What Is Newborn Screening And Why It Has To Be Done Within 24 Hours After Birth

As a soon-to-be mom, you surely have a million things going on in your mind, and one of those things should be about what is newborn screening. It is a blood test taken within 24 hours of birth to check if your baby has been born with a disorder. It becomes critical after almost 72 hours.

According to Dr. Rosanne Sugay, a pediatrician and internist, most of the disorders detected in newborns are initially chemical problems in the body that, at first, don't have physical manifestations.

For instance, most babies with the metabolic disorders included in the newborn screening look “normal” at birth. Hence, you may not know your baby has a condition unless he’s tested or, worse, until the condition has irreversibly affected her health.

The same goes with growth and mental retardation, brain damage, and death as some of the consequences newborn screening can avoid with early detection and, subsequently, early treatment and management.

Importance of newborn screening

The Department of Health (DOH) has its Newborn Screening Program to underscore the importance of the testing. It explains that newborn screening is an "essential public health strategy that enables the early detection and management of several congenital disorders." When left untreated these disorders may lead to mental retardation, or even death.

The DOH explainer further pointed out on the service that has been available in the Philippines since 1996: "Early diagnosis and initiation of treatment, along with appropriate long-term care help ensure normal growth and development of the affected individual. It has been an integral part of routine newborn care in most developed countries for five decades, either as a health directive or mandated by law."

Under Republic Act No. 9288 or the "Newborn Screening Act of 2004," newborn screening is made available for every Filipino infant. The DOH's program aims to have all Filipino newborns to be screened by the year 2030. That's why its implementors are set on stepping its efforts.

To date, they have grown from one to seven operational Newborn Screening Centers (NSCs). They have increased its 24 pilot hospitals to more than 7000 Newborn Screening Facilities (NSFs) in 2020. They have also expanded from one to 29 G6PD Confirmatory Centers, along with 14 continuity clinics for the long term management of patients.

Newborn screening options

Through the Newborn Screening Act of 2004, the National Institutes of Health, University of the Philippines created the Newborn Screening Reference Center (NSRC). It provides information on the options you can choose as the newborn screening guide.

Standard newborn screening

This covers tests for six disorders in infants:

• Congenital Hypothyroidism (CH)
• Congenital Adrenal Hyperplasia (CAH)
• Galactosemia (GAL)
• Phenylketonuri (PKU)
• Glucose-6 Phosphate Dehydrogenase Deficiency (G6PD)
• Maple Syrup Urine Disease

According to the medical experts, the possible effects of these six congenital disorders in a child are severe. For example, congenital hypothyroidism, a condition where the thyroid hormone is lacking or absent can cause growth and mental retardation if not detected and treated within two weeks of birth.

Meanwhile, galactosemia and phenylketonuria can cause liver and brain damage, whereas congenital adrenal hyperplasia and maple syrup urine disease can lead to death.

Experts point out of all the conditions in the newborn screening panel of disorders, G6PD is the most common with a prevalence of 1 in 56 babies. Infants with G6PD must not be exposed to toxic substances, and that early management is crucial.

Expanded newborn screening

This covers tests for 28 conditions including the six disorders in the standard newborn screening, such as:hemoglobinopathies, disorders of amino acid and organic acid metabolism, disorders of fatty acid oxidation, disorders of carbohydrate metabolism, disorders of biotin metabolism and cystic fibrosis.

Newborn Care Package

This is provided for free by Philhealth for infants of eligible members (either mother or father), whose mother gave birth at an accredited facility. The Newborn Care Package has been expanded since January 6, 2019. Its coverage has been increased to Php2,950 (from the original Php550 and then to Php1,750), in accordance to National Comprehensive Newborn Screening System.

Aside from the tests, which are the same in the standard and expanded newborn screening options, the enhanced Newborn Care Package provides supplies for essential newborn care, such as:

• Vitamin K
• Eye ointment
• Vaccines for Hepatitis B and BCG
• Newborn hearing screening test
• Fees of the attending healthcare professionals

As your due date nears, experts suggest to not only to learn more about what is newborn screening, but also where and how you will get it for your baby.