Frequently Asked Questions

All babies born in Alabama are required by law to have a blood test shortly after birth to screen for metabolic and other inheritable disorders. The Alabama Newborn Screening Program helps identify babies who may have one of these disorders and can alert the baby's doctor to the need for further testing and the need for special care. With early diagnosis and medical treatment, complications from these serious, but uncommon, disorders can usually be prevented.

Newborn screening conditions are classified as "core" or "secondary". Core conditions are those which are specifically identified by the methods used in newborn screening. There are currently 37 core conditions listed in the Recommended Uniform Screening Panel (RUSP). The RUSP is a list of disorders that the U.S. Secretary of the Department of Health and Human Services recommends for states to screen as part of their state universal newborn screening programs. The RUSP establishes a standardized list of conditions that are chosen based on evidence that supports the potential net benefit of screening, the availability of tests that are specific and sensitive enough to detect the disorder, and the availability of effective treatments.

Secondary conditions are those that testing is not necessarily trying to detect but may be found inadvertently when screening for core conditions.  A secondary condition can also be found as a consequence of confirmatory testing after a newborn is found to be at high risk for a core condition.  There are currently 26 secondary disorders listed in the RUSP.  However, this list does not represent all conditions that may be detected incidentally through newborn screening.

Because newborn screening tests are designed to distinctly detect core conditions but not secondary ones, some states may only list the core conditions in their counts. However, other states may list secondary conditions in addition to the core conditions for a more comprehensive view of the potential disorders that may be detected through newborn screening. Therefore, unless it is clearly defined how each state being compared counts the conditions for which it screens, misrepresentation of data may occur and inappropriate comparisons between states can be made. A national committee has been working to help establish a more uniform manner in which newborn screening programs count conditions for which they are truly screening for versus those that may or may not be found incidentially.

As a parent, you may refuse newborn screening if your religious beliefs and practices do not allow this testing. If you refuse to have the tests done, you will be asked to sign a form stating that you refused to have your baby tested for these very serious disorders.

Yes! Even if your baby looks healthy, he or she may have one of these disorders. Most babies identified by the Alabama Newborn Screening Program show no signs of the disorder immediately after birth.

A sample of blood is taken by pricking the baby's heel. This sample is then placed on special paper, which is sent to the state laboratory for testing. The lab uses this one sample of blood to test for all of the disorders. The sample is usually taken between 24 and 48 hours of age, although it may be collected sooner in some cases.

Your baby's blood is tested for the disorders found on Disorder Descriptions.

The results of the tests are sent to your baby's doctor and the hospital where your baby was born. You can ask about the results when you take your baby in for a regular check-up. Generally, parents are notified only if more testing is needed. If your baby's doctor asks you to bring your baby in for more testing, do so as soon as possible. Even if your baby's screening test is normal, there are many disorders for which the Alabama Newborn Screening Program does not test. It is very important for your baby to have regular check-ups and good medical care.

Additionally, you may request newborn screening laboratory results by completing the "Patient Release of Completed Laboratory Results" and faxing them to the State Health Laboratory at (334) 285-6642 or emailing the form to [email protected]. Please be aware that the newborn heel stick is a screen and is not intended to be diagnostic. A presumptive positive result typically requires further confirmatory or diagnostic testing.

Laboratory results are issued to the person on whom testing was performed, to the person who consented to have the testing performed, or if under 19, to a parent/guardian, or to the person authorized by the patient to receive the results. The laboratory has up to 30 days from the time the request has been received to provide laboratory test results. This allows time for the provider to review the results and provide treatment if required. If you have questions please call (334) 290-6130.

No. There are several reasons why your baby's doctor may have told you that your baby needs to be retested. Some of these reasons include:

• Unsatisfactory Specimen
  There is not enough blood to complete all the required screening tests, or the sample does not work for other reasons.
• Presumptive Positive Result
  A presumptive positive test result means that a disorder may be present. If the repeat test indicates that further evaluation is needed, your baby's doctor will be called right away. Note: Premature or low-birth-weight newborns are more likely to have presumptive positive test results on the first specimen even if a disorder is not present.

An out-of-range newborn screening result does not necessarily mean that a baby has a condition but that further diagnostic or confirmatory testing may be needed. The Alabama Newborn Screening Follow-Up Program will notify the baby's doctor right away if a result is out-of-range or presumptive positive.

According to the Joint Committee on Infant Hearing (JCIH), some infants who pass the newborn hearing screening at birth may be identified later in childhood as deaf or hard of hearing. Hearing loss identified later in childhood is known as late-onset or progressive hearing loss.

Some common risk factors for late-onset hearing loss include a hospital stay greater than 5 days and parent concern. The hearing risk factor card identifies risk factors known to be associated with late-onset or progressive hearing loss. It is recommended a child receive another hearing evaluation by a pediatric audiologist between 3-9 months of age if a risk factor is identified. You may speak with your child's doctor at any time if there is concern regarding your child's hearing development.

Newborn screening blood specimens are stored for 3 months in Alabama and then destroyed after 3 months. The blood specimens are used to test for over 30 conditions that could lead to death or disability if not screened soon after birth.

Alabama's newborn screening program is funded by collecting fees from hospitals, birthing centers, or third party payors. Fees are set by the State Committee of Public Health based on the schedule of laboratory fees established for use by the Centers for Medicare and Medicaid Services.