Postnatal screening

Postnatal screening

Screening tests for newborn babies in the Netherlands consists of the heel prick test and hearing test. Both performed in the first week after birth.

 

Heel prick test

A small amount of blood is taken from the heel of your newborn child in the first week after birth. This blood is tested in a laboratory for a number of rare diseases. Early detection and treatment of these diseases can prevent or limit serious impairment of the physical and mental development of your child. Most of these diseases cannot be cured but they can be treated, for example with suitable medication or a diet.
Participation in the heel prick is voluntary. Your permission for performance of this test will therefore be requested. The heel prick can be important for the health of your child, which is why participation in the screening is strongly recommended.

The heel prick can only be performed if you have reported the birth of your child to the municipal Civil Registry Office. This must be done as soon as possible (no later than 3 days after the birth). Please note that the Civil Registry Office is closed on Saturdays, Sundays and public holidays.
After registration, the Civil Registry Office will send an electronic report to a national registration system of the National Institute for Public Health and the Environment (RIVM) known as Praeventis. The Child Health and Welfare service (JGZ) will then be informed, and they will instruct a screening assistant to visit you.

A member of the Child Health and Welfare service (JGZ) staff will visit you at home a few days after the birth of your child in order to perform the heel prick. If your child is in hospital, the heel prick will be performed there.
A pinprick puncture is made in your baby’s heel, and a few drops of blood are collected on a special collection card known as the Guthrie card. Your baby may cry a little.

What diseases are tested for by the heel prick?
The blood collected by means of the heel prick is tested for:

  • a disease of the thyroid gland,
  • a disease of the adrenal gland,
  • a type of anaemia (sickle cell disease),
  • a disease of the lungs (cystic fibrosis),
  • a number of metabolic diseases.

Most of these diseases are hereditary, and do not occur often. For full details (in Dutch) of all the diseases involved, please visit RIVM.
The heel prick can also show that your child is a carrier of sickle cell anaemia but does not have the disease itself.

The results of the heel prick are nearly always known within 4 weeks. If the results are normal, you will not be informed. If an abnormality is detected, your GP will let you know and refer you to a pediatrician. In some cases, the amount of blood collected is not enough for all the tests that have to be performed. The heel prick will then have to be repeated. Once again, you will not be informed if the results of the repeat first heel prick are normal, but you will be informed if any abnormality is found.

 

Hearing test

Your baby will be given a hearing test in the first month after birth to check whether his or her hearing is good enough to learn to talk. It is also referred to as neonatal or newborn hearing screening. The hearing test is provided by the Child Health and Welfare service (JGZ), the organiza- tion that runs your baby clinic. It will be carried out by an expert JGZ or maternity care worker, most likely together with the heel prick.

The health worker inserts a soft-tipped earpiece in your baby’s ear. This is connected to a device that measures your baby’s hearing. The test only takes a few minutes and does not hurt. Your baby will hardly notice anything and will usually sleep through it.

You will be given the result of the test straight away and the health worker will discuss it with you on the spot. The result is a ‘pass’ in about 95 out of 100 children. If the baby fails the test it will be repeated about a week later. If necessary a third test will be carried out after another week using a different device.
A fail does not necessarily mean that your child cannot hear properly. If your baby also fails the third test in one or both ears, his or her hearing will be tested at an Audiology Centre. You will receive more information in this case. An Audiology Centre is a clinic that specializes in investigating hearing, speech and language.