What is a routine newborn screening in Singapore? What does newborn screening include? What are the 6 disorders in newborn screening?
Whether you’re still preparing for your baby’s arrival or you have already given birth to your newborn, your baby’s health is your top priority as a parent. You want to make sure that they’re off to a good start. One of the things that can help you make sure of that is by letting them undergo newborn screening. Learn more about newborn screening in Singapore here.
Newborn Screening in Singapore
After birth, your newborn can be examined for more than 40 rare medical conditions to ensure that he or she has the best possible start in life and stays healthy.
Although most newborns with these diseases appear healthy at birth, they may have major health difficulties later in life. If their problem is not recognised and treated early, they may experience learning difficulties, repeated illness, and even death.
Newborn screening is performed to assess your child’s health. If diagnosed early, these illnesses have the potential to prevent lasting damage or even death.
These are the tests done for newborn screening in Singapore:
- G6PD deficiency (lack of an enzyme)
- Hypothyroidism (low thyroid function)
- Hearing loss
- Metabolic Disorders (looking for Inborn Errors of Metabolism, which are disorders involving abnormalities in the breakdown of fats or proteins)
Image from Freepik
These illnesses are extremely rare, affecting approximately one in every 3,000 births in Singapore. Such problems can be treated early, frequently before any sign or symptom appears, by testing neonates during their first few days of life.
The disorders in the newborn screening in Singapore include:
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Inborn Errors of Metabolism
When the body is unable to break down (metabolise) certain components in food or milk, such as lipids, protein, or sugar, they can accumulate and become toxic to the body. This can lead to major health issues.
The newborn screening looks for more than 30 metabolic-related disorders in the following categories:
- Organic Acid Disorders
- Fatty Acid Oxidation Disorders
- Amino Acid Disorders
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Cystic Fibrosis
This is a hereditary disorder that causes thick mucus to accumulate in many organs, resulting in severe chest infections and poor growth.
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Congenital Adrenal Hyperplasia
This is a problem of hormone production that can impair the baby’s metabolism, immune response, ability to manage salt levels, and sex characteristics.
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Severe Combined Immune Deficiency (SCID)
As a result of this condition, the child’s immunity is severely compromised, and they become vulnerable to serious illnesses.
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Galactosemia
Galactose-intolerant babies are unable to metabolise lactose-containing milk feeds, and intake can result in liver failure.
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Biotinidase Deficiency
This is a metabolic condition in which the body fails to recycle biotin, resulting in a deficit. Seizures, developmental delays, and decreased muscle tone can all occur from this. Skin and hair abnormalities in babies are also possible.
Plasma Acylcarnitine
This test can detect fatty acid oxidation abnormalities as well as many organic acidurias. The outcome is also used to evaluate and monitor patients suffering from fatty acid oxidation and organic acid problems.
It is crucial to emphasise that while these are all significant medical diseases, early detection and treatment can result in a positive outcome.
Image Source: iStock
How Is Newborn Screening Done?
Newborn screening in Singapore typically happens during the first 24 to 48 hours.
A tiny blood sample from your infant is required to run the screening tests. By lightly pricking the heel, a few droplets of blood are collected on special filter paper. For analysis, the sample is forwarded to the National Expanded Newborn Screening Laboratory.
While it may seem uncomfortable for you to see your baby being poked, remember that it is necessary and a few seconds of pain may actually save their life in the long run. It can help if you or your partner will be with the baby during the procedure.
Blood samples can be taken from your baby between one day (24 hours) and seven days. Ideally, the newborn screening should be done within 24 to 72 hours after birth.
Newborn Screening Test Result
When the sample has been analysed and the results are available, one of the following things will happen:
- Your baby’s result is Negative for all the disorders
This category includes more than 99 per cent of all infants. This signifies that your baby has a very low chance of developing these diseases. The outcome will be recorded in your baby’s medical record. In rare cases, a condition may go undetected by the metabolic screen.
- A repeat sample is required
A second sample is required for approximately one in every 1000 infants. It is frequently required since the first sample produced borderline results, implying that it was unable to determine whether or not a problem existed. You will be contacted to schedule another sample collection.
- Your baby’s result is Positive for one of the conditions
A good result does not always imply that your kid has a problem. It just signifies that more testing is required. You will be called to arrange for a metabolic physician to review and investigate your case.
If a diagnosis is made, your baby will get immediate treatment. It is critical to understand that the majority of newborns in Singapore are screened negative. These rare but potentially fatal illnesses can typically be avoided with early detection and treatment.
Universal Newborn Hearing Screening
Image from Pixabay
Another important test that your baby will have to undergo during his first few days is the hearing screening test. This is a newborn screening procedure that helps detect potential hearing loss in the first few months of a baby’s life.
The sooner a hearing loss is identified, the higher the chances of maximising a baby’s developmental potential. Babies who cannot hear properly will have trouble understanding words and learning to speak because we learn to speak by listening.
When will this hearing screening be done?
A hearing test is also part of newborn screening in Singapore.
Hearing screening for newborns is normally done within the first few days of birth, usually before the baby is discharged from the hospital. It is carried out by trained personnel and causes no harm to the infant. It takes at least 30 minutes to complete because a baby must be sleeping softly.
How will this hearing screening be done?
There are two kinds of automated screening exams. One or both of these tests may be performed on your infant. During each test, your baby will wear a tiny earphone and listen to a variety of mild noises.
The test uses a special machine, which might be an otoacoustic emission (OAE) analyzer, an automated auditory brainstem response (AABR) analyzer, or even both. With the OAE, a tiny ear probe is gently placed at the entrance of your baby’s ears. The machine emits clicking sounds, and the probe listens for the echoes generated by your baby’s ears in response.
In the case of AABR, three soft jelly tab sensors are affixed to your baby’s head. They’ll then hear clicking sounds through a gentle earphone, and the machine records your baby’s responses to these sounds.
Your baby’s reaction to the sound will be measured by the computer. Screening may not always be completed before release, and your kid may require an outpatient follow-up screening test.
The hearing test is most effective when your baby is quiet, preferably asleep. Preparing your infant for the exam, such as feeding and changing diapers, will help. It would be beneficial to bring extra milk, diapers, and a pacifier or toy to soothe your baby.
What does it mean if my baby does not pass the hearing screening?
It signifies that your baby’s hearing screen should be repeated either before discharge or as an outpatient procedure. This does not imply that your child has hearing loss.
The following are some of the reasons why a baby may need to repeat the hearing screening test:
- Fluid in the ear
- The baby was moving a lot
- The baby has a hearing loss
Testing is the only way to determine whether or not a baby has hearing loss, and the earlier we can detect hearing loss, the better for the kid.
If your infant fails the repeat screening test, they will be referred to an Ear, Nose, and Throat (ENT) specialist. The ENT doctor and the audiologist (hearing specialist) will conduct extensive hearing tests on your child to gain a complete picture of their hearing skills.
If they discover an issue, there are numerous things that may be done to assist a baby’s hearing, speech, and language development.
Newborn screening assists us in identifying newborns who have certain critical medical issues so that they can begin treatment as soon as possible.
Most of the time, these newborns appear normal and healthy at delivery. They frequently do not display symptoms for several weeks or months.
Newborn screening aids in the diagnosis of these babies before they exhibit symptoms. Serious problems, like illness, intellectual disability, or death, can often be avoided by beginning therapy early.
If you have any more questions about newborn screening in Singapore, do not hesitate to ask the nearest maternity hospital in your area.
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 to 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.
