Newborn screening looks for certain conditions before a baby develops obvious symptoms. Finding a condition early can make treatment more effective. In Australia, bloodspot and hearing screening are offered through state and territory programs, alongside your baby’s physical health checks.
Screening is an early check, not a diagnosis
A screening result identifies babies who may need further assessment. It does not by itself diagnose a condition, and a reassuring result cannot rule out every health problem. A baby who seems unwell needs medical care regardless of their screening result.
Screening is different from vaccination and from tests ordered to investigate a symptom. Ask the team to explain which test is being offered, what it can find and what happens next.
The newborn bloodspot test
A midwife or nurse takes a few drops of blood from the baby’s heel onto a special card, which is sent to a screening laboratory. It is usually collected in the first few days, often around 48 to 72 hours after birth. Exact timing and any repeat samples follow the local program and your baby’s circumstances.
If you leave hospital early or have a home birth, confirm who will collect the sample and when. Do not assume it has been arranged. Babies born early, receiving particular treatments or needing a repeat sample may have a different plan.
Bloodspot screening checks for a range of uncommon but important conditions. Examples include congenital hypothyroidism, phenylketonuria and cystic fibrosis. Programs are expanding, so ask which conditions are included where your baby is being screened rather than relying on a fixed national number.
Consent and the bloodspot card
The screening team should give you information and ask for your agreement. You can ask about the benefits, limitations, the heel prick, how your baby can be comforted and what happens if you decline or delay. Screening is strongly recommended, but the decision should be informed.
Ask your state or territory program how the bloodspot card is stored, how long it is kept and what consent applies to any other use. Storage and privacy arrangements are not identical everywhere. Keep the information sheet if you would like to revisit it later.
Results and repeat samples
Many programs contact families only if another sample or further testing is needed. Before discharge, ask how to confirm that screening was completed, who receives the result and how to request it. Make sure your contact details and your baby’s care provider are correct.
A repeat request may mean the sample was insufficient or the result was unclear; it does not necessarily mean your baby has a condition. Arrange the repeat promptly and follow the team’s instructions. If the result suggests a condition, further diagnostic tests and specialist assessment are needed.
Do not assume that no phone call proves a sample was collected or processed. If you are unsure whether screening happened, contact your midwife or screening program. A normal result also does not remove the need to assess symptoms later.
Newborn hearing screening
Hearing screening is usually offered soon after birth, often before discharge or at an arranged follow-up appointment. The test records a response to soft sounds while the baby is settled or asleep. The method and pathway vary by program.
A result requiring another screen or audiology assessment does not automatically mean permanent hearing loss. Fluid or a temporary blockage can affect the result, but follow-up is important. If screening was missed, including after a home birth, ask for a referral.
Hearing can change after a baby passes screening. Tell your GP or child health nurse if you are concerned about responses to sound or later communication, even if the newborn screen was reassuring.
Other checks and your take-home plan
Your baby also needs a physical examination and routine follow-up. Some services offer additional checks, such as oxygen-level screening, according to their pathway or your baby’s needs. Ask what has been done, what remains outstanding and who is responsible for follow-up.
Before leaving care, make sure you know the next appointment, any repeat test date and whom to call if you cannot attend. Keep screening paperwork with the baby’s personal health record so the next clinician can see it.
When your baby needs urgent care
In Australia, call 000 if your baby is struggling to breathe, has blue or grey lips, is unresponsive or very difficult to wake, collapses or has a seizure.
A baby younger than 3 months with a temperature of 38°C or higher needs urgent medical assessment. For a newborn, go to a hospital emergency department; for an older baby under 3 months, go to emergency if you cannot obtain prompt medical care. Do not wait to see whether fever medicine works. A newborn can also be seriously unwell without a fever.
Seek urgent medical care for green vomit, markedly reduced feeding, unusual floppiness or sleepiness, substantially fewer wet nappies or a rapidly worsening condition. If you think something is wrong, get help rather than waiting for a routine appointment or test result.
This is general information for Australian readers, not a diagnosis or a personalised care plan.
Sources and further reading
- Queensland Health: routine newborn assessment
- Australian Government: newborn bloodspot screening
- Australian Government: state and territory newborn screening programs
- HealthyWA: newborn bloodspot screening and results
- Children’s Health Queensland: newborn hearing screening
- Australian Government: National Framework for Newborn Hearing Screening
- Pregnancy, Birth and Baby: baby’s first 24 hours
- Pregnancy, Birth and Baby: routine health checks
- Royal Children’s Hospital: recognising an unwell newborn or young infant
- Pregnancy, Birth and Baby: fever in babies and children
- Pregnancy, Birth and Baby: breathing difficulties in babies