Health screening for newborn babies

Dr P.K Gupta, MBBS, DCH, MNAMS, Consultant Pediatrician & Neonatologist

“The motto is to have a safe childhood”

There have been tremendous advances both in the understanding and the availability of technology for effective and rational management of development of development of healthy newborn babies. The focus has also shifted from mere survival to intact survival and the quality of life among survivors. Our aim should be to reduce the neuromotor disability and sensory neural handicaps to our society. Because the modern specialised obstetrical and neonatal care converting deaths into disability eg. Cerebral palsy, mental retardation etc.

So, proper health screening for every neonate, esp. LBW, VLBW, and extremely premature babies are must. Following is an indication for proper screenings and follow ups

  • All infants with a birth weight < 1800 gms
  • All infants with a < 35 weeks gestations
  • Birth asphyxia with 5 minutes APGAR score of 3 or less
  • Babies with assisted ventilations
  • Babies with metabolic disorders
  • Neonatal seizure due to any cause
  • Infants with abnormal neurological behavior
  • Neonatal Sepsis
  • Infants with malformations
  • Infants of HIV & Hep B+ve mother

  Screening Parameters

  1. Physical growth
  • Anthropometric evaluation eg. Weight, length, head circumference etc
  • Assessment of muscle tone
  • Development screening – for details assessment of neuromotor development to assess the effect of cerebral palsy
  • To assess the development of intelligence
  • Vision-especially in premature, LBW, VLBW babies
  • Hearing- regular assessment especially in an asphyxiated child, a child with meningitis or premature babies

2. Systematic Disorders

Sick babies, premature sick babies discharged from NICU may develop following systematic disorders which must be kept in mind while re-evaluating babies during Screening Programme.

  • Pulmonary

-Bronchopulmonary dysplasia

– Reactive airway disease

– Recurrent respiratory infection

– Blocked nose, Palatal groove

– Damage to vocal cords and speech disorders

  • Cardiovascular

-Systematic Hypertension

-Carpulmonate

-Pulmonary Hypertension

  • Renal

-Nephrocalcinosis

-Renal dysfunction

  • G.I.T

-Gastroesophageal reflux

-Feeding difficulties

-Shut gut

– Umbilical/ Inguinal hernias

  • Reticuloendothelial

– Nutritional Anaemia

– Immunodeficiency

  • Endocrinal

– Growth Hormone

– Thyroid function

  • Miscellaneous

– Rickets

– Haematological disorders

So, it is our duties to select high-risk babies & do their screening on a regular interval and if possible all babies must be screened up to 1 yr of age regularly.