood. Low oxygen levels can be a sign of Critical Congenital Heart Disease (CCHD) or other conditions such as breathing problems or infections. More testing is needed to find out why a low oxygen level was detected.
What is the treatment for CCHD?
Babies with CCHD typically need surgery within the first year of life. Each baby with CCHD will require a unique treatment plan developed for his or her particular heart defect.
Do parents have to ask for the screening?
No, pulse oximetry screening is required for all babies. Always be sure to ask your provider about your baby's screening results. The results should be available right away.
What if my baby is not born in a hospital?
It is important for babies born outside of a hospital to receive pulse oximetry screening too. Parents should arrange screening with a health care provider or midwife. Visit the main page to find a birthing facility near you.
What do parents need to know?
Most babies who pass the pulse oximetry screen will not have a CCHD. It is important for parents to know that newborn screening cannot identify every child with a critical heart problem. Warning signs that all parents should watch for are: bluish color to the lips or skin, grunting, fast breathing, poor feeding, and poor weight gain. If you notice any of these signs in your baby, please contact your baby's health care provider right away.
Is there financial assistance to help pay for CCHD screening?
The Special Health Services (SHS) Financial Coverage Program provides coverage for services that promote early diagnosis and treatment to children with special health conditions who meet eligibility criteria.
To see if your family may qualify, please review the Diagnostic and Treatment fact sheet and contact SHS with any questions.
The North Dakota Health and Human Services, Special Health Services Unit, does not assume responsibility for the content obtained from external hyperlinks accessed from this website. Any links to external sources are outside of our domain. Information on external websites does not necessarily reflect the views and opinions of the North Dakota Health and Human Services agency or Special Health Services Unit.