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Heel Stick Test For Newborns: Is It Really Necessary?

7 min read

A doctor or nurse will remove a little drop of blood from your baby’s heel as part of her initial health examination; despite its small size, the sample is jam-packed with crucial data.

The purpose of the heel stick test, what to anticipate during the extremely brief operation, and how you can keep your new bundle comfortable are all explained here.

Table of Contents

  • What Is The Heel Stick Test for Newborns?
  • What Is Tested With A Heel Stick?
  • Why Is The Heel Stick Test For Newborns Done?
  • What Part Of An Infant’s Heel Should Be Punctured?
  • Newborn Heel Stick Technique
  • Heel Stick Test Procedure
  • When Is A Heel Stick Test For Newborns Not Done?

What Is The Heel Stick Test for Newborns?

The newborn heel stick test, which is administered to infants 24 to 48 hours after birth, is used to check for major medical issues, such as several metabolic and hormonal diseases that don’t have symptoms at birth but can be fatal if left untreated.

In order to collect a tiny amount of blood for the test, a baby’s heel is pricked. After that, the blood is taken to a lab for examination. You will be informed and referred for additional testing if the screening turns up any anomalies. If the screening results are positive, there’s a good chance you won’t hear anything.

Before a child leaves the hospital, heel stick tests are done. Within 24 to 48 hours of birth, babies born at home should be transported to a nearby hospital for screening. In some areas, infants must additionally undergo a follow-up heel-stick test one to two weeks later.

What Is Tested With A Heel Stick?

newborn foot with a band aid - heel stick test article

Image Source: iStock

Tests like the following use blood from heel sticks:

  • Full blood counts
  • Tests for liver function
  • Toxicologic evaluations
  • Glucose monitoring at night
  • Blood gas evaluation
  • Screening for newborns

One of the main purposes of a heel stick is newborn screening. Typically, a screening heel stick is done within 48 hours of a child’s delivery, if not sooner.

In some circumstances, successful therapy or even illness prevention might be aided by early diagnosis of any genetic problems. Newborns are screened for up to 50 genetic diseases, including the following in more than 95% of cases:

  • Phenylketonuria: A metabolic disorder

  • Sickle cell disease: Red blood cell disorder

  • Hypothyroidism: Underactive thyroid

  • Cystic fibrosis: A disease that affects the lungs and the digestive system

A positive heel-stick test result does not always indicate that your kid has a disease. To be sure, your physician may probably ask for a more precise diagnostic test or want to repeat the screening. Your infant may begin treatment in the interim, just in case.

Why Is The Heel Stick Test For Newborns Done?

Heel Stick Test For Newborns: Is It Really Necessary?

Image from iStock

Blood tests are the only way to find certain uncommon issues with how your kid absorbs nutrition and find diseases that are related to the blood and hormones. Many of these illnesses don’t manifest symptoms when a baby is initially delivered, but they still need to be treated right once to avoid significant difficulties or disabilities later in life.

For instance, infants with hypothyroidism need to begin thyroid hormone therapy right away in order to ensure proper growth and brain development, and those with phenylketonuria (PKU), an inherited disorder that can cause mental disability and other symptoms and is passed down from both parents, require a special formula that is low in the amino acid phenylalanine.

Even though the heel stick test detects a wide range of illnesses, talk to your doctor about any particular worries if:

  • There is a history of inherited illnesses in your family.
  • A condition may be to blame for the death of an infant in your family.
  • A prior child you had was born with a condition.
  • There is a genetic disorder predisposition in your family that is based on ethnicity (such as sickle cell disease).

You might need to collaborate with a specialist to get your infant the best care if a heel-stick screening or a more focused diagnostic test reveals that your baby has one of the conditions being checked for. In addition to proper medical supervision, many of the illnesses can be addressed with dietary restrictions, supplements, and drugs.

What Part Of An Infant’s Heel Should Be Punctured?

The inside (medial) and outside borders of the heel are the best places to puncture an infant’s heel (lateral). In order to protect the calcaneus bone, which is close to the skin in the posterior heel, the curve in the rear of the heel should not be used for a heel stick. Also should be avoided are previous puncture areas.

Newborn Heel Stick Technique

With your thumb behind the heel and your second finger just below the ventral surface of the toes, hold the ankle region with your three ulnar-side fingers. Blood can be expressed by alternately pressing the lateral three fingers, then milking the second finger.

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Heel Stick Test Procedure

The heel stick is carried out on a newborn baby by a paediatrician or a nurse with paediatric care training. Although anaesthesia is not necessary, the doctor nevertheless makes the infant comfortable by:
  • Swaddling
  • Lessening of background noise and light
  • Taking oral sucrose with a filler or sucking on a pacifier dipped in sugar solution
  • Prior to performing the treatment, the doctor could warm the heel for five minutes using a heel warmer.

Prepare

For 3-5 minutes, warm the heel with a warm towel or an instant chemical heel warmer. Utilise an alcohol prep pad to sanitise the heel. Utilise sterile gauze to wipe dry.

Stick

Check that the baby’s leg is below the heart. For healthy newborns, use a lancet that is 2.5mm long and 1.0mm deep. For premature or low birth weight infants, use a smaller lancet. Only puncture the heel where it is shaded!

Drop

Gently touch the filter paper to the blood droplet, allowing it to soak until it reaches the other side of the paper. Avoid wiping or rubbing the heel against the paper. A circle with blood in it should not be filled with more blood.

Care

Lift the infant’s leg above its body with caution. Use sterile gauze to gently press against the puncture site to stop blood flow. Don’t use bandages.

Dry

For at least three hours, lay the blood samples flat to dry. The card should be raised off the surface while drying. Avoid the heat, humidity, and direct sunshine. Once they have dried for three hours, immediately deliver the NBS cards to the NBS Lab Courier pickup site. Do not put NBS cards in mailboxes or drop boxes that are exposed to the sun.

Check

Before sending a newborn home, ALWAYS conduct one last quality check.

When Is A Heel Stick Test For Newborns Not Done?

The following circumstances do not call for the use of a heel stick:
  • If the sampling area in the baby’s heel has any
    • Injury
    • Anomaly
    • Infection
    • Oedema
  • If the blood volume required for testing is relatively larger
  • Certain types of blood tests such as
    • Coagulation tests
    • Blood cultures
    • Chromosomal analyses
    • Immunoglobulins and titers
mum holding baby feet - heel stick test article

Image Source: iStock

Indiana Department of Health

Here at theAsianparent Singapore, it’s important for us to give information that is correct, significant, and timely. But this doesn’t serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.

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Matt Doctor

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