Pregnancy Week By Week

Most mothers would agree that within the first few minutes of holding their newborn child, she has counted their toes, counted their fingers, and checked "all" vital parts for any imperfections. This of course is not a scientific or even a medical exam, just a maternal instinct that sets a worried mom's mind at ease. Fortunately, with the exception of Wyoming and Maryland, state law's require hospitals to perform their own screening of newborns, thankfully, those that are mindful of disease and other medical problems. For the most part, state health departments decide which screenings will be done on newborns, some states test for up to 30 disorders and other states only test for three or four. The average state tests for 10 different disorders, other screenings may be available at additional costs to the parents. Most state's health departments offer literature available to parent's regarding both mandatory and optional screenings available for newborns.

Usually before your baby leaves the delivery room, he or she will be given an Apgar score. This acronym stands for Activity, Pulse, Grimace, Appearance, and Respiration. Each of the five components has a score of 0-2, 2 being best, 0 being the lowest. Babies that score an overall 7 or above are then deemed healthy. Well, at least for that first minute of life. Five minutes later, the screening is given again; in some cases if medical personnel feel it necessary, a third screening at ten minutes may be administered.

Most medical facilities prefer to perform the remainder of the screening when the newborn is at least 24 hours old. Because of the insurance dilemma concerning hospital stays, often times this is not possible. But for best results, the baby should be at least 24-36 hours old. A small sample of blood will be taken from your baby's heel. This sample will enable doctors to tell whether newborns have certain conditions that could eventually lead to life threatening circumstances.

The following is a list of tests that most state's currently screen newborns for; but as stated before, you would need to check your state's health department guidelines to confirm.

• PKU is a metabolic disorder that can be treated with diet changes.
• Hypothyroidism is a thyroid disorder that can be treated with hormone replacement medication.
• Galactosemia is a lack of an enzyme that breaks down sugars; this can be treated with diet and the elimination of milk and dairy products.
• Sickle cell disease is an inherited disorder that causes children and adults to be very prone to infections. Treatment involves antibiotics at birth, prior to the onset of infections.
• Biotinidase Deficiency is another enzyme deficiency disease where the body cannot process biotinidase, one of the B vitamins. Treatment involves giving the infant biotin.
• Congenital adrenal hyperplasia is a disorder that involves the lack of adrenal gland hormones. Treatment for this disorder involves hormone replacement medication.
• MSUD or maple syrup urine disease is an enzyme deficiency disease where the body cannot break down certain amino acids. Treatment involves a strict diet that eliminates high-protein foods that contain these amino acids.
• Homocystinuria is a metabolic disorder. Treatment involves diet changes and vitamin supplements.
• Tyrosinemia is a disorder that involves the lack of the ability to break down the amino acid tyrosine. Often times a special diet or a liver transplant is needed to treat this disorder.
• Cystic fibrosis is an inherited disorder that causes the body's organs to produce thick mucus, which can lead to respiratory disease. At present time, there is no cure. However, early detection of this disorder can improve an infant's life. Often times diet and antibiotics can decrease infection.

There are several other disorders that can be detected at birth, but most are optional screenings that are only preformed when the parent's request them. For example, if you or your family has experienced certain inherited disorders, you may ask the doctor if there is a test available that your newborn can be given. If you or your spouse suspect that the child may have any disorder for example AIDS; you will need to inform your physician.

Many states have implemented the use of mass spectrometry screening or MS/MS. This test can detect over 30 different disorders simultaneously. Further studies are underway regarding the use of DNA-based technology. Collecting samples of a newborn's DNA may offer the possibility of screening for even more disorders. However, at this time the research is problematic.

Some states require that a newborn's hearing be tested prior to leaving the hospital. Although, not all states require this, pediatricians do recommend getting an infant's hearing tested before the age of 3 months. Early diagnosis of hearing loss will improve your child's chances of getting the help they need.

These screenings have saved lives, they have gave the medical field the ability to treat disorders prior to the onset of symptoms; and best of all, they have put the minds of mother's at ease.

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