Newborn Screening Tests on the Isle of Man

Newborn blood spot test (heel prick test)

The newborn blood spot screening test — commonly known as the heel prick test — is offered to all babies in the first week after birth, usually when your baby is 5 days old. A midwife will prick your baby's heel to collect a few drops of blood onto a special card.

The blood sample is sent to a laboratory to screen for 5 rare but serious conditions:

• Phenylketonuria (PKU) — affects how the body processes a protein building block called phenylalanine
• Congenital hypothyroidism (CHT) — a thyroid hormone deficiency
• Cystic fibrosis (CF) — affects the lungs and digestive system
• Sickle cell disease (SCD) — an inherited blood disorder
• Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) — affects how the body converts fat to energy

The Isle of Man currently screens for fewer conditions than some parts of the UK, where the programme has been expanding in recent years. The IoM programme covers the most common and serious conditions detectable through the blood spot test.

These conditions are all rare — most babies will receive normal results. However, early detection allows treatment to begin before symptoms develop, which can prevent serious health problems.

Newborn hearing screening

All babies born on the Isle of Man are offered a newborn hearing screening test in the first few weeks of life, usually carried out before you leave the Jane Crookall Maternity Unit at Noble's Hospital.

The test is quick, painless, and usually done while your baby is settled or asleep. Small sensors are placed on your baby's head and ears. The test measures responses to sound and takes only a few minutes.

There are two types of hearing screening test:

• Automated otoacoustic emission (AOAE) — a small earpiece plays gentle clicking sounds and measures the response from the inner ear
• Automated auditory brainstem response (AABR) — sensors on your baby's head measure how the hearing nerve responds to sound

If the test does not produce a clear result on the first attempt, you will be offered a repeat test. This is common and does not necessarily mean there is a hearing problem.

Newborn physical examination

Within 72 hours of birth, your baby will have a thorough physical examination, usually carried out by a doctor or specially trained midwife at the Jane Crookall Maternity Unit. This is sometimes called the newborn and infant physical examination (NIPE).

The examination checks for problems with your baby's:

• Eyes — checking for cataracts and other eye conditions
• Heart — listening for heart murmurs that may indicate a congenital heart condition
• Hips — checking for developmental dysplasia of the hip (DDH)
• Testes — in boys, checking that the testes have descended properly

A second physical examination is offered at 6 to 8 weeks of age, usually carried out by your GP. This checks the same areas and also includes a general health check.

How results are communicated

For the hearing screening, you will usually receive the result on the same day. If the result is clear, no further action is needed.

For the physical examination, the doctor or midwife will discuss the findings with you immediately after the check.

For the blood spot test, results are usually available within 6 to 8 weeks. You will only be contacted if:

• A repeat sample is needed (this can happen if the first sample was not sufficient)
• The result shows your baby may be a carrier of a condition
• The result is positive and further tests are needed

If you have not heard anything by the time your baby is 6 to 8 weeks old, you can ask your health visitor or GP to confirm the results were normal. Results are recorded in your baby's personal child health record (the “red book”).

What happens if a screening result is abnormal

If any screening test produces an abnormal or unclear result, you will be contacted promptly to arrange further investigation. It is important to understand that:

• A positive screening result does not necessarily mean your baby has the condition — further diagnostic tests are needed to confirm
• You will be referred to an appropriate specialist at Noble's Hospital
• For very rare conditions, your baby may be referred to a specialist centre in the UK for further assessment and treatment

Your midwife, health visitor, or GP can answer any questions you have about the screening process and results.

Where screening takes place

Newborn screening on the Isle of Man is provided by midwives and doctors through Manx Care:

• Physical examination and hearing screening — at the Jane Crookall Maternity Unit, Noble's Hospital, before you go home
• Blood spot test — by your community midwife during a home visit when your baby is 5 days old, or at the maternity unit if you are still in hospital
• 6–8 week check — at your GP practice

Further information

For more information about newborn screening, visit:

• gov.im — Newborn Screening Tests

You may also find our other guides helpful:

• How to book a midwife on the Isle of Man
• Vaccinations in pregnancy on the Isle of Man
• Your antenatal care pathway on the Isle of Man
• Maternity preparation checklist

Sources

• Newborn Screening Tests — gov.im