Newborn Screening Program

What to Expect from Newborn Screening

Learn how screening works, when it happens, and how results are shared.

Newborn Screening: What to Expect

	1. Before your baby is born Your prenatal health care provider should give you information about newborn screening (PDF) as required by California law. You’ll learn that newborn screening is safe, confidential, and an important public health program that screens all babies for many serious but treatable genetic or congenital conditions. Most of the conditions do not have symptoms at birth, so screening permits early diagnosis and treatment before a baby develops larger health problems.
	2. Your baby is born and now it’s time for screening: Between 12 and 48 hours after your baby is born, a blood sample will be collected from their heel for newborn screening. Your baby can stay swaddled the entire time. To make the process easier, your health care provider will gently warm your baby’s foot to increase blood flow. They will then make a quick pinprick on your baby’s heel to obtain droplets of blood, similar to a finger stick blood collection. Your baby may feel the prick and may cry, but the collection process will be over very quickly. The droplets will be used to fill six small circles on a blood spot card made of filter paper. Each of the circles will be filled to make sure there is enough blood to complete the newborn screening test. After the blood spots dry, the card will be sent to a state-approved California Newborn Screening (NBS) Program laboratory for testing.
	3. Laboratory testing At the lab, a machine similar to a hole puncher will be used to cut small pieces of the dried blood spot card for testing.
	4. Detectable disorders The California Newborn Screening (NBS) Program screens for a specific panel of conditions. To see this list of conditions, visit the California NBS Program’s Detectable Disorders page.
	5. Test results Newborn screening results are usually ready in about five to seven days after the blood sample is collected and sent to the laboratory. The NBS Program sends the results to your baby’s hospital of birth or your midwife and to your baby’s health care provider, as indicated on your baby’s NBS Test Request Form.
	6. More testing may be needed A very small number of babies will need more testing after the first newborn screen. This may include a second (repeat) screening test if the first one could not be done due to issues with the sample. Your health care provider will contact you directly if another heel prick is needed.
	7. A positive screen A positive screening test result means that more testing is needed to determine if the baby has one of the conditions the NBS Program screens for. Your baby’s health care provider will contact you to coordinate and arrange for any needed follow-up services and/or diagnostic testing. Your baby’s health care provider will help choose where to refer you for follow-up services, most likely to a state-approved Special Care Center. Diagnostic testing may be needed before or after your baby is seen at the Special Care Center, depending on the condition of concern.
	8. Treatment If your baby is diagnosed with one of the screened conditions, a state-approved Special Care Center will most likely provide all follow-up services, including genetic counseling and timely treatment for your baby’s diagnosed condition. These Special Care Centers have medical specialists who have experience treating these conditions. Also, the primary care provider and specialists may work together to provide follow-up services.
	9. Biobank After the newborn screening process is complete and results are available, the dried blood spot collection card will be securely stored in the California Biobank. This storage supports important medical research and public health studies, helping to improve the test, advance knowledge and optimize medical care. Learn more about dried blood spot storage.
	10. Develop new screenings The NBS Program uses stored blood spots to create new and better screening methods for conditions it already checks for and those not yet on the screening panel. The blood spots may also be used for studies on diseases in women and children. The NBS Program follows all federal and state privacy and research laws. If you would like your baby’s blood spot collection card to be destroyed after their screening, you should complete the Parent Request to Have Newborn Blood Specimen Card Destroyed.