Frequently Asked Questions
Has DSHS altered guidance for collection of newborn
screens?
No. The 1st newborn screen
should be collected between 24 - 48 hours of age, or before hospital discharge.
The 2nd newborn screen should be collected on every infant at 1-2 weeks of age.
DSHS recognizes that healthcare providers may require
adjustments to newborn screening protocols.
Completely and accurately fill out all information requested
on the collection kits.
Incomplete or inaccurate demographic information can
result in specimen rejection, incorrect results, or delay in initiation of
follow-up on out of range results.
Ensure parