Newborn jaundice and screening tests

In the first days after birth, your baby has some routine screening tests, and the care team also watches for jaundice. Knowing what these tests are for and what to look out for with jaundice helps you feel more at ease in the first weeks.

Heel stick screening

In Türkiye, a few drops of blood are taken free of charge from the heel of every newborn. This screening looks for certain inborn conditions that can be treated or managed when they're caught early:

• Phenylketonuria (PKU)
• Congenital hypothyroidism (an underactive thyroid gland)
• Biotinidase deficiency
• Cystic fibrosis
• Congenital adrenal hyperplasia
• Spinal muscular atrophy (SMA)

The first sample is taken just before you leave the hospital. A second sample needs to be taken at your family health center within the first week; don't skip this step. If there wasn't enough blood or the result is unclear, another sample may be requested. If the results are normal, you won't be contacted, so it's important that the contact details on the sample card are correct. A positive screening result doesn't mean your baby has the condition; it means further tests are needed, and your baby should see the relevant specialist as soon as possible. This applies in Türkiye; if you live elsewhere, follow your doctor's advice and your own country's health program.

Hearing and hip screening

Newborn hearing screening is also done before discharge, using a probe placed in your baby's ear while they're naturally asleep; no medicine is given for the test. Babies who don't pass the first test are retested and, if needed, referred to a center for detailed testing. Not passing doesn't always mean hearing loss; for example, there may be fluid in the ear canal. Passing doesn't rule out hearing loss that may develop later, either; if your child's speech falls clearly behind that of their peers, ask for their hearing to be tested again.

In Türkiye, as part of screening for developmental dysplasia of the hip, every baby's hips are examined in the hospital before discharge and then by the family physician at the day-41 visit. Babies with risk factors such as breech position, a family history of hip dysplasia, being a first-born girl, a multiple pregnancy or low amniotic fluid have a hip ultrasound at 3–4 weeks.

“Screening tests buy time for conditions that need to be found before they cause symptoms.”

Newborn jaundice

Jaundice is a yellowing of the skin and the whites of the eyes caused by a buildup of a substance called bilirubin in the baby's blood. It's common in newborns and usually harmless; it's typically most noticeable when the baby is about 3 days old and goes away in about 2 weeks. It starts on the face and then spreads to the chest, belly, arms and legs. It's easiest to see in daylight; on darker skin, check the whites of the eyes, under the tongue and inside the cheeks. Feeding your baby often, 8–12 times a day, can help it clear faster; if your baby is very sleepy, wake them for feeds. If treatment is needed, a special light (phototherapy) is usually used. Putting your baby in sunlight is not a safe way to treat jaundice.

When should you see a doctor about jaundice?

• If your baby turns yellow within the first 24 hours after birth, go to the emergency room or call your local emergency number right away.
• If, along with jaundice, your baby is unusually sleepy or hard to wake, isn't feeding, is floppy or stiff, has jerking movements, has a temperature of 38°C or higher or 36°C or lower, has no wet diapers, or is having trouble breathing, call your local emergency number or go to the emergency room right away.
• If the jaundice is getting worse or not improving, your baby's belly, arms or legs are turning yellow, their pee is dark yellow or brown, or their poop is pale and cream-colored, see your doctor the same day.
• If the jaundice hasn't gone away within about 2 weeks, have your baby checked by a doctor.