Health Professionals Guide to Newborn Screening

When to Collect a Blood Specimen

Full-Term Infants
Collect a specimen before discharge from hospital of birth, as mandated by statute. If the initial specimen was collected before 24 hours of age, obtain a repeat specimen in about 14 days, as recommended by the American Academy of Pediatrics. (Pediatrics, Vol. 89 No. 2, Feb. 1992)
 
Home/Out-of-Hospital Births
The Newborn Screening Statute applies to all births in Wisconsin. The birth attendant (physician, midwife, or nurse certified under 441.15) is responsible for collecting a specimen before one week of life for out-of-hospital births. NOTE: Due to the life-threatening consequences for some of the disorders, it is recommended that the specimen be collected between 24 and 48 hours.
 
Extended Hospital Stays (Low Birth Weight/Sick Infants)
Collect a specimen by the seventh day of life unless a transfusion is imminent (see below). For birth weight below 2,200g, collect second specimen around 2 weeks of age, a third around 30 days and monthly thereafter until discharge.  Should any of the collections occur post-transfusion, follow re-testing guidelines on the laboratory report. For babies weighing more than 2,200g and hospital stays greater than 14 days re-test at the time of discharge or at one month of age if hospital stay is longer than one month.  
 
NOTE: Always collect a newborn screening specimen (filter paper) at discharge unless the previous specimen was collected within 6 days of discharge. 
 
Transfused Infants

• Collect initial specimen before transfusion, if possible.
• If specimen is collected before transfusion and less than 24 hours of age, repeat testing at 30 and 60 days of life.
• If initial specimen was collected post-transfusion, testing should be done at 6, 30, and 60 days of life. Always list date of most recent transfusion on specimen collection card.

Transferred Infants
If transfer to another hospital is imminent, collect a specimen before transfer if at all possible. Be sure to inform the receiving hospital of collection status, including whether or not the specimen was collected, age at time of collection, transfusion status, etc.
 
Parent Refusal of Newborn Screening Testing
Parents may refuse newborn screening testing of their baby ONLY "on the grounds that it conflicts with their religious tenets and practices." Parents refusing under this condition should sign a statement that is placed in the infant's medical record.

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