newborn heel stick test

[SublimeBirthGirl]

I keep having students whose doctors are telling them babies no longer need to be on breastmilk for 48 hours for these tests to be accurate. Is there a new method for conducting the screening, and if so, how can I determine which of my local hospitals are actually using it?

[JunipersMom]

How could that be? I thought they tested metabolic disorders.. how can you tell if food is being metabolized correctly before they've ever eaten? Maybe I'm completely mis-understanding what they are looking for in the blood.

[MidwifeErika]

I am familiar with it being done after 24 hours. That is what is recommended here by the lab.

[sevenkids]

The new recommendations are 24 hours of protein feeds.

[AmieV]

They are NOT accurate after that short of a time, however, they recommend a follow up PKU at 1 or 2 weeks. A baby receiving cololstrum isn't really getting 24 hours of "protein feeds", no? Our old stupid ped was all over us about not doing a second PKU but I don't think he even understood why it would be necessary...it's completely because that first one in the hospital is worthless, whereas if you get your midwife to do it after your milk comes in, it's a much more accurate test.

[Midwife Kris]

Originally Posted by SublimeBirthGirl

I keep having students whose doctors are telling them babies no longer need to be on breastmilk for 48 hours for these tests to be accurate. Is there a new method for conducting the screening, and if so, how can I determine which of my local hospitals are actually using it?

State labs do the testing, hospitals, birth centers, and home birth practices simply collect the specimen and send it off to the lab. States that use "tandem mass spectrometry" do not require the baby have fed anything at all because of the technology's ability to pick up things it took food or chemicals as a reagent to highlight. Check with Georgia state health/newborn screening departments to find out what they do. Some places still do it the old school way and that requires food and digestion.

[sevenkids]

Originally Posted by AmieV

They are NOT accurate after that short of a time, however, they recommend a follow up PKU at 1 or 2 weeks. A baby receiving cololstrum isn't really getting 24 hours of "protein feeds", no?

Yes, they are indeed getting protein feeds, colostrum is 3 times higher in protein than mature milk, though significantly less water.

The previous recommendations were after 48 hours of feeds but have been updated since Feb 2007. The only reason a repeat would be necessary is if taken before 24 hours old, the specimin was inadequate or if positive, or if a sick baby in NICU transfusions, hyperalimentation or other treatments will be performed.

[Reha]

The woman who educates providers for the state lab here has also taught that the first screen finds about 90% of the babies with disorders, and the 2nd screen (done at 2 weeks here), picks up about 10% of them. (She also says that it is best to do the screen within 24 hours, as it leads to babies with disorders being found earlier).

[SublimeBirthGirl]

Thanks everyone!