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Sunday, June 1, 2008

The Best Way to Do a Newborn Screening Test


PKU (newborn screening or the heel stick) is a test usually done in the hospital on all newborns required by law. The nurses usually do this. From previous employment and training, I remember this always being done in the nursery away from the mother and it looks like a real bother to the baby and another reason used to separate the pair. Some home health nurses do a PKU. I do not know if Pediatricians and other FP's do this. They may not have any reason to?

I am providing this service in my office for established families who choose to birth at home or otherwise need a heel stick done. With an assistant to help me, I am able to do this with the mother nursing the baby. I get mom and baby comfy in a rocking chair and I can pull up to the side on my stool. Mom can stay in constant contact with her baby. The stick is made with a lancet specially made for a baby's heal. This baby didn't cry. After I make the stick, the blood drips on a card and is not painful.
In Florida the heel stick test checks for PKU, galalctosemia, other and metabolic diseases. Cystic fibrosis, Hemoglobin diseases (sickle cell and thalassemia's) and some others.
Some families have declined it. Despite it being required by law, no one has come after me or them. I am not sure you can decline this in the hospital. Some families have delayed it 2-3 weeks. The metabolic diseases can be prevented by modifying infants diet from expressing themselves if identified very early. The other diseases it screens for are things that are nice to know, but don't have to be known the minute the baby is born. All the results are a screening and positives need to be confirmed.
My first two sons had theirs done in the hospital and by homehealth. There is (or at least was) a silly rule if the baby wasn't 72 hours old when discharged it had to be done again. The hospital did it anyway just incase you didn't come back for follow-up. My third son's midwife did the heel stick in my bed in my presence. It only had to be done once.
It took me a while to find the best lancet and the best position to do this in. Now that I have found the best way, I am happy to share to share my example.
I apppreciate Dino taking the photo and for the mother to allow me to share this.

1 comment:

womantowomancbe said...

Both of my midwives (I gave birth in two different states) had the newborn screening included as part of their "home birth" package. The heel stick was done on the 24- (or 48)-hour-after-birth home visit. I've heard that many hospitals do the heel stick, but do it too soon -- the baby has to have eaten something and be at least 24 hours old for the test to be accurate. This means that many hospitals are making the babies go through it twice (unnecessarily), or else they may be now keeping them in the hospital longer than normal, so that they can get the heel-stick done. I've heard several moms say that the test done in the hospital was "inconclusive" so they ended up having to get it done at the pedi's office anyway.

Kathy

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