Newborn screenings are simple tests, recommended by American College of Obstetricians and Gynecologists (ACOG) done in the hospital, birth center, or clinical office soon after your baby is born. They contain three parts: a hearing screen, a screen to look at oxygen levels, and a blood test to check for metabolic conditions. These tests help babies get any treatment they might need early.
Hearing screen
Hearing screens in newborns help identify hearing loss. These tests are important because children screened for and diagnosed as d/Deaf* or hard of hearing early can get connected with follow-up care. (*The word “deaf” can refer to both a condition and a culture. Many advocacy organizations and clinical spaces are beginning to use the spelling “d/Deaf” to be inclusive of both hearing status and cultural identity.)
A study funded by the CDC’s Early Hearing Detection and Intervention showed that among children with hearing loss, those who participated in universal newborn hearing screening performed better academically than those who were not screened. Early interventions and follow up can help improve outcomes, especially since hearing is critical to speech-language development.
There are two types of screening tests. Both tests use tiny earphones and sensors to see how a baby’s brain or ears respond to sound. These tests are painless for the baby. If a baby doesn’t pass the test, follow-up testing will be recommended. Sometimes, if your baby doesn’t pass the hearing test, it might not be due to hearing loss. It can be due to other factors like too much noise in the room.
Pulse oximetry screening
The pulse oximetry screening, which looks at the amount of oxygen in your baby’s blood, helps check for heart defects present at or before birth. The sensor, similar to the one put on your finger during a medical appointment, is placed on your baby to check their oxygen levels. If a baby passes the screening test, they are unlikely to have a life-threatening heart defect. If they don’t pass the screen, they might need an additional screen or an echocardiogram, which is an ultrasound of the heart that is painless and non-invasive.
An observational study published in 2017 showed that U.S. states that implemented early screening tests for congenital heart defects can save over 100 babies per year from heart-related causes compared to when they didn’t have screening policies.
Heel stick screening
The heel stick screening is a blood test that looks for different conditions that can be deadly or debilitating if not identified and treated early. These disorders include diseases such as, but not limited to:
- Phenylketonuria, which occurs when the body can’t break down an amino acid called phenylalanine, leading to a toxic build-up
- Galactosemia, which occurs when babies can’t break down galactose, a sugar in milk. This also causes build-up which can cause neurological problems, cataracts, and learning delays.
- Sickle cell disease, which is a disease where blood cells form a sickle shape instead of a round shape and can cause clots and strokes
- Congenital adrenal hyperplasia, where a part of the body called the adrenal gland cannot make enough of a hormone called cortisol. This can lead to dangerous drops in blood pressure.
On top of the basic number of screenings recommended (which covers around 30 conditions), each state decides on additional conditions that they test for as well. For example, Pennsylvania screens for 64 different conditions on its newborn screening and Kansas screens for 36. Regardless of how many and which screenings are done in your state, it is very important to get your newborn screened.
A volunteer group of experts, the Advisory Committee on Heritable Disorders in Newborns and Children (ACHDNC), regularly reviewed recommended screenings. The list of recommendations was then shared by the Department of Health and Human Services.
In 2025, this federal committee was eliminated, with no replacement process put in place. This increases the burden on state health departments. The American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG)remain trusted resources for information about newborn screenings.
Overall, newborn screenings are important to catch different conditions early and make sure every baby has a chance to live a healthy life.
Useful resources:
ACOG – Newborn Screening and the Role of the Obstetrician Gynecologist
Children’s Hospital of Philadelphia – Newborn Screening Tests and My Baby Failed the Newborn Hearing Screening — Now What?
CDC – Screening for Critical Congenital Heart Defects [archived link]
The American Academy of Pediatrics (AAP)
American College of Obstetricians and Gynecologists (ACOG)
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