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Newborn Screening Prenatal Curriculum

This curriculum, developed in conjunction with our Newborn Screening Guide for Prenatal Educators, outlines ten goals for prenatal educators when teaching expectant parents about newborn screening.

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Goal 1: Explain why newborn screening is important
Goal 2: How newborn screening is performed
Goal 3: The newborn screening test results
Goal 4: Follow-up to newborn screening
Goal 5: A false-positive result
Goal 6: A positive result
Goal 7: Cost of testing
Goal 8: Special considerations
Goal 9: New England’s state newborn screening programs
Goal 10: Questions about disorders

Goal 1: Why is universal newborn screening important?

Objectives: Describe basic benefits of newborn screening for parents and infants.

Disorders are rare and can be detected.
Babies with disorders may look healthy at birth, and the symptoms may not present themselves until outcomes have happened.
Early detection and treatment can prevent serious health problems, such as mental retardation, physical disability or even death.

Goal 2: How is newborn screening performed?

Objectives: Describe the details of how the blood sample is taken

A small heel prick is used to take blood from the baby. It is not painful. This blood sample is then transferred onto a card that will be read by a device called the Tandem Mass Spectrometer.
A small bandage will be placed on the baby’s heel.
The sample is usually taken 24 to 48 hours after birth.

Goal 3: How will the parents receive the newborn screening results?

Objectives: Describe the process that the New England Newborn Screening program uses for giving the results.

After the lab runs the tests, a lab representative will contact the baby’s pediatrician and give them the results. The pediatrician will then inform the family of the newborn screening test results.
Some doctors do not inform parents of the results if follow-up is not needed.
Parent’s may ask for their results if they are not contacted by their doctor.

Goal 4: What should parents do if their baby needs follow-up to newborn screening?

Objectives: Describe the importance and possibility of timely follow-up if needed.

If needed the pediatrician will inform parents of three possible actions for
follow-up:
- The need to be re-screened
- An immediate referral to a metabolic clinic
- An emergency room visit
If a baby needs to be rescreened, the abnormal results are often due to:
- Premature birth
- A blood sample taken incorrectly
- A transient finding

Goal 5: What about false-positive newborn screening results?

Objectives: Describe the likelihood of a false-positive test results and alleviate parental anxiety when follow-up to newborn screening is needed.

The majority of repeat tests do not indicate a metabolic disorder.
It is important to stress the importance of timely follow-up but explain that re-testing is common with newborn screening.

Goal 6: What about positive newborn screening results?

Objectives: Describe that a positive newborn screening result still does not mean that an infant has a metabolic disorder.

If screening indicates a true positive result the family is referred to a metabolic specialist.
The specialist will do additional laboratory and/or genetic tests to confirm the diagnosis.
Through their clinic infants and families will then receive treatment and a care plan to help prevent the consequences of an untreated metabolic disorder.

Goal 7: How much does newborn screening cost for parents?

Objectives: Describe that newborn screening and follow-up screening are at no cost to parents.

Goal 8: Are there any special considerations to newborn screening?

Objectives: Describe the special circumstances that can affect newborn screening results and what actions should be taken.

If a blood transfusion is needed, the nurse will wait at least 24 hours to take the blood sample. Additional samples may need to be taken for these infants.
Premature or sick infants will receive newborn screening just before they leave the hospital or at 4 to 6 weeks after birth. This increases the accuracy of the testing and ensures that a delayed release of hormones has affected their metabolism.

Goal 9: New England’s state newborn screening programs

Objectives: Describe the New England area’s screening program methods of testing.

The American College of Medical Genetics recommends 29 for expanded newborn screening and every state in New England offers screening for all of these.
Some states only mandate some of the tests while others require all 29. Know your states regulations and inform your class of their choices for newborn screening.
Newborn screening can be refused for reasons of religion in all states in New England.

Goal 10: Questions about disorders

Objectives: Describe that you can answer disorder specific questions about the 29 metabolic disorders included in the panel for screening.