For the sake of your baby’s health, your newborn will receive several tests and vaccinations — some of them required by the state of California — following birth. All babies are screened, even if they look healthy, to check for potentially serious conditions, some of which can be life-threatening. Discovering these conditions soon after birth can help save a baby’s life or help prevent serious problems, such as brain damage. You may refuse any of these tests for your baby. If you refuse the state-mandated Newborn Screening Test, you must submit a signed waiver to the state, indicating you are aware of the risks.
California Newborn Screening Test
This is a blood test to check newborns for a number of metabolic abnormalities, including phenylketonuria (PKU), hypothyroidism and cystic fibrosis. This test is administered through a tiny heel prick. The blood sample is sent to a newborn screening lab for testing.
Newborn Hearing Test
The state also requires newborns to undergo a hearing test that checks the brain’s response to sound. For this test, a sensor is placed on your baby’s head to monitor brain wave activity while he or she listens to a series of soft tones through headphones. This quick and painless test can be done while your baby sleeps.
This safe and painless test helps to detect certain types of congenital heart disease that might otherwise not be discovered before leaving the hospital. Early detection improves treatment results and can prevent death. The test can also reveal other treatable conditions, such as pneumonia. The test measures the oxygen level in your baby’s blood using a sensor that is gently wrapped around the hand and foot for a few minutes.
Bilirubin is a by-product of the recycling of red blood cells that is excreted by the liver into the bile, and leaves the body via the stool. It normally takes newborns a few days to activate the liver mechanisms that allow for efficient bilirubin excretion. If bilirubin levels get too high, babies will develop a yellow-orange color to their skin known as jaundice. This is common and does not cause any problems in most babies. In some babies, however, the bilirubin can rise to extremely high levels and cause permanent brain injury. The bilirubin check, which uses blood from the same heel prick performed for the Newborn Screening Test, helps detect babies who are at risk of developing dangerously high bilirubin levels.
Infants are particularly vulnerable to infectious disease. Making sure you and your baby are immunized against disease is an important way you can protect your newborn’s health. UCLA offers babies and their mothers several vaccines to protect them against disease.
1. Hepatitis B Vaccine (HepB)
The Centers for Disease Control and Prevention recommend that all infants receive a Hepatitis B vaccine before leaving the hospital. Full immunity isn’t achieved until babies have received additional booster shots. Starting the series at birth means the baby achieves full immunity sooner, and provides an extra margin of safety for the baby.
2. Hepatitis B Immunoglobulin (HBIG)
This vaccine is given only to babies born to mothers who are carriers of Hepatitis B that is, who test positive to the Hepatitis B surface antigen. For these babies, HBIG and the HepB vaccine will be administered within 12 hours of birth. This combination is highly effective in preventing transmission of Hepatitis B from mother to baby.
This single vaccination protects against tetanus, diphtheria and pertussis. Pertussis, also known as whooping cough, is sometimes deadly in babies. Because infants don’t begin to receive this vaccine until they are two months old, Tdap is offered to mothers any time after their second trimester or as soon as possible after delivery to help protect them from catching and transmitting pertussis to their baby. We recommend that fathers and all other family members and caretakers who will have contact with the baby also receive this vaccine.
2. Flu Vaccine
Women in their second and third trimesters of pregnancy are at increased risk for hospitalization from influenza. Routine influenza vaccination is recommended for all women who are or will be pregnant during flu season, which usually runs between early October and late March. Mothers who did not receive this vaccine during prenatal care should receive it before leaving the hospital to protect them and to reduce the risk of spreading it to their babies. We recommend that fathers and all other family members and caretakers who will have contact with the baby also receive a flu shot.
3. Pneumococcal Vaccine
This vaccine can provide long-lasting immunity to Streptococcus pneumonia, a type of bacteria that can cause severe infections of the lungs, blood or the lining of the brain. The CDC recommends the vaccine for people over 65 and people under 65 who smoke or suffer from chronic illnesses, such as asthma or immune disorders. Because administration during pregnancy has not been studied, UCLA offers it to women with asthma, diabetes and immune disorders after delivery.