Less painful way for PKU testing?

[amberskyfire]

Not sure if the test varies by location, but I live in Hawaii.

I plan to have baby tested for PKU at the pediatrician at about 1-2 weeks pp. Is there a less painful place to prick than the heel or is the heel  necessary for some reason? I just know that it hurts like heck to get poked in my heel and it's sore for days afterward. Getting pricked in my pinkie finger is painless, however. Is there a less painful place to prick where baby won't notice it? Our pediatrician is super sweet and would do anything I asked, so I don't have to worry about him thinking I'm crazy if I ask him to.

[IdentityCrisisMama]

That's a good question.  I don't know anything about other places to get blood but I do have a few suggestions based on our experience.  I got the PKU from the midwife and then again from the pediatrician.  I wish I had just waited for the Dr.  It sounds like you already know that.  :-)  

The nurse who did the PKU was really sweet.  She put warm water in a glove and we held that on the baby's heel for a long time, which is supposed to help.  The nurse gave me the options before she started - said she could prick the heel and then prick again if she needed more blood OR she could prick and then nick with a small blade.  She needed to get more blood from my DC and I just deferred to her on what to do (I could tell she really hated causing my baby pain and trusted her choice).  She did the prick and nick and I think that was a good call.  

[Mom2M]

We did the heel prick testing and it really didn't seem to bother them at all. They had us hold a warm pack on for a long time, DD was sleeping while we did it and she opened her eyes when the nurse pricked it but didn't even cry.

[Caracol8]

It seems that, although the poke does hurt, the "milking" (grip and pull) of the heel is what really agitates the baby, because it can take a long time to get enough blood on those stupid paper circles.  My midwife warmed his heel with a warm washcloth (brings more blood to the area) and poked his heel twice in a row to get a good supply/stream going so that she wouldn't have to milk so hard and for so long.  AND I was breastfeeding him at the time so he cried out when he got pricked and then went back to feeding fiercely for comfort.

[slimkins]

I'm thinking your heel is probably sore for days because you walk on it. Your baby won't have hat problem. :)

Not sure why the heel is the chosen part. Maybe a question for your ped?

And I like the PP's suggestion about two pokes and minimal milking. Luckily, my son didn't really react to either. But the milking did take forever. :(

[WaitingForKiddos]

As far as location...finger tips and feet seem to be the more painful. But if they did it on the arm/leg how would they milk it to keep the blood going?

Our nurse did it very gently. First she put a sposie with a hot pack in it around his foot. Then he laid for a long time with his foot being the lowest point of his body. She did one stick, which made DS fuss but then she cooed to him and put my hands on him and he closed his eyes back up. She was gentle with the milking and didn't press anywhere near the wound. The last couple of drops were when she was finally seemingly needing to work the foot more, which didn't seem to bother DS as he was used to getting his foot messed with. I think having not having had vit K made it easier than how some friends of mine described it. 

No idea how we'll be doing it this time around. If at all. I have a feeling our Pedi office will be rough and I'm not interested in that

[katelove]

I wouldn't recommend using the fingers on an infant. It's ok for an adult or older child but an infants subcutaneous tissue isn't really thick enough and you would risk piercing the bone. The  outer edges of the heel are chosen because there is minimal risk of damage to underlying structures.

I agree with the PPs who suggested that we find heel sticks painful because we then have to walk on them. It may also be a bit individual. I find fingerprick testing *very* unpleasant.

[doulawoman]

I have heard there is a new test done with urine for PKU...sounds crazy but if you know anything about EC, it's pretty easy to catch a pee for this and send to a lab. Not sure where or mroe details, my midwife is looking into it for me.

[amberskyfire]

Yep, we do EC, but we don't get new things here very often. I live on an island that's pretty isolated. Still, it's worth asking about!

[doulawoman]

i'm in canada lol, but I think you do have to send it to a lab...look into it anyway.

[krjt]

Don't know if it's too late for this, but I had my first baby in Sweden.  There, they try the scalp first, and if that doesn't work (it didn't for my son) then they do the back of the wrist/hand.  They don't do the heel because of the pain, and my son didn't seem bothered by the prick at all (he was nursing the whole time).  I asked my current midwives here if they would do that, and they thought they needed more blood than a wrist prick would provide.  I still need to email my Swedish midwife and ask her about the quantity produced, but I imagine there has to be a way for it to be enough.  Hope that helps!

[Lisoula]

Originally Posted by slimkins 

Not sure why the heel is the chosen part. Maybe a question for your ped?

They use the heel because the capillary bed is biggest there in infants, therefore more blood flow.  We use heel-warmers where I work, which are WONDERFUL!  If the infant is in the crib at the time of the stick, and not on the breast, I elevate the head of the crib so that gravity assists in blood flow to the baby's foot, too.