Newborn screening and examination
All parents are offered medical examinations of their newborn baby to detect any anomalies or congenital disorders. The vast majority of babies born to term after a normal pregnancy are healthy.
Medical examinations of newborns, newborn screening, oxygen saturation in the blood, hearing screening and vitamin K injections are options offered as standard, and are performed with the consent of the baby’s parents or guardians.
Newborns are currently checked for 26 rare serious congenital disorders through the newborn screening programme. Most of the disorders screened for are metabolic diseases. Although these are rare, about 1 in 1,000 babies in Norway is born with one of the 26 conditions the screening detects.
Affected babies are usually born with no symptoms, so testing is the only way of discovering that they have any of these disorders. It is important to detect the conditions early, so that effective treatment can be started quickly, which prevents or reduces the harmful effects of these medical conditions.
How is newborn screening done?
The screening is done by taking a blood sample from the baby’s heel as soon as possible after 48 hours have elapsed since the baby was born.
The blood sample is sent to The Newborn Screening Programme at Oslo University Hospital for analysis. The regional health authorities have routines in place for providing parents/guardians with information about, and obtaining their consent for, screening. This test is voluntary.
When the test result is normal, the parents are not informed. On suspicion of a medical condition, the parents are contacted by the doctor immediately to arrange for further diagnostics.
If the Newborn Screening Programme receives a sub-standard sample, the parents will be contacted by the place of birth and asked to have a new blood sample drawn from their baby. This does not mean that the child is suspected of having a medical condition.
Follow-up of the families where a medical condition is detected is usually from the local hospital’s paediatric department or from Oslo University Hospital. If the test results indicate a disorder, the results of confirmative tests will usually be available within 1-2 weeks.
Withdrawing consent for retention of blood samples
If you wish to withdraw your consent for retention (storage) of your child's blood sample, you can do this by logging in to helsenorge.no or printing and completing this PDF form:
If you withdraw your consent, the blood sample will be destroyed. It is not possible to reverse this decision.
After a straightforward vaginal birth, the midwife observes and examines the newborn baby immediately. If a doctor attends at the delivery, the doctor will assess the baby and talk to the parents. If there are any signs of a medical disorder and visible malformations, the baby will be examined by a doctor.
The vast majority of babies born to term after a normal pregnancy are healthy. The usual practice is for newborns to undergo a standardised medical examination 1-3 days after being born.
In approximately 20 percent of healthy newborns, the examination may detect a minor anomaly. More serious malformations are seen in 1-2 percent of all newborns. If the findings are uncertain, an additional examination will be done.
Blood test for oxygen saturation
In the early days after the baby has been born, a test will be done to measure oxygen saturation in the blood of the newborn, called pulse oximetry. This test can reveal critical congenital heart defects that were not diagnosed before birth or at the clinical examination after the birth.
Early identification of any medical condition is important in being able to start treatment and reduce adverse effects.
How pulse oximetry is done
A small sensor is attached to the infant’s foot and hand. Within a couple of minutes, it is possible to assess the oxygen saturation in the blood. This will usually be 95-100 percent.
If the baby’s saturation is lower, which happens in 1-2 percent of all newborns, then the test has to be repeated 2-3 hours later. If the infant still has too low oxygen saturation, then the paediatrician will examine the infant.
All newborns are offered a hearing test when they are one to two days old. The aim of this screening is to detect deafness and severe hearing impairment as early as possible, in order to take action and provide treatment for the best possible outcome. Out of 1,000 newborns, 1-2 will be born with deafness or severe hearing loss. The reason for this may be genetic, effects during pregnancy or something else.
How is the hearing test done?
The test is quick and painless for the infant. A tiny plug containing a microphone and an amplifier is placed in your baby’s ear canal. The amplifier sends clicking sounds into the ear, and when the clicking sounds are processed, a sound is generated in the inner ear that is measurable in the ear canal.
If the ear does not produce a normal response, then the test will be repeated. If there is still evidence of hearing loss in one or both ears, your baby will be followed up with further testing at a hospital hearing centre.
Vitamin K injection
In Norway, all babies are injected with a shot of vitamin K within two hours of birth. Newborns have a low level of vitamin K. The level normalises at the age of six weeks.
Deficiency of this vitamin may cause Vitamin K Deficiency Bleeding (VKDB), a disorder that can arise at any stage in the neonatal period. About half of the bleeds are intracranial (between the skull and the brain).
Studies show that vitamin K given to infants immediately after birth reduces the number of cases of VKDB in newborns.