To support the long term health and wellbeing of babies who have required neonatal care, the following 4 screening areas are monitored within specific timescales to ensure that if treatment or specialist service referrals are required they are done so in a timely manner.
Newborn Blood Spot Screening
This short video explains blood spot screening in newborn babies
Due to your baby being either on the neonatal unit or Transitional care unit, the test will be performed by the neonatal nurse caring for your baby.
To have your baby screened is your choice and you will always be asked for verbal consent to the test from the nursing staff. If you do not wish your baby to be screened but later change your mind, the test can be performed up to 12 months of age (with the exception of Cystic Fibrosis screening).
The test is performed on day 5 of life however this may be delayed for a few days if your baby has had a blood transfusion and all babies born before 32 weeks gestation do require a repeat test on day 28 of life as certain conditions are not able to be detected until this age.
You are very welcome to be present at the time of the test and provide comfort to your baby with containment holding, cuddles or a feed (the nurses will always guide you in which comfort measure is most suitable at that time) and can provide you with information on various other comfort measures such as swaddling, non- nutritive sucking and sucrose.
You will receive the results by letter or from a healthcare professional by the time your baby is 6-8 weeks old. If your baby has screened positive for any of the metabolic conditions you will receive the results sooner than 6 weeks so that your baby can be referred to a specialist and treatment as early as possible.
Your baby’s nurse will be able to answer any questions that you may have.
Additional information can also be found here.
Retinopathy of Prematurity (ROP)
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What is Retinopathy of Prematurity (ROP)?
Retinopathy of Prematurity is an eye condition which affects the developing blood vessels of the retina. The retina is a thin layer of tissue that lines the back of the eye and allows us to see. Babies born extremely premature and those who require high oxygen requirements are at a greater risk of developing ROP. If severe, the scar tissue can damage the retina and may lead to vision loss and blindness. It is therefore necessary that we screen all babies born before 32 weeks gestation or with a birth weight below 1501 gms.
When will my baby need to be screened
The first screening examination will take place when your baby is 4-6 weeks old. You will be told the specific date of the test 1 or 2 weeks beforehand and will have the opportunity to discuss the procedure with a member of the Newborn Screening Service. Examinations are usually performed every 1-2 weeks until the Ophthalmologist is confident that your baby can be discharged from the service.
What happens during the screening?
Screening takes place on the Neonatal Unit and your baby is given eye drops to make the pupil open widely (dilate) so that the retina can be seen. An Ophthalmologist (eye specialist) will examine the retina using a special magnifying glass called an ophthalmoscope, or sometimes a camera. They may also use a speculum (to hold the eyelid open) and an indenter (to rotate the eye) to get a good view of the retina.
Will the examination be painful?
Eye examinations can be uncomfortable and some babies can show signs of distress during the procedure. The nurses on the Neonatal Unit have a lot of experience in caring for babies during the examination and will utilise measures to minimise discomfort and pain such as non-nutritive sucking, swaddling and sucrose. Anaesthetic eye drops will be used to numb the eye and your baby will be given a dose of paracetamol to help support their recovery from the procedure. Your baby’s nurse can give you more information about our pain relief and comfort methods. You are very welcome to be present at the time of the test as your presence will be off great comfort for your baby, you will not be able to hold your baby until after the test is completed due to the position they will need to be in for the ophthalmologist to gain a clear view of the retina.
How will my baby react to the examination?
Some babies can become quiet after the examination. They may not feed as frequently or be as alert and interactive with you. In very rare circumstances some babies may require additional oxygen or additional support with their breathing. This is usually only for a very short time. If your baby is not already on monitoring then they will be placed on monitoring for the duration of the day of the examination to ensure that they have recovered fully from the procedure. The eye drops that dilate pupils will make your baby’s eyes very sensitive to bright light. On the day of the procedure your baby will be cared for in a darkened environment until the effects of the eye drops have worn off. If your baby is in a cot or coming out of an incubator for cuddles they will be given a protective eye mask to wear.
Will my baby have finished ROP screening before going home?
In some circumstances your baby may be well enough to be discharged home from the Neonatal Unit, but may still require ROP screening. If this is the case you will be invited back to the hospital to continue ROP screening as an outpatient. Your baby will continue to be cared for by a neonatal nurse during these appointments.
What happens if my baby has ROP?
ROP is very common in premature babies, but it is usually very mild and will settle on its own. In very few cases further treatment may be required. ROP treatment requires specialist expertise. This is not available at Royal Preston Hospital so your baby will be transferred to either Manchester Children’s Hospital or Liverpool Women & Children’s Hospital for treatment. There are 3 treatment methods; laser treatment, cryotherapy (freezing the retina) or intravitreal injections (injecting a solution into the eye). The method of treatment can vary from one baby to another depending on the condition of the eye. The ophthalmologist will discuss this with you along with the risks and benefits of the selected treatment method.
We fully understand that having a baby screened for ROP can be upsetting and stressful, if you have any questions or queries after reading this information or prior to an examination, please come and talk to a member of staff and we will sit down with you and work towards alleviating any worries you may have.
Additional information can also be found here.
Preston and Chorley newborn hearing screening programme
This short video explains Hearing Screening in newborn babies
If your baby has been in a special care baby unit for more than 48 hours, they will need to have 2 types of hearing screening tests. These are an AOAE (automated otoacoustic emission) test and an AABR (automated auditory brainstem response) test.
If the test results do not show a clear response, an appointment will be made with a hearing specialist in the audiology department. About 9 babies in every 100 cared for in a special care unit for more than 48 hours do not show a clear response to the screening tests. It is very important that you attend the appointment in case your baby has a hearing loss.
Finding out about hearing loss early gives babies a better chance of developing language, speech and communication skills.
Screening does not pick up all types of hearing loss, so it is important to check your child’s hearing as they grow up. If you have any concerns about your child’s hearing, you should tell your health visitor or GP.
Our Hearing Screen Team will be happy to answer any questions or concerns you may have.
Read more on NHS UK's website here.
How to contact us:
Telephone number 01772 524128
Local Manager: Jackie Harris, Jacqueline.harris@lthtr.nhs.uk
NHSP Team Leader: Chris Brockbank, Chris.Brockbank@lthtr.nhs.uk
Newborn and Infant Physical Examination Screening (NIPE)
All parents are offered a thorough physical examination for their baby within 72 hours of giving birth. The examination includes screening tests to find out if your baby has any concerns with their:
- Eyes
- Heart
- Hips
- Testicles (testes) in boys
For babies being nursed on the Neonatal / Transitional Care Unit the newborn physical examination screening tests will not be done until your baby is well enough. If you choose to have this screening test, the examination should take place before your baby goes home. You will be offered a further examination when your baby is 6 to 8 weeks of age, as some conditions can become apparent later.
Learn more on NHS UK's website here.
