Newborn Screening For Your Baby’s Health

Department of Health Why is my baby tested? even be fatal. Some may slow down a baby’s development, To help make sure your baby will be as healthy as possible. The cause intellectual disabilities, test provides important increase a baby’s risk for information about your baby’s infection, or cause other problems health that you and your doctor if undetected and untreated. might not otherwise know. The That is why: Newborn Screening Program identifies who may have Early treatment one of several rare, but treatable diseases that don’t show is very important! symptoms right away. With early diagnosis and medical treatment, But my baby seems serious illness, and even death, can often be prevented, so it is very healthy. Are these very important for us to test your tests still needed? baby’s sample and report the Yes. Most infants with a disease results to your baby’s doctor. Ask identified by the Newborn your baby’s doctor for your baby’s results. Screening Program show no signs of the disease right after birth and look healthy. With these Is newborn screening special laboratory tests, we can new? identify a baby who may have No. Every state has a newborn one of these diseases and tell screening program. The New the baby’s doctor of the need for York State program is mandated more tests and special care. Most by Law, and it of the time, it is very important to began in 1965. Some diseases start treatment before your baby can affect a child very early in life shows symptoms or becomes – even within the first few days. sick. Many of the diseases are Timely testing and diagnosis are genetic, and they are inherited important for treatments to work from the baby’s parents. the best. Every baby has two sets of genes – one from their mother and the For how many diseases other from their father. Sometimes is my baby tested? only one set of the genes has a The number has increased from problem, but because the other one in 1965 to more than 45 set doesn’t, the baby is not sick. today. They are listed in this These babies are called carriers. booklet. Although these diseases Although these babies are not are rare, 1 in 300 babies born sick, this means that at least in New York every day has one one or sometimes even both of of these diseases. Most of the their parents are also carriers. diseases are serious and can Newborn screening tests can identify carriers for some genetic diseases some of the time, but the How is my baby tested? program is not designed to find All the tests are performed on all carriers. It is important to get a tiny sample of blood taken by genetic counseling if your baby pricking the baby’s heel. The has a carrier result because most blood is put on a special filter parents who are carriers do not paper. The sample is usually taken know. Counselors can help you when the baby is one or two days understand this information. old. The sample is sent for testing to the laboratory at the State But children in our Health Department in Albany. family have never had any of those Will I get the health problems. test results? Parents who have already had Be sure to tell the nurse at the healthy children do not expect hospital the name and office any problems, and they are information for your baby’s doctor almost always right. But there or clinic. This doctor will be told is still a chance your new baby of the results and will contact you may have one of these diseases. immediately if anything is wrong. Each of these diseases is very To be sure, ask about the result rare, and the chances are when you bring your baby to the excellent that your child will not doctor or clinic for his or her first have one of them, but altogether check-up. The hospital nurse 1 in 300 babies born in New should give you a pink form, which York every day does have one will tell you how to get the test of them. A negative newborn results from your baby’s doctor. screen for your new baby does not guarantee that your future If all the tests are children will be negative too. Some babies and parents can be screen-negative, does carriers for diseases even if no that mean my baby will one in your family has a disease. be healthy? Many families go for genetic The Newborn Screening Program counseling to better understand only looks for a few of many these risks to their future children diseases a baby could have. In and other family members. It is addition, some babies with these also important to remember that diseases may not be identified for newborn screening does NOT several reasons. You should bring find all babies who are carriers for your baby to the doctor or clinic these genetic diseases. The tests for all their check-ups. Always are designed to find most babies watch your baby for unexpected with these genetic diseases. symptoms or behavior, and call the doctor immediately if things don’t seem right. A negative newborn screen screen is also abnormal. On very for your new baby does not rare occasions, because a disease guarantee that your future may cause a baby to become children will not have a disease. very sick quickly, the doctor will Also, newborn screening treat the baby immediately while does NOT find all babies who waiting for the results of the are carriers for these genetic second series of tests. If you are diseases. Carriers have one asked to have your baby retested, gene mutation but are healthy. please bring in your baby as soon Babies and their parents can be as possible, so the repeat test can carriers without any family history be done immediately, to determine of a disease. Many families go if your baby needs treatment.

