When Should Preterm Infants Have Heel Prick Blood Tests?

Heel blood

Hello, I would like to ask when my baby, who was born at 36 weeks as a preterm infant, will have the heel prick test?

Lai, 20~29 year old female. Ask Date: 2005/02/16

Dr. Lin Wenxian reply Pediatrics

Dear Meiling,
I believe your question pertains to when newborn metabolic screening will be conducted.
The purpose of heel prick blood sampling is to obtain specimens for testing, such as measuring bilirubin levels and blood glucose.
In Taiwan, the government mandates that every newborn undergo five basic metabolic screenings.
Additionally, there is a second-tier screening available at one's own expense, which can test for nearly thirty different conditions.
Typically, heel prick blood sampling for newborn metabolic screening is performed 48 hours after birth.
This timing is crucial as full-term infants have usually consumed a sufficient amount of milk by this point.
Certain congenital metabolic disorders are related to issues with lactose metabolism, so blood samples must be taken after feeding to detect problematic metabolites in the bloodstream.
To avoid delaying treatment, blood sampling should not be conducted too late, allowing for early diagnosis and intervention.
For premature infants, the timing of blood tests may be delayed due to varying degrees of prematurity, accompanying illnesses, and feeding status.
However, blood sampling is generally performed before discharge.
The Tainan City Hospital wishes you and your baby good health and all the best!

Reply Date: 2005/02/16

More Info

Heel prick blood tests, also known as newborn screening tests, are crucial for identifying certain metabolic and genetic disorders in infants. For preterm infants, such as your baby born at 36 weeks, the timing of these tests can vary slightly compared to full-term infants.
In general, the recommended practice is to perform the heel prick test at least 48 hours after birth. This timing allows for adequate feeding, which is essential for accurate testing, especially for conditions related to metabolism. For full-term infants, this is typically done within the first week of life, but for preterm infants, the timing may be adjusted based on their health status and feeding capabilities.

For your 36-week preterm infant, the heel prick test is usually conducted before discharge from the hospital. However, if your baby is still in the neonatal intensive care unit (NICU) or has specific health concerns, the healthcare team may decide to delay the test until the infant is stable and has started feeding well. This is because certain metabolic disorders may not be detectable until the infant has been fed, as the presence of specific metabolites in the blood is influenced by the infant's diet.

In many regions, including Taiwan, newborn screening is mandated by health authorities and includes tests for several conditions, such as phenylketonuria (PKU), congenital hypothyroidism, and cystic fibrosis, among others. In addition to the standard tests, there are also expanded screening panels available that can test for a broader range of disorders, which may be beneficial for your baby, especially considering their preterm status.

It's important to discuss with your pediatrician or the healthcare team about the specific timing and tests that will be performed for your preterm infant. They can provide guidance tailored to your baby's needs and ensure that any potential health issues are identified and managed early on.

In summary, heel prick blood tests for preterm infants like your 36-week-old baby are typically performed before discharge from the hospital, ideally after 48 hours of life to ensure accurate results. If you have any concerns or questions about the process, don't hesitate to reach out to your healthcare provider for more information and support. Early detection and intervention can significantly improve health outcomes for infants, particularly those born prematurely.

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