In this section
The Antenatal and Newborn Screening Team work across the Managed Clinical service and are based at St Mary’s hospital, Oxford Road Site, St Mary’s at Wythenshawe and North Manchester General Hospital.
This short animation shows the screening tests offered during pregnancy and after your baby has been born.
You can also read about the screening tests in more detail in the Screening test for you and your Baby leaflet.
The information is available in 12 other languages: Arabic, Bengali, Chinese, French, Latvian, Lithuanian, Polish, Portuguese, Punjabi, Romanian, Somali and Urdu and Easy read versions of this leaflet are available.
What screening tests will I be offered after my baby is born?
New-born Physical Examination (eyes, heart, hips and testes)
This examination is recommended by the NHS, but like all screening tests it is optional. You can decide to have your baby examined and screened for any, all, or none of the conditions.
This short video explains screening for eyes, heart, hips and testes in new-born babies.
This examination will take place in hospital or at home.
The screening tests will be carried out again between 6 and 8 weeks of age at your GP as some conditions do not develop or become apparent until then.
Each part of the new-born physical examination is looking for different conditions.
Eyes
About 2 or 3 in 10,000 babies have problems with their eyes that need treatment. The examination checks the appearance and movement of the eyes. The main reason for screening is to identify a condition called cataracts (a clouding of the transparent lens inside the eye). The examination cannot tell how well your baby can see.
Heart
There is a general examination of your baby’s heart and sometimes murmurs are picked up. A murmur is a noise made by the blood as it passes through the heart. In almost all cases when a murmur is heard, the heart is normal. Murmurs are common in babies and this does not always mean there is a problem. However, around 1 in 200 babies have a heart problem that needs treatment.
Hips
Babies can be born with hip joints that are not formed properly and if untreated this can lead to a limp and to joint problems. About 1 or 2 in 1,000 babies have hip problems that need treatment.
Testes
Baby boys are checked to make sure their testes are in the right place. It can take several months for testes to descend into the scrotum. About 1 in 100 baby boys have problems with undescended testes that need treatment to reduce the risk of problems later in life, such as reduced fertility.
The health professional carrying out the examination will give you the results straight away. Usually there will be nothing of concern found. If the health professional finds a possible problem, they will discuss this with you at the time of the examination and your baby will be referred for further assessment and tests if appropriate.
Blood Spot Screening
The blood spot screening test is recommended by the NHS, because it could save your baby’s life but like all screening tests it is optional.
This short video explains blood spot screening in newborn babies.
You can choose to have your baby screened for sickle cell disease, cystic fibrosis or congenital hypothyroidism individually. Screening for the six inherited metabolic diseases must be done as a group of all six diseases or none at all. If you do not want your baby screened for any of the conditions or have any concerns about the test, please talk to your midwife.
This examination will take place in hospital or at home.
Early screening is best as treatment can be started as soon as possible if needed. But if you choose not to have screening, your baby can have the test later if you change your mind. Babies can be screened up to 12 months of age for all the conditions except cystic fybrosis (only up to 8 weeks of age).
Early treatment can improve your baby’s health and prevent severe disability or even death. If you, the baby’s father, or a family member already has one of these conditions, please tell your health professional straight away as your baby may need to be screened earlier, even as soon as within 24 hours of birth.
About these conditions
Sickle cell disease
About 1 in 2,800 babies born in the UK has a sickle cell disease (SCD). These are serious, inherited blood diseases. They affect haemoglobin, a part of the blood that carries oxygen around the body. Babies who have SCD will need specialist care throughout their lives.
People with SCD can have attacks of severe pain, get serious, life-threatening infections and are usually anaemic (their bodies have difficulty carrying oxygen). Babies with SCD can receive early treatment, including vaccinations and antibiotics, which, along with support from their parents, will help prevent serious illness and allow them to live a healthier life.
Cystic fibrosis
About 1 in 2,500 babies born in the UK has cystic fibrosis (CF). This inherited condition affects the digestion and lungs. Babies with CF may not gain weight well and frequently have chest infections. Babies with CF can be treated early with a high-energy diet, medicines and physiotherapy. Although children with CF may still become very ill, early treatment can help them live longer, healthier lives.
Congenital hypothyroidism
About 1 in 2,000 babies born in the UK has congenital hypothyroidism (CHT). Babies with CHT do not have enough of the hormone thyroxine. Without thyroxine babies do not grow properly and they can develop permanent serious physical problems and learning disabilities.
Babies with CHT can be treated early with thyroxine tablets and this will allow them to develop normally.
Inherited metabolic diseases
It is important to let your health professional know if you have a family history of a metabolic condition as your baby may need to be screened earlier, even as soon as within 24 hours of birth. Babies are screened for 6 inherited metabolic diseases (IMDs).
These are:
- phenylketonuria (PKU)
- medium-chain acyl-CoA dehydrogenase deficiency (MCADD)
- maple syrup urine disease (MSUD)
- isovaleric acidaemia (IVA)
- glutaric aciduria type 1 (GA1)
- homocystinuria (pyridoxine unresponsive) (HCU)
About 1 in 10,000 babies born in the UK has PKU or MCADD. The other conditions are rarer, occurring in 1 in 150,000 babies to 1 in 300,000 babies.
Babies with these inherited conditions cannot process certain substances in their food. Without treatment babies with some of these conditions can become suddenly and seriously ill. The symptoms of the conditions are different; some may be life threatening or lead to severe developmental problems.
They can all be treated by a carefully managed diet, which is different for each condition and may include additional medicines.
Results
Most babies will have normal results indicating that it is unlikely that they have any of the conditions. A small number of babies will screen positive for one of the conditions. This does not mean they have the condition but they are more likely to have it. They will be referred to a specialist for further tests.
Screening for cystic fibrosis finds some babies who may be genetic carriers of the condition. These babies may need further testing. Screening does not detect all carriers.
Occasionally, other medical conditions might be identified through these screening tests. For example, babies with beta thalassaemia major (a serious blood disease) will usually be detected. These children also need to be referred for lifelong treatment and care.
Screening for sickle cell disease also finds babies who are genetic carriers of these or other red blood cell diseases. Carriers are healthy although they can experience some problems in situations where their bodies might not get enough oxygen, for example, if they are having an anaesthetic.
You should receive the results from a health professional by the time your baby is 6 weeks old. The results should be recorded in your baby’s personal child health record (‘red book’). Please keep this safe and bring it with you to any further appointments. You will be contacted sooner if there is thought to be any problem with your baby.
Hearing Screening
Finding hearing loss early is important for your baby’s development.
This short video explains screening for hearing loss in new-born babies.
1-2 babies in every 1,000 are born with a permanent hearing loss in one or both ears. Most of these babies are born into families with no history of hearing loss.
Permanent hearing loss can significantly affect a baby’s development. Finding out early can give these babies a better chance of developing speech and language skills. It will help babies make the most of relationships with their family and carers from an early age.
The hearing screening test will be offered to you in hospital before discharge, or when you are at home, or you will be invited to attend a clinic appointment. In some areas, screening will be done by the health visitor within the first few weeks. Ideally, the test should be done in the first 4 to 5 weeks, but it can be done at up to 3 months of age.
The test called the AOAE (automated otoacoustic emission) test takes a few minutes. A small soft tipped earpiece is placed in your baby’s ear and soft clicking sounds are played. When an ear receives sound, the inner part (called the cochlea) responds and this can be picked up by the screening equipment.
It is not always possible to get clear responses from the first test. This does not necessarily mean your baby has a hearing loss. It can mean:
- your baby was unsettled when the test was done
- there was background noise
- your baby has fluid or a temporary blockage in their ear – this is very common and passes with time
- your baby has a hearing loss
In these cases your baby will be offered another test. This may be the same as the first test, or another type called the AABR (automated auditory brainstem response) test. This involves 3 small sensors being placed on your baby’s head and neck. Soft headphones are placed over your baby’s ears and soft clicking sounds are played. This test takes between 5 and 15 minutes.
If you decide not to have the new-born hearing screening test you will be given checklists to help you check on your baby’s hearing as they grow older. If you have any concerns you should speak to your health visitor or GP.
Results
You will be given your baby’s results as soon as the hearing test is done.
If your baby has a clear response in both ears then they are unlikely to have a permanent hearing loss. However, new-born hearing screening does not pick up all types of hearing loss and children can develop hearing loss later on. It is important to check your child’s hearing as they grow up. The checklist in your baby’s personal child health record (‘red book’) tells you how to do this.
If the screening test results do not show a clear response from one or both of your baby’s ears an appointment will be made with audiology to see a hearing specialist.
About 2 to 3 babies in every 100 do not show a clear response on the screening tests. Being sent for further tests does not necessarily mean your baby has a hearing loss.
A hearing specialist should see you within 4 weeks of having your baby’s hearing screening test. It is very important that you attend the appointment in case your baby has a hearing loss.