1 in 300 babies born each day in NYS has one of the screened diseases! to genetic counseling to better What if my baby has understand disease and carrier risks to their future children and one of these diseases? other family members. The tested diseases all have treatments that can lessen the Does a “repeat test” effects of the disease. mean my baby may Sometimes the symptoms can be completely prevented if a special have a disease? diet or other medical treatment Not necessarily. Repeat testing is started early. Most of these may be needed for a number of diseases are very complicated reasons. The most common is that to treat, and medical care should the blood was put on the special be coordinated by a doctor who filter paper incorrectly. Usually this specializes in the specific disease. does not mean there is anything wrong with your baby. It simply means that another blood sample If my new baby has a must be taken as soon as possible. disease, will my future When the first test results children have it? suggest a problem, the results That depends on the disease. are not considered final until the Most of these diseases are screening tests are done again. genetic and inherited by children This requires a new blood sample. from their parents. A negative In general, a doctor will discuss newborn screen does not the need for further diagnostic guarantee that future children testing only after a baby’s second will not have the disease. Also, newborn screening does NOT find all babies who are carriers How much will these for these genetic diseases. Carriers have one gene mutation tests cost me? and are healthy. Babies and Nothing. These tests are done at their parents can be carriers no cost to families. without any family history of the disease. Many families seek How can I make it genetic counseling to better easier for the doctor to understand how their child got the disease, and to understand help my baby? disease and carrier risks to their First, be sure you tell the nurse future children and other family at the hospital where your baby was born the name of your members. Some diseases are not baby’s doctor so we can contact inherited. For example, congenital the doctor if we need to. If you hypothyroidism has many causes, change your doctor, let us know while HIV infection is caused by a by emailing or calling us (see virus, not a gene mutation. back of this booklet). If your doctor asks you to bring your Why is my baby tested baby in for a repeat test, do so as soon as you can. If your baby for HIV? does have a disease, quick action We test the baby for HIV is very important. antibodies. If the test is positive, If you do not have a telephone, that means the mother has the give your doctor the phone virus and we want to be sure number of someone who can the baby is not infected with the contact you immediately. If you virus. HIV can be transmitted by move soon after your baby is born, an infected mother to her baby tell your doctor or clinic your new before it is born, during delivery address and phone number right or from breastfeeding. In NYS, away. Then your doctor will know most pregnant women are tested where to reach you if your child for HIV before the baby is born. needs more tests or treatment. Ideally, the mother should get Remember, time is very medicine during pregnancy and important. As a parent, you can labor to protect the baby from the help the Newborn Screening HIV infection. Program make sure that your baby is as healthy as possible by making sure your baby’s doctor knows how to reach you. Be Informed: Get your baby’s newborn screening results from his or her doctor! See our website for much more information on newborn screening. Diseases Identified by the New York State Newborn Screening Program

Group Diseases Congenital adrenal hyperplasia (CAH) Endocrinology Congenital hypothyroidism (CH) Hb SS disease (Sickle cell anemia) Hematology, Hb SC disease Hb CC disease Other hemoglobinopathies Infectious Disease HIV exposure Homocystinuria (HCY) Hypermethioninemia (HMET) Maple syrup urine disease (MSUD) Diseases (PKU) and Hyperphenylalaninemia (HyperPhe) Tyrosinemia (TYR-I, TYR-II, TYR-III) -acylcarnitine translocase deficiency (CAT) Carnitine palmitoyltransferase I (CPT-I) and II (CPT-II) deficiencies Carnitine uptake defect (CUD) 2,4-Dienoyl-CoA reductase deficiency (2,4Di) Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHAD) Medium-chain acyl-CoA dehydrogenase deficiency (MCAD) Fatty Acid Medium-chain ketoacyl-CoA thiolase deficiency Oxidation Diseases (MCKAT)

Inborn Errors of Metabolism Medium/short-chain hydroxyacyl-CoA dehydrogenase deficiency (M/SCHAD) Mitochondrial trifunctional protein deficiency (TFP) Multiple acyl-CoA dehydrogenase deficiency (MADD) (also known as Glutaric acidemia type II (GA-II)) Short-chain acyl-CoA dehydrogenase deficiency (SCAD) Very long-chain acyl-CoA dehydrogenase deficiency (VLCAD) Group Diseases Glutaric acidemia type I (GA-I) 3-Hydroxy-3-methylglutaryl-CoA lyase deficiency (HMG) Isobutyryl-CoA dehydrogenase deficiency (IBCD) (IVA) Malonic acidemia (MA) 2-Methylbutyryl-CoA dehydrogenase deficiency (2-MBCD) 3-Methylcrotonyl-CoA carboxylase deficiency Organic Acid (3-MCC) Diseases 3-Methylglutaconic acidemia (3-MGA) 2-Methyl-3-hydroxybutyryl-CoA dehydrogenase deficiency (MHBD) Methylmalonyl-CoA mutase deficiency (MUT), Cobalamin A,B (Cbl A,B) and Cobalamin C,D (Cbl C,D) cofactor deficiencies and other Methylmalonic acidemias (MMA) Inborn Errors of Metabolism Mitochondrial acetoacetyl-CoA thiolase deficiency (Beta-ketothiolase deficiency) (BKT) Multiple carboxylase deficiency (MCD) (PA) (ARG) Argininosuccinic acidemia (ASA) Diseases (CIT) (X-linked) (BIOT) (CF) (GALT) Other Genetic Diseases Pompe Disease Severe Combined Immunodeficiency Disease (SCID)

For more information on the New York State Newborn Screening Program and the diseases in the panel please visit our webpage at www.wadsworth.org/programs/newborn The New York State Newborn Screening Program is a service provided by the State Health Department to families with newborn babies. Important: Questions about newborn screening? Need to let us know information about your baby’s doctor? Write, call or visit our website: Newborn Screening Program Wadsworth Center New York State Department of Health P.O. Box 22002 Albany NY 12201- 2002 Email: [email protected] www.wadsworth.org/programs/newborn

Dear Parents, Your child’s specimen(s) will be stored by the Newborn Screening Program for up to 27 years under secure conditions where access is strictly controlled. Should the need arise, the specimen(s) may be used for diagnostic purposes for your child with your consent. A portion of the specimen will also be stripped of all information that might identify your child and may be used in public health research that has been reviewed and approved by a Board charged with overseeing compliance with all applicable laws and ethical guidelines. You may arrange to have your child’s specimen(s) destroyed or prevented from being used in public health research by calling (518) 473-7552 for instructions. You may visit our website for more information or to download a copy of the form we need to honor your written request. Note: Upon request, we will completely destroy specimens. We cannot do this until 8 weeks after you give birth.

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