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Newborn Tests and Procedures

A few routine tests and procedures are offered for your newborn the first few days after birth.

All tests and procedures are considered routine and are recommended for promoting optimal health for you and your baby. However, it is still your decision. You can decline any of these tests or procedures. Discuss with your doctor or midwife.

You can help your baby during these procedures by

  • holding them skin-to-skin (baby's bare chest to your bare chest); and/or
  • feeding your baby during the procedure if possible, or right after the procedure.
Immediately after birth

Vitamin K helps your baby's blood to clot and prevents bleeding in your baby's brain and other areas. A single injection (shot) of Vitamin K is recommended for all babies in their first six hours of life, as newborns have low amounts of this vitamin at birth. Giving Vitamin K by mouth requires three doses and may be less effective.


For more information: Canadian Pediatric Society. Vitamin K for Newborns.

Eye infections caused by gonorrhea or chlamydia, sexually transmitted infections (STIs), carry the risk of causing blindness. You will be tested by your maternity care provider during your pregnancy for STIs. If you do have an STI, you can be treated before the baby is born, reducing the risk of passing along the infection to your baby. Erythromycin antibiotic eye ointment is given to all babies within an hour of birth to protect them against eye infections caused by STIs. With your verbal consent, it is given by placing a small amount of eye ointment into your baby's lower eyelid.


You can ask your maternity care provider to check during your pregnancy if you have gonorrhea. If you do, you can be treated before the baby is born, reducing the risk of passing along the infection to your baby.

During your hospital stay

The newborn screening test is a blood test to screen for 24 rare but treatable conditions. Screening babies at birth allows for early identification, care and management of these conditions, and if treated early, can prevent more severe health problems. The test is usually done about 24 hours after birth, or before hospital discharge.


  • For this test, your baby's heel is pricked to get a small amount of blood which is spotted onto a card. The lab tests your baby's blood spot card for all 24 conditions at the same time. If your baby's screening result is negative, the chance that your baby has one of these disorders is very low.
  • If your baby's screening result is positive, your baby will need to have more tests to find out for sure. A positive screening result does not mean that your baby has one of these disorders, but it is possible.


For more information: BC Newborn Screening Program Parent Information Sheet

Newborn jaundice is common in 50% of full-term babies and typically shows up 2-4 days after birth. Jaundice occurs as levels of a yellow pigment called billirubin rise naturally in the first few days of life. Billirubin is a yellow substance created when the body breaks down old red blood cells. A newborn's liver may take time to be able to remove billirubin from the body (during pregnancy the billirubin was removed by the placenta). Most of the time it goes away within 2 weeks; if billirubin levels are high however, sometimes jaundice may need to be treated.


The Bilirubin screening is a recommended blood test to check for the level of bilirubin in your baby's blood. The blood test for jaundice is usually done at the same time as the bilirubin screening. If the test shows your baby has high levels of bilirubin, your baby may need follow-up tests or treatment. Treatment is done using phototherapy, where your baby is placed under a special blue light. The light helps your baby's liver to break down bilirubin. This treatment may also be offered through our Home Phototherapy Program.


Help your baby by

  • Feeding often. Feed your baby at least 8 times in a 24-hour period. Feeding speeds up the rate the stool (poo) passes through their intestines which can reduce the amount of billirubin.

Call your care provider if

  • Baby's skin looks yellow during the first 24 hours of life.
  • Baby's skin turns from light yellow to more orange-yellow which can also be seen on your baby's arms or legs.
  • Baby is sleepy and difficult to wake up for feeding or stops feeding.
  • Baby is not peeing or pooing for more than 12 hours (diaper is dry).
  • Baby starts to look or act sick, has a high-pitched cry, or is becoming more irritable.

For more information: Jaundice and your newborn.

 

All babies in BC have their hearing checked soon after birth. A small number of babies are born with hearing loss which can affect their speech and language skills. Without checking, there are no obvious signs to tell early on if a baby has hearing loss.


The newborn hearing screening plays soft sounds into your baby's ears while a computer measures the ears' reactions. The test is safe and doesn't hurt your baby. It is usually done in your hospital room but, if you go home early, can also be done at a community clinic.


You will be given the results as soon as the test is done. Some babies need to have a second screening to get a clear answer. This does not mean that your baby has hearing loss.


For more information: BC Early Hearing Program

Sometimes babies are born with major heart problems that were not found during pregnancy. These heart problems lead to low levels of oxygen in a newborn's blood and may be identified using a simple bedside test called a pulse oximetry screening. A device is placed on the baby's hand to look at the level of oxygen in the blood. The test is repeated on the baby's foot and the two numbers are compared to each other. They should be within 3% of each other to indicate a normal test result.


  • Low levels of oxygen in the blood can be a sign of critical congenital heart defect (CCHD).
  • Babies with a CCHD will need to be followed by a pediatric cardiologist (specialist in heart problems) and may need surgery or other procedures in the first year of life.

The test is usually done at least 24 hours after birth. It is painless and takes only a few minutes.


Read the CCHD handout


Watch a short video of a CCHD test





SOURCE: Newborn Tests and Procedures ( )
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