NBS or newborn screening as it is sometimes referred is done to check for genetic, metabolic and blood abnormalities. It is not that prevalent in India. I will talk about this later, first let me talk about the examination performed at birth.
Newborn Examination
The first examination of the baby happens in the delivery room just after delivery. This examination helps in determining the well-being and health of the newborn. However, the mother in the delivery room may not be aware of this examination because it is generally done away from her visibility.
1. The first thing that is done immediately after the baby is born is to clear the newborn’s airways by suctioning.
2. Umbilical cord is first clamped and cut. Then antibiotic is applied to the cord stump. The clamp is usually left on for the first 24 to 48 hours. You will see the clamp when the baby is given to you for feeding.
3. The doctor then checks the placenta. This is done to make sure that it is complete and is proper.
4. Now the doctor does an Apgar’s Test. This is the first main test that is done at 1 minute and repeated 5 minutes after birth. (You can find complete details on Apgar’s Test by clicking here).
5. Body parts are checked. This evaluation is done to look for signs of abnormality that may be visible. At this time, the fingers and toes are also counted.
6. Eyedrops or antibiotic ointment is administered. This is done to prevent infection as the eyes may have been exposed during delivery. It may also be given as prevention for gonococcal or Chlamydia infection.
7. Check for passage of urine and stool. This is observed in a baby to check internal organs and how the elimination process is behaving. This observation may be done for 24-48 hours and the doctor may also advise you to keep track (count) of urine and stool for the first few days.
8. Vitamin K injection may be administered to enhance clotting property of the blood.
9. Baby is weighed. The average weight of babies born is around 3.4 kg. However, more than 94% of the babies are born between 2.5 kg and 4 kg.
10. Baby’s length is measured. The average length of a newborn baby is 50 cm. However, more than 95% of the babies are between 44 cm and 54 cm.
11. Head circumference is measured. The average is 35 cm. However, the normal range is 30 cm to 38 cm.
Also of note is that before your baby is shifted from delivery room, an ID band may be placed on your baby. Footprints of the baby may be taken for identification. The ink used for taking the footprint may also be washed and removed although there may be some smudges that may remain but these are temporary and will go away on their own in a few hours. This practice of placing ID band, taking footprint, etc., is not followed at all clinics. However, the big ones like Artemis Health Institute, Gurgaon, do follow them.
Newborn screening (NBS)
The screening is done by obtaining blood from infant's heel, to be screened for: (a) Phenylketonuria (PKU) and hypothyroidism; (b) from the umbilical cord for the Coombs test, to screen for antibodies that would indicate RH sensitization has occurred; (c) for any other necessary metabolic screening tests (for low blood sugar, bilirubin for jaundice); (d) other tests as applicable like sickle cell screening. These tests are more prevalent abroad than in India. In India, some tests are done but a comprehensive panel is not done; however, the trend is picking up as more parents are now aware and they are opting to do a newborn screening to detect the disorders early and take proper action before the condition aggravates.
