Neonatal heel prick

cope

Dagobah Resident
Something nobody seems to know about. The same explanation for the procedure is used everywhere and does not convince me. There seems to be a larger underlying reason. I found that when you refuse the screening like i did, hostilities with the nurses rise instantly. It should be done, they say, between 5 and 8 days after birth, but they took from my kids coveredly 20 hours after birth, from the incubator. I found out only because the child was bleeding from the heel when i picked her up. They could/would not give me the illegally taken sample. Whats up with that?
 
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Here is what I found in a quick search. I'll just copy and paste a few paragraph:

About 24 hours after your baby is born before you’re discharged from the hospital, a nurse will administer a “heel prick” test to look for indications in the blood of rare medical conditions such as phenylketonuria or PKU. We asked pediatrician Thomas Phelps, MD, what else parents need to know about the newborn screening panel.

Why does your newborn need a blood test?​

Newborn screening got its start in the 1960s when scientists developed a blood test for PKU, an amino acid disorder. “Babies with PKU appear perfectly healthy at first,” says Dr. Phelps. “But if their condition isn’t treated soon after birth by changing their milk supply, they will eventually experience a host of serious health issues including the possibility for developmental delays, brain damage and even death,” he says.

Over time, states added tests (Ohio has 38 conditions tested) for other conditions besides PKU to this heel prick test. In particular, they test for conditions that aren’t obvious at birth and are treatable before it is too late and symptoms appear.

“Knowing whether your baby has one of these conditions before symptoms appear can make a huge difference in your baby’s health,” Dr. Phelps says. “In fact, early treatment, which can sometimes involve something as simple as a change in diet, can prevent how the disease affects your child as an infant and throughout their whole life,” he says.
 
Here is what I found in a quick search. I'll just copy and paste a few paragraph:
Testing first day. Hazardous for newborn. Hospital full of nasty germs.
First day? 2-7 days? The first day it will not have yet the high level of phenylalanine.
Ketone smell. Jaundice. Test not conclusive. Clinical disorders still possible.
Nothing a doctor could not see, looking at a baby.
But a lot of fearmongering for an occurence of one in 15000.
"We will discard the sample after testing, unless we keep it for further research, "

What types of blood tests do newborns need?​


Although newborns can potentially require any type of testing, there are a handful of routine tests that are common in neonatal medicine:
Phenylketonuria (PKU) – This free, state-performed screening test is done as a public service for all newborns. Although its named after just one particular metabolic disorder, the test actually screens for about a dozen critical disorders, including thyroid dysfunction, sickle-cell anemia, and cystic fibrosis.

Bilirubin – Immediately after birth, many newborns can develop jaundice, a yellowing of the skin and eyes caused by the buildup of bilirubin. Although a temporary condition, bilirubin levels need to be monitored with blood tests until the condition resolves.
Complete blood count – Usually called a CBC, blood counts are an important monitoring tool for a number of issues that can arise with neonates. CBCs are used to screen for anemia, infection, or disorders of red cell shape and function. These are usually performed on newborns that are staying in the hospital.
Genetic studies – A number of chromosomal disorders can be detected using the DNA contained within white blood cells.
Neonatal phlebotomy can be understandably intimidating. There are certain things to consider when performing a phlebotomy procedure on a young infant. Be cognizant of the fact that their small body and thin veins are more vulnerable to damage, and use the utmost caution at all times. Also, infants have a miniscule blood volume compared to adults, so only draw the amount needed for testing.
Their tininess does also have some benefits; unlike older people, babies cannot anticipate or remember pain, so there is no anxiety on their part. Parents, on the other hand, can create a bigger challenge. Always take the time to explain the procedure well, and offer compassion and reassurance for nervous parents. If you require their assistance in holding or restraining an infant, be certain of their competence to do so. Distressed babies are notorious for erasing their parents’ ability to remain objective! If you do not feel the phlebotomy can be comfortably assisted by a parent, ask a coworker to help instead.

wiki

Signs and symptoms​

Untreated PKU can lead to intellectual disability, seizures, behavioral problems, and mental disorders.[1] It may also result in a musty smell and lighter skin.[1] A baby born to a mother who has poorly treated PKU may have heart problems, a small head, and low birth weight.[1]

Because the mother's body is able to break down phenylalanine during pregnancy, infants with PKU are normal at birth. The disease is not detectable by physical examination at that time, because no damage has yet been done. Newborn screening is performed to detect the disease and initiate treatment before any damage is done. The blood sample is usually taken by a heel prick, typically performed 2–7 days after birth. This test can reveal elevated phenylalanine levels after one or two days of normal infant feeding.[10][11]

If a child is not diagnosed during the routine newborn screening test and a phenylalanine restricted diet is not introduced, then phenylalanine levels in the blood will increase over time. Toxic levels of phenylalanine (and insufficient levels of tyrosine) can interfere with infant development in ways which have permanent effects. The disease may present clinically with seizures, hypopigmentation (excessively fair hair and skin), and a "musty odor" to the baby's sweat and urine (due to phenylacetate, a carboxylic acid produced by the oxidation of phenylketone). In most cases, a repeat test should be done at approximately two weeks of age to verify the initial test and uncover any phenylketonuria that was initially missed.[citation needed]

Untreated children often fail to attain early developmental milestones, develop microcephaly, and demonstrate progressive impairment of cerebral function. Hyperactivity, EEG abnormalities, and seizures, and severe learning disabilities are major clinical problems later in life. A characteristic "musty or mousy" odor on the skin, as well as a predisposition for eczema, persist throughout life in the absence of treatment.[citation needed]

The damage done to the brain if PKU is untreated during the first months of life is not reversible. It is critical to control the diet of infants with PKU very carefully so that the brain has an opportunity to develop normally. Affected children who are detected at birth and treated are much less likely to develop neurological problems or have seizures and intellectual disability (though such clinical disorders are still possible inclding asthma, excema, anemia, weight gain, renal insufficiency, osteoporosis, gastritis, esophagus and kidney deficiencies, kidney stones, and hypertension). Additionally, major depressive disorders occur 230% higher than controls; dizziness and giddiness occur 180% higher; chronic ischemic heart disease, asthma, diabetes, and gastroenteritis occur 170% higher; and stress and adjustment disorders occur 160% higher.[12][13] In general, however, outcomes for people treated for PKU are good. Treated people may have no detectable physical, neurological, or developmental problems at all.
 
What I would do is say no and guard the baby 24/7 to refuse all needles and sharp instruments.
 
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