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Newborn Tests & Procedures


Updated May 20, 2014

Photo © J. Yoder

Newborn Screening & PKU

Newborn screening is the term we use to define the set of tests done to screen your baby for various diseases including Phenylketonuria, commonly called the PKU. While many moms may say they are having the PKU screening, they are really being tested for multiple disorders at one time. What exactly is being tested for varies by state.

Phenylketonuria (PKU) is a genetic disorder. It is routinely tested for during the first few days of life. In many states the test is required, and is frequently done in conjunction with several other tests, such as: Galactosemia, Thalasemia, etc.

This test involves sticking the foot of the child for blood. It is only accurate when your baby has been receiving a diet containing phenylalanine, in both human milk and artificial formulas, for a period of 24 hours. For this reason a breastfed baby should not be tested until at least one day after birth. If your hospital or doctor is trying to encourage a breastfeeding mom to take this test before then, the results will not be valid. Many places do the test before you leave the hospital and ask you to return in one week to have the test repeated. This is usually for their convenience to make sure you've at least had one test for their records, even though it is not valid. Talk to your pediatrician about having this done only once, though in about 10 states, it is required to be repeated. Your pediatrician will guide you or you can check the state by state listings.

Hepatitis Vaccine

This vaccine is now mandatory in most states. You have two choices for when to start this vaccine, at birth or at the two month check up. If you choose to have this vaccine, I encourage you to assess your own risk of hepatitis before deciding when to have this vaccine done.

Talk to your practitioner about the use and safety of this and any vaccine.


The APGAR is your baby's first "test." In most places it is done without ever being noticed by the parents because it's simply an evaluation of the way your baby looks and sounds.

A score is given for each sign at one minute and five minutes after the birth. If there are problems with the baby an additional score is given at 10 minutes. A score of 7-10 is considered normal, while 4-7 might require some resuscitation measures, and a baby with an APGAR Score of 3 and below requires immediate resuscitation.

Despite what parents will tell you this doesn't correspond to your child's SAT scores later in life. In fact, in some circles this test is criticized for not being very useful. For example, a baby obviously in distress will not be left alone until the one-minute APGAR says that they need help. All in all this is a harmless test that many parents look forward to hearing their baby's score.

More on the APGAR Score


There are many things that may be done either on a routine or not so routine basis, including a hearing test, blood sugar testing, ultrasound, etc.

Make sure that you have all of the information necessary to make a well-informed decision about your baby's care. Just as you did during pregnancy.

APGAR Scoring

  Sign 0 Points 1 Point 2 Points
A Activity (Muscle Tone) Absent Arms and Legs Flexed Active Movement
P Pulse Absent Below 100 BPM Above 100 BPM
G Grimace (Reflex Irritability) No response Grimace Sneeze, cough, pulls away
A Appearance (Skin Color) Blue-gray, pale all over Normal, except for extremities Normal over entire body
R Respiration Absent Slow, Irregular Good, Crying
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