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Newborn screening testing in Washington

For most parents, the newborn period is a time of profound joy, incredible challenges, and LOTS of questions.  As pediatricians, some of the questions we are frequently asked are related to a simple blood test done on all infants in Washington State.  Commonly referred to as the “newborn screen” or “NBS”, “PKU”, or “newborn metabolic testing”, this test checks for several congenital disorders that are rare but can be life-threatening. 

Often parents want to know:

  • What does the test involve? The newborn screen is done by pricking the heel of the infant at around 24 hours of age, then collecting a few drops of blood onto a piece of test paper.  This is dried and then sent to the state lab, where the testing is performed.  Because some of the conditions may take several days to show up, the test is repeated at 7-14 days old (usually by your primary care doctor; it can also be done in the hospital if the baby is still there for any reason).

  • Does it hurt? The needle prick is performed by trained nurses and is done quickly.  It may feel similar to pricking your finger to test blood sugar.  And you can significantly decrease the discomfort of the quick poke by breastfeeding your baby during or immediately after the test!

  • Why do we need this? The diseases we check for are typically rare, but if undiagnosed and untreated can cause a variety of complications, including blindness, poor growth, brain damage, and even death.  The reason that testing every baby is essential is that babies with these conditions can look and act perfectly healthy even while the disease is damaging their bodies, until they get so sick they need to be hospitalized or have permanent damage.  Starting treatment as early as possible can prevent many of the complications.

  • What are you testing for? The ...

Reducing fear for kids who need blood tests or shots

Imagine the following scenario:  for several weeks, your daughter has been complaining of a tummy ache.  You find yourself sitting in her doctor’s office hoping to uncover what’s wrong.  Your daughter is nervous, but you’re doing your best to assure her that the doctor will come in soon, ask a few questions and make the pain go away. 
 
Just as the visit comes to a close, the doctor mentions that he’d like to “run some tests”.  Immediately, the looks on your daughter’s face changes, and you know she’s scared.   Tears well-up in her eyes as she whispers in your ear, “What tests, mommy?  What does he mean….Are they going to poke me?”  Whispers soon escalate into screams, “How big is the needle?  Does this mean I’m getting shots? NO!  No shots! Please mommy, no shots!”
 
Being a phlebotomist, this is a common scenario that I know all too well.  Since I came to work at the Swedish Pediatric Specialty Care clinic almost 2 years ago, I’ve made it my personal challenge to make a child’s phlebotomy experience as smooth and pleasant as possible.  The entire team here is committed to show children that doctor visits can be fun.  Even though part of the medical experience may include having blood drawn, it doesn’t have to be painful or scary. 
 
Some of the tools I use to make children feel less nervous include ...

Parent's guide to newborn testing, screening, and prevention measures

When picturing the first days of an infant’s life, what we look forward to the most is love. We express our love in so many ways: skin-to-skin, breastfeeding, swaddling and snuggling. 
 
Love also means keeping them safe. 
 
Advances in maternal-infant health are one of the greatest success stories of the 20th century, with a drop in the death rate of 99%. But some of those dangers only stay in the past through constant vigilance. Behind every screening test and preventive measure is a careful, research-driven rationale. Here are seven newborn tests, screenings, and prevention measures you should know about:
 
Vitamin K injection 
Vitamin K is vital for blood to clot properly. Newborns cannot make Vitamin K and it is poorly transferred in breast milk. Without this injection, babies are at risk for spontaneous bleeding from the umbilical cord, mucus membranes, even in the brain. Giving Vitamin K has greatly reduced this "hemorrhagic disease of the newborn," but rates are increasing as more parents refuse it. Oral Vitamin K has not been shown to prevent this potentially devastating disease. 
 
Hepatitis B vaccine
This is an anti-cancer vaccine. Before this vaccine existed, approximately 10,000 kids under age 10 contracted hepatitis B each year. Most had no known exposure to it. Kids are more likely than adults to get very sick and to have complications. Vaccination at birth has greatly reduced rates of pediatric liver cancer due to hepatitis B. 
 
Antibiotic eye ointment
This prevents bacterial eye infections. Some of these infections are associated with sexually transmitted bacteria, but not all of them are. Negative testing or a monogamous relationship does not ...

What you should know about Hepatitis B or C on World Hepatitis Day

Break out the champagne and streamers—it’s World Hepatitis Day! Okay, so it might not sound like much of party, but if you are one of the millions of people with viral Hepatitis there is no reason to be a wallflower.

Over 500 million people around the world are infected with either Hepatitis B or C, the two most common forms of chronic viral Hepatitis. Both Hepatitis B and C are viruses that can cause chronic inflammation in the liver. Over the course of years this can lead to scarring in the liver and ultimately cirrhosis—severe scarring and fibrosis of the liver where liver function can be comprised. Additionally, these chronic viruses, particularly Hepatitis B, can increase the risk of developing a primary cancer of the liver called hepatocellular cancer. The liver, unlike, say, the appendix, is a vital organ that—among other functions—stores and helps process nutrients, detoxifies and filters blood, and produces blood coagulants. In short, the liver is vital to life and a failing liver absent a liver transplant means trouble.

The best first step to combating these viruses is awareness. It is important to know the risk factors for these viruses and get tested if you are at risk. Hepatitis B and C differ somewhat in risk factors and transmission. With an estimated 350 million people worldwide who are carriers (most commonly in Asia and Africa), chronic Hepatitis B is the most common chronic virus of the liver. It is most often transmitted by birth or through blood-borne or sexual contact. Hepatitis B is not transmitted through ....

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