minnesota newborn screening program
This section has been written based on 2013 specimen cards. Older specimen cards have several different fields. Please follow the instructions below for only those fields found on the newborn screening cards used by your facility.
When health professionals accurately complete the demographic section of the newborn screening cards, MDH can locate a baby with an abnormal result as soon as possible. If affected babies are untreated, many of the disorders can lead to permanent mental or physical problems or even death. When a baby has an abnormal result, MDH calls the baby’s health care provider. Accurate information on the newborn screening cards is essential for quickly finding babies with abnormal results. The submitter is legally responsible for the accuracy and completeness of the information on the newborn screening card. Please take special care to fill out all fields.
Particular areas on the newborn screening card have repeatedly been a source of questions and/or concerns. The Newborn Screening Program has created a handout with tips for how to fill out these areas.
Hospitals and birth attendants purchase newborn screening cards from the Minnesota Department of Health.
Visit the Newborn Screening Specimen Card/Ordering page for information on obtaining cards.
The MDH Newborn Screening Program uses standards developed by the Clinical and Laboratory Standards Institute for blood collection on filter paper specifically for newborn screening programs.
The primary goal of this standard is to ensure the quality of blood spots collected from newborns. Poor quality specimens place an unnecessary burden on the hospital, potentially delay the detection and treatment of the affected infant, and may contribute to a missed or late diagnosed case. When the MDH Newborn Screening Program receives an unacceptable specimen, program staff request a repeat sample from the hospital.
Proper specimen collection techniques as outlined by the Clinical and Laboratory Standards Institute are below:
- Ensure that the expiration date of the specimen collection card has not passed. Complete the required patient information included on the card. Avoid touching the area within the circles on the filter paper section before, during, and after collection of the specimen, since oils and other materials from the hands might affect or contaminate the card or specimen. Do not allow water, feeding formulas, antiseptic solutions, glove powder, hand lotion, or other materials to come into contact with the specimen card before or after use.
- Blood collection from the heel is the standard for newborn screening. The medial and lateral parts of the underfoot are preferred. Blood should never be collected from:
- the arch of the foot
- the fingers
- a swollen or previously punctured site
- IV lines containing other substances (TPN, blood, drugs, etc.).
Diagram of Unsatisfactory Specimens (PDF: 130KB/1 page)
Umbilical Catheter Collection
Although direct collection from a heel-stick is preferred for optimal laboratory results, it is acknowledged that alternate collection methods may be used at times. For example, in sick newborns, blood has been collected from umbilical catheters. In order to avoid contamination from substances previously infused through the line, draw off 2-2.5 cc’s before collecting the newborn screening specimen. Collect the blood in a syringe and apply it to the circles immediately to avoid blood clots that would make the specimen unsatisfactory. Each circle holds 0.1 cc of blood.
Continue with steps 7-9 above.
Capillary Tube Collection
Blood collection using capillary tubes is discouraged because it increases the risk of a layered specimen or a torn or chafed card. If capillary tube collection becomes necessary due to clinical circumstances, use a fresh heparinized tube (EDTA is a coagulant and may interfere with analysis) for each circle to be filled. Touch the tip of the capillary tube to the blood drop from the heel and allow the blood to flow into the tube. The tube may fill better by holding it in a near horizontal position as it touches the drop of blood. Immediately after filling the capillary tube, apply the contents to the center of the first circle on the newborn screening card, allowing the blood to flow out and fill the circle. Waiting too long may allow the blood and plasma to separate and interfere with test analysis. Do not touch the tube to the filter paper. Do not dab the blood on or “color in” the circle. These actions can result in an unsatisfactory specimen because of scratching or compressing the paper or layering of over-filling the circle. Use blood from only one tube per circle.
Continue with steps 7-9 above.
Venous Blood Collection
If circumstances warrant specimen collection from the dorsal hand vein, avoid drawing from an extremity where an IV is in place. Using appropriate pediatric blood drawing techniques, obtain the sample through a butterfly (winged) whole blood collection set. Remove or shorten catheter length so the blood can flow freely onto all the filter paper circles. Syringe collection of the blood is discouraged because the lack of anticoagulant and time delays can cause clot formation and separation of the specimen.
Continue with steps 7-9 above.Updated Monday, 17-Jun-2013 09:33:21 CDT