AROMIN, Patricia Anne L.

BSNII AO1

Health Teaching Report - NBS Group 24 Mrs. Jennifer Reyes

NEWBORN SCREENING TEST Republic Act 9288 - Newborn Screening Act OBJECTVES (according to Department of Health): 1. To ensure that every newborn has access to newborn screening for certain heritable conditions that can result in mental retardation, serious health complications or death if left undetected and untreated; 2. To establish and integrate a sustainable newborn screening system within the public health delivery system; 3. To ensure that all health practitioners are aware of the advantages of newborn screening and of their respective responsibilities in offering newborns the opportunity to undergo newborn screening; and 4. To ensure that parents recognize their responsibility in promoting their childs right to health and full development, within the context of responsible parenthood, by protecting their child from preventable causes of disability and death through newborn screening. New born Screening Test (NBS) a simple procedure to find out if your baby has a congenital metabolic disorder that may lead to retardation and eve death if left untreated. - the process of collecting a few drops of blood from the newborn onto an appropriate collection card and performing biochemical testing for determining if the newborn has a heritable condition. - It provides opportunity for early treatment of diseases that are diagnosed before symptoms may appear. DISORDERS UNDER THE PHILIPPINE NEWBORN SCREENING PROGRAM: o Congenital Hyperthyroidism (CH) o Congenital Adrenal Hyperplasia (CAH) o Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD Def) o Galactosemia (Gal) o Phenylketonuria (PKU) GOAL: Chance to have a normal life.

WHY NBS IS IMPORTANT: - Most babies with metabolic disorders look normal at birth. No one will ever know that the baby has the disorder until the onset of signs and symptoms and more often ill effects are already irreversible. Also, for early detection of illness that can lead to death. IS NBS REQUIRED? - The Department of Health and other health organizations strongly recommend babies to undergo Newborn Screening. Sometimes, some parents decline for various reasons, such as religious concerns. In these cases, they are asked to to acknowledge in writing that they understand the benefits of NBS and that they know they may be placing their newborn at risk for undiagnosed congenital conditions by declining the test. This dissent form is included in the newborn's medical record and is recorded in the National Newborn Screening Database. WHEN NBS SHALL TO BE DONE? - It is ideally done on the 48th hour or 2 days or at least 24 hours from birth. Some disorders are not detected if the test is done earlier than 24 hours. The baby must be screened again after 2 weeks for more accurate results. WHERE IS IT AVAILABLE? - NBS is available in practicing health institutions like hospitals, lying-ins, Rural Health Unit and Health Centers. If delivered at home, the baby may be brought to the nearest institution offering and new born screening. WHO WILL COLLECT THE SAMPLES FOR SCREENING? - A physician, a nurse, a midwife or medical technologists. HOW IT WILL BE DONE? - Since NBS is a simple procedure, using the Heel Prick Method, the physician, nurse, midwife or medical technologist will prick the heel of the baby to get few drops of blood for about 3mm. the taken blood will be blotted on a special absorbent filter card. The blood is dried for 4 hours and sent to NBS laboratory. WHEN WILL BE THE RESULTS CAN BE RELEASED? - It can be released within after 4 weeks or 1 month after the NBS laboratory receives and tests the samples. - It will be released by NBS laboratory to the institutions and furnish the copy to the proper attending physicians.
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** Parents may seek the results from the institutions where samples are collected. INTERPRETATION OF RESULTS: - A NEGATIVE SCREEN means that the result of the test is normal and the baby is not suffering from any of the disorders being screened. the process of collecting a few drops of blood from the new born onto an appropriate collection card and performing biochemical testing for determining if the new born has a heritable condition. **in case of POSITIVE SCREEN result, the NBS nurse coordinator will immediately inform the coordinator of the institution where the samples are collected for recall of patients for confirmatory testing and explain what will be the other procedures to be done. WHAT SHALL BE DONE IN A POSITIVE SCREEN? - Babies with positive result should be referred at once to the nearest hospital or specialist for confirmatory test and further management. If there is no specialist in the area, the NBS secretariat officer will assist its attending physician. EFFECT SCREENED EFFECT IF SCREENED AND TREATED Normal Alive and normal Alive ad normal

Congenital Hyperthyroidism (CH) Congenital Adrenal Hyperplasia (CAH) Glucose-6-Phospate Dehydrogenase Deficiency (G6PD Def) Galactosemia (Gal) Phenylketonuria (PKU)

Severe Mental Retardation Death Death or Cataracts

Severe Mental Retardation Severe anemia, Kernicterus

Normal Normal

DESCRIPTION OF THESE DISORDERS: 1. Congenital Hyperthyroidism (CH) - A lack or absence of thyroid hormone, which is necessary for growth of the brain and the body. Treatment is required within the first four weeks to prevent stunted physical growth and mental retardation. 2. Congenital Adrenal Hyperplasia (CAH) - An endocrine disorder that causes severe salt loss, dehydration, and abnormally high levels of male sex hormones. Left undetected and untreated, a baby may die within seven to 14 days.
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3. Glucose-6-Phosphate Dehydrogenase (G6PD Def) - A condition where the body lacks the enzyme called G6PD, which may cause hemolytic anemia resulting from exposure to oxidative substances present in certain drugs, foods and chemicals. Parents of G6PD-positive babies are given a list of these substances. This is the mildest disorder that is covered in NBS. 4. Galactosemia (Gal) - A condition in which babies are unable to process galactose. or the sugar present in milk. Increased galactose levels in the body lead to liver and brain damage, and to the development of cataracts.

5. Phenylketonuria (PKU) - The inability to properly utilize the enzyme phenylalanine, which may lead to brain damage.

Sources: http://www.doh.gov.ph/faq/show/457.html http://www.phil-newbornscreening.blogspot.com http://www.doh.gov.ph