Mothering Forum banner
1 - 20 of 20 Posts

·
Registered
Joined
·
1,595 Posts
Discussion Starter · #1 ·
So I'm ordering my birth kit and I was wondering which lancet to get... Here are my options...

Tenderfoot, 1mm depth 2.5 width
Neat Nick, 1 or 2 mm depth (suppose to be a clean cut so it doesn't cause as much pain and heals quicker)
Nicky
BD Quickheel, 1mm 2.5 width

Any suggestions? This is for the PKU test that's required by my state... No exemptions yet.
:

TIA!!
 

·
Registered
Joined
·
248 Posts
I didn't know you could do the PKU yourself! That's good to know...

From one NE momma to another...good luck with your home birth!!!!
 

·
Registered
Joined
·
1,595 Posts
Discussion Starter · #3 ·
Oh, well I don't know if you can do it yourself? I'm just buying the lancet to bring to the Dr.'s office so because I don't want another awful experience like what I had w/dd. But it's worth looking into... I know other states you can do it yourself. I don't know if I'd trust myself to do it though.


Good to see someone else from NE!!! Where abouts are you at?
 

·
Registered
Joined
·
4,005 Posts
my midwives always used the Tenderfoot ones, and they worked fine.

Just fill a sposie with hot water and hold it to their foot first, and lay baby over your shoulder, or wet a rag and do the same.

works like a charm
 

·
Registered
Joined
·
1,707 Posts
Quote:

Originally Posted by bamamom View Post
my midwives always used the Tenderfoot ones, and they worked fine.

Just fill a sposie with hot water and hold it to their foot first, and lay baby over your shoulder, or wet a rag and do the same.

works like a charm


ITA!! Gotta warm that foot first, it makes a world of difference. The warm disposable diaper secured to the food for about 20 minutes will make the blood flow fast and make it totally painless except for the quick little prick. My son startled at the click of the prick thingy, and then slept through the whole thing!
 

·
Registered
Joined
·
3,282 Posts
I worked as a phlebotomist and I believe that although the pin prick hurts for a minute, the baby is not in terrible agony, if you squeeze correctly. I think that they get upset over being uncovered, mainly.

Make sure that foot is very warm. It will help the blood flow easily and you can get the test over and done with quickly.
 

·
Registered
Joined
·
4,368 Posts
I believe I've been using the Neat Nick or the Tenderfoot (whichever one is cheaper). NBS used to be my NEMESIS. I hated it and could never get enough blood w/o multiple pricks, which caused much trauma to mom (not so much to baby, though, really!). At the reccomedation of someone from a birth supply company, I switched. I still have two lancets in my birth kits, but I have not had to use the second one, EVER. I'm about to change the birth kit.

(FYI: I warm the foot with a baby rice sock first, and prick the tip of the big toe, not the heel--i'm sure someone will flame me for that, but it's how I was taught and it's all that I've found works)
 

·
Registered
Joined
·
2,845 Posts
Tenderfoot, warm with moist warm heat, hold the foot dependently (below the body), let baby nurse or suck on mama's finger during stick, NO SQUEEZING, just be patient the drop will come. If you squeeze, you actually do more tissue damage and cause faster clotting. If you just wait, the drop will form. Sometimes I had to wipe the area with a washcloth once after getting one or two drops, but I rarely (and I mean rarely) had to ever stick twice.

I used to be the worlds worst PKU collector right when I started; I learned in school and clinicals to poke and squeeze aggressively. I hated collecting PKUs! Then I was complaining to a nursery nurse, and she told me how to do it correctly. Since then, most of the babies sleep or nurse through it, and rarely do they even flinch, much less cry.

Another thing, though--it's not the end of the world if you don't get a good specimen. I don't stick twice usually--if it's not flowing, it's not flowing, and there is no sense in me poking again. I just wait until the next check up (usually at 2 weeks pp) to restick. By then, it's very easy to get the sample. It's not often I have to do that, but it's just nice to keep in the back of your mind, oh, no need to freak about this. If I don't get enough, or if baby is unhappy, or mama is freaking out (I've delayed more PKUs for this than anything else, I think), then there is NO harm in waiting a while, and probably MORE harm in forging ahead at full steam, know what I mean?
 

·
Registered
Joined
·
1,185 Posts
--it's not the end of the world if you don't get a good specimen. I don't stick twice usually--if it's not flowing, it's not flowing, and there is no sense in me poking again. I just wait until the next check up (usually at 2 weeks pp) to restick. QUOTE]

I don't know, I've seen too many "indeterminte" results from inadequate specimens to send off incomplete specimens. My feeling is, if parents want to do the screen because they want to be sure baby does not have one of these disorders, and we are going to poke the baby, well, we might as well do what we can to get a complete specimen.
 

·
Registered
Joined
·
2,845 Posts
Maybe it depends upon the state testing facilities and procedures. In Kansas, if something is abnormal, the first thing you do is retest, though sometimes they will want a blood draw instead of a capillary sample. Maybe the recommendations are different elsewhere--our state only tests for four or five diseases.
 

·
Registered
Joined
·
248 Posts
Quote:

Originally Posted by huskermommy View Post
Oh, well I don't know if you can do it yourself? I'm just buying the lancet to bring to the Dr.'s office so because I don't want another awful experience like what I had w/dd. But it's worth looking into... I know other states you can do it yourself. I don't know if I'd trust myself to do it though.


Good to see someone else from NE!!! Where abouts are you at?
I'm in Sidney...other end of the state!
 

·
Registered
Joined
·
1,595 Posts
Discussion Starter · #13 ·
Quote:
Orginally Posted by homebirthbaby
I'm in Sidney...other end of the state!
Oh wow! ALL the way over there! I just moved to a small town and am trying to get use to it. It's not horrible though!

I think I will definitely go w/the Tenderfoot. Could I just use a heel warmer? I wouldn't even be doing this PKU test if it wasn't state mandated. Here it has to be done within 1 week pp.:p I'm just hoping for a better experience this time... I will tell them NOT to squeeze!!! I HATED that on DD.

Thanks for all the great replies! I really appreciate it!
 

·
Registered
Joined
·
1,185 Posts
The states I've practiced in both use the Oregon lab for NB screening. They do the broad spectrum of tests available now, but I've seen "indeterminate" for CH and other conditions when less than all the circles are completed, or they are spotty. So after I started seeing those it really didn't make sense to not poke baby a second time because of the potential delay in treatment that could arise from the time lapse. On the otherhand, we weren't using the tenderfoot, and some of the other doozies they have now. We were using the small square shaped lancets, the ones they don't make anymore.
 

·
Registered
Joined
·
500 Posts
Quote:

Originally Posted by huskermommy View Post
So I'm ordering my birth kit and I was wondering which lancet to get... Here are my options...

Tenderfoot, 1mm depth 2.5 width
Neat Nick, 1 or 2 mm depth (suppose to be a clean cut so it doesn't cause as much pain and heals quicker)
Nicky
BD Quickheel, 1mm 2.5 width

Any suggestions? This is for the PKU test that's required by my state... No exemptions yet.
:

TIA!!
Well, I do have two daughters who have PKU and when they were babies the Tenderfoot was the one that I preferred and so did my husband (he used to be a phlebotomist but is now a medical technologist and in both situations this is the one he prefers). Remember to make sure the foot is very warm before you start and if you can get the foot lower than the rest of the body even better. I know when we used to do out girls (they are now 15 and 8 yrs old so we have to use their fingers), but when they were babies I would hold them and nurse them while dh held their foot low, warmed it and poked it.

As for the excemptions for the newborn screening I know it seems like a hassle but truthfully if they find something it is a lifesaver. I have had so many people say "well no one in my family has it" or "I am not at a high risk for it", etc and truthfully no one in my family had it, some would say that we are low on the level of carriers since dh is of asian decent, etc. It is a small test that can make a world of difference if something is picked up.

It is also important to know that many states test for so many more disorders than just PKU (I know my state tests for over 30 disorders!)
 

·
Registered
Joined
·
2,237 Posts
We use the Tenderfoot as it makes a nice slit, rather than a puncture, that heals well, and it bleeds well enough. I rarely have to poke twice. THey are expensive (nearly $5 CAN each for us) but worth it compared to other brands, IMHO.
 

·
Registered
Joined
·
9,295 Posts
Quote:
I don't know, I've seen too many "indeterminte" results from inadequate specimens to send off incomplete specimens. My feeling is, if parents want to do the screen because they want to be sure baby does not have one of these disorders, and we are going to poke the baby, well, we might as well do what we can to get a complete specimen.
i might get flamed for this, but your not going to get an accurate result at a few days old anyway, the one at 2weeks pp will be the most accurate. If they truly have PKU you wont know until they start fully digesting MILK and that wont come into play with a bf infant until 2-5days after birth.
 

·
Registered
Joined
·
1,185 Posts
Quote:

Originally Posted by romans_mum View Post
i might get flamed for this, but your not going to get an accurate result at a few days old anyway, the one at 2weeks pp will be the most accurate. If they truly have PKU you wont know until they start fully digesting MILK and that wont come into play with a bf infant until 2-5days after birth..
Well I kindly disagree. Around here, if we waited to screen babies here until 2 weeks postpartum some babies would become very sick-- babies that could have been treated earlier. A handful of disorders can be detected at 24 hours.

PKU can absolutely be detected on a 24 hour hour screen, I've seen it first hand. Screening does not require 24 hours of digesting milk proteins on the part of the newborn, (at least through the labs offering expanded screening).

Many states are now doing the expanded screening, not just the big five most commonly screened for. In fact, they bumped up the recommendation for the first screen, now optimally collected as close to 24 hours pp as possible.

My my own research and the research of my peers (on the old panel of fove tests) leads me to believe that if you are only going to do one screen, day 4 is optimal. If you wait longer treatments will be delayed for conditions that could have been detected.

Having said all this, of course I offer my clients informed choice. Most of them elect to do one screen and I support that.
 

·
Registered
Joined
·
7,527 Posts
I also disagree romans_mum - not everything they're testing for is determined upon ingestion of breastmilk. It all depends on the lab.
 

·
Registered
Joined
·
5,492 Posts
so although technically correct the PKU test is more accurate after milk feeds-
Newborn Metabolic screening tests for many many more errors of metabolism now, so it use to be called a PKU test because that was the main illness they tested for and maybe there were only 3 illnesses they tested for when it was called that ---now a delay in screening can miss something that could be known and further testing can be done ASAP rather than waiting-
 
1 - 20 of 20 Posts
Top