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Newborn testing and treatment: The need-to-knows

Being in the hospital after giving birth can feel like a whirlwind. There can be a lot going on, and if you’re a first-time parent, making medical decisions for someone else can also feel like a new experience. To reduce the overwhelm, it helps to know some of the routine medications and newborn testing that will be offered to you for your new baby!

Medications and vaccines

Immediately after giving birth, routine care for newborns includes a few different treatments. It can be really helpful to know more about these recommendations ahead of time!

An antibiotic eye ointment, called erythromycin, is a clear gel that is gently squeezed into each eyelid. It looks greasy, but should not cause your baby any discomfort. It helps to protect against an eye infection called neonatal conjunctivitis that can be caused by many different bacteria present in the vagina, or rarely in amniotic fluid. Neonatal conjunctivitis can cause serious complications like blindness and requires IV antibiotics for treatment. In some states, you may not be able to sign refusal for this medication, it is mandated by law. 

Vitamin K is a small injection of — you guessed it — Vitamin K. Vitamin K is essential for forming blood clots. After infancy, our bodies develop bacteria in the gut that make Vitamin K for us. But when they’re born babies don’t have this in their bodies yet. The shot gives them protection against bleeding while they develop their own gut bacteria to take over the job of making the vitamin for them. 

Not having enough vitamin K can cause bleeding issues that range from minor — like a little extra bleeding after getting a shot — to a severe condition called Vitamin K Deficiency Bleeding, which can be fatal. Many parents are curious about using oral Vitamin K as an alternative to the shot. This is an option, but because Vitamin K in this form is processed through the digestive system (instead of going directly into the muscle and being absorbed into the bloodstream with the shot), oral doses have to be given weekly and are less effective than a one-time injection of the vitamin. Therefore, they are not typically offered or recommended. 

Hepatitis B is the only vaccine recommended for newborns. It is part of a 3 dose series, which is continued at your well-baby visits. If you have tested positive for Hepatitis B during pregnancy, the routine for your baby’s care will be slightly different.

Hearing, hearts, and jaundice

Some routine testing, like a hearing screen, cardiac screening, or bilirubin scan, are brief and non-invasive. Checking your baby’s hearing, pulse oximetry, and their jaundice level are all things you can expect before going home. If there are any red flags on those tests, your pediatric provider will discuss your options and next steps (which are often just re-checking the tests at a later hour or day). 

You might wonder why it’s so important to do these tests in the first days of your baby’s life. Let’s break it down. 

Hearing test 

A hearing test is important because even a newborn baby is already learning language. If their hearing is impaired (even in just one ear) knowing and addressing it early on can make a big difference for your baby’s language development. 

Oxygen levels

A pulse oximetry test of your baby’s oxygen level in different parts of the body — usually done by putting a sticker with a red light on your baby’s hand and foot. This test can help to catch worrying heart problems that happen in about 1 in 1,000 babies and might otherwise go unnoticed. 

Jaundice screening 

Jaundice screenings, often also done with a special light placed on your baby’s skin, make sure that bilirubin levels aren’t getting too high. Sometimes instead of a skin sensor, this is checked using a blood test, collected along with the blood sample discussed below. High bilirubin levels can cause problems like lethargy, poor feeding, and in some rare extreme cases, brain damage.

Newborn screening

Newborn screening is another test that is typically done after your baby is 24 hours old. It involves a small blood sample. You might picture having your blood drawn in your arm as an adult, but this test requires a very small sample and it can be tricky to find a tiny newborn vein. So most of the time, a heelstick is used. Your baby will have their foot warmed and then a small prick is made in their heel. Some babies barely notice, others might cry. Blood is collected onto a paper form, which is sent to your state’s processing lab by the hospital. 

But why?

The biggest question is, what are they screening my baby for? And that’s a great question! The answer varies because testing is a little bit different in each state. In general, the test covers multiple conditions that a baby can be born with and are impossible to see on a physical exam. Most of these conditions have treatments that are important to start early in life, so testing is essential.

It can be helpful to check what the testing requirements and suggestions are in your area, and discuss any particular concerns you have with your pediatric provider — such as a family history of a metabolic disorder. You can look up what your state tests for here if that information isn’t provided by your hospital. If you give birth outside of a hospital, it’s recommended that you have newborn screening done between 24 and 48 hours of life. This can typically be done by your home birth or birth center provider, or at a lab. 

Reviewed by the Ovia Health Clinical Team

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