Tests Newborns Get in the Hospital

mother holding baby in hospital
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For the parents of newborns, the number of tests that a perfectly healthy baby undergoes in their first few days of life can seem endless. But these tests are important to ensure your new bundle of joy is developing as expected, and that there are no medical conditions that could require treatment. 

Newborn Screening Test

The newborn screening test, called the Recommended Uniform Screening Panel (RUSP), is done when your baby turns 24 hours old and is usually performed in the nursery at the hospital. The nurse will swab your baby's heel, then prick the heel and blot five small blood samples on a testing paper. The samples are sent to your state's screening facility and tested for more than two dozen different diseases, most of which are very rare.

You will also be asked if you'd like to donate any of your baby's sample for future research, as sometimes the test doesn't need all five blood samples and there may be some left over. You can definitely decline to donate the samples and you'll have to sign your consent either way. In the unlikely event that your baby tests positive for any disorder that the newborn screening test picks up, your baby's doctor will let you know.

Hearing Test for Newborns

Sometime in the first day after your baby is born, they will also have a hearing test done. Typically, this test is done at least six hours after birth, as the process of birth leaves some residue in the baby's ears that can interfere with the hearing screen. Waiting allows the ear canals to clear out a bit more.

This test is very simple and completely painless to your baby. A nurse places some special headphones on the baby's ears that release sound and measure the baby's response to the sounds.

If the test detects a low response, the hearing screen will typically be repeated. If your baby fails the hearing screen again, another repeat will be scheduled for approximately one week after you leave the hospital. If your baby fails that repeat, you will be referred to a hearing specialist.

Bilirubin Test

At one day old, your baby's bilirubin levels will be tested. This test, which can help detect liver abnormalities, only takes seconds and is usually done in conjunction with the other tests. Through a monitor that is placed on the forehead, the baby's bilirubin level is displayed. Your baby's doctor and nursing staff will use that number to determine if your baby is at risk for jaundice.

Blood Sugar Test 

If your newborn is large for gestational age (LGA), which is just a fancy term for having a baby that's a bit bigger than most, or small for gestational age (SGA), the hospital will follow protocol to have their blood sugar tested. Babies that are born to moms with gestational diabetes are often LGA, for example.

Babies who are either larger or smaller than average may have difficulty regulating their blood sugar levels on their own, which can affect many parts of a baby's system, especially their temperature. If your baby has low blood sugar, you will more than likely to encouraged to feed your baby to help stabilize their blood sugar and keep them warm and cozy next to you.

By Chaunie Brusie, RN, BSN
Chaunie Brusie is a registered nurse with experience in long-term, critical care, and obstetrical and pediatric nursing.