It is strongly recommended that all newborns receive an injection of vitamin K, which is needed for blood clotting. Adults get most of their vitamin K from their diet, but babies have very little vitamin K in their bodies at birth. With low levels of vitamin K, some babies can have very severe bleeding – sometimes into the brain, causing significant brain damage or even death. Bleeding can occur up to 12 weeks after birth.
A baby’s eyes are exposed to many bacteria that might be present in the birth canal. Eye ointment containing an antibiotic medication is placed in a newborn's eyes after birth. This medication is recommended to protect the baby from an unknown gonorrhea, chlamydia or other infection in the mother's body.
Hepatitis B Vaccine
Hepatitis B is a disease of the liver that is spread by contact with infected blood and body fluids. The hepatitis B vaccine, given to nearly all newborns after birth, prevents this disease. Additional doses are given before the age of 18 months. If newborns are exposed to hepatitis B before, during or after birth, both the vaccine and a special hepatitis B immune globulin dose are given within 12 hours of birth. The other two doses of the vaccine are also given before the age of 18 months.
Hearing loss is one of the most common birth defects. Only 50 percent of babies born with a hearing loss have an identified risk factor. Hearing loss affects education, language, reading, writing and speech. Intervention at or before six months of age allows a child with impaired hearing to develop normal speech and language.
The state of New Jersey requires that every newborn baby have a hearing test. This test will usually be done on the day of discharge or the day before. The audiology technician who performs the test will also ask about any family history of early childhood hearing loss and give you the results of the screening test.
Screening for Critical Congenital Heart Defects
New Jersey was one of the first states in the country to pass a law that all newborns need to be screened for critical congenital heart defects (CCHDs). A congenital heart defect is a problem with the way the heart formed in utero, or the way that the blood flows through the heart. The screening test uses a pulse oximeter to check the amount of oxygen in the baby’s blood. A small sensor with a light is placed on the baby’s hand and foot. Low oxygen in the baby’s blood can be a sign of a CCHD. If your baby’s screening test shows a low oxygen level, more tests will be needed to find the cause. This pulse oximeter test will detect many types of heart problems at birth. Not all heart problems can be identified this way, so it is important to bring your baby for regular check-ups with your pediatrician.
Screening for Bilirubin
Many newborn babies develop jaundice, which is caused by excess bilirubin in the blood. Jaundice causes the skin and whites of the eyes are yellowish in color within a few days after birth. The American Academy of Pediatrics recommends that all newborns be screened for excess bilirubin in the blood. In extreme cases, too much bilirubin in the blood (severe jaundice) of a newborn can lead to seizures and brain damage. Your baby will be checked using a device that measures the bilirubin level in the baby’s skin. Some babies will also need to have the level of bilirubin checked with a blood test and receive follow-up care for jaundice after discharge.
Screening for Errors of Metabolism
All states screen newborns for certain metabolic birth defects, which are chemical changes that take place within living cells. These conditions cannot be seen in the newborn, but can cause physical problems, mental retardation and, in some cases, death. The baby’s heel is pricked to obtain a few drops of blood for laboratory analysis. The results of the screening test do not establish a diagnosis, but serve to identify a subset of patients who warrant further testing. Additional testing is available; learn more about metabolic testing >
Fortunately, most babies receive a clean bill of health when tested. If test results show that the baby has a birth defect, early diagnosis and treatment can make the difference between lifelong disabilities and healthy development.
Other Blood Tests
Some babies will need additional blood tests to evaluate blood sugar levels, bilirubin levels, or blood cell counts. The baby’s heel is pricked to obtain a few drops of blood for laboratory analysis.
We use several methods to manage your baby’s pain when we have to perform a painful procedure such as a blood test. A baby can be held or swaddled during the procedure. We will sometimes give the baby a sugar solution which been shown to reduce pain in newborns undergoing painful procedures. We may also give the baby a pacifier for comfort with or without the sugar solution.
Pacifiers should only be used for pain management in the first three to four weeks of life until breastfeeding has been well established. After breastfeeding has been well established, offer your baby a pacifier at nap time and bedtime to decrease the risk of Sudden Infant Death Syndrome (SIDS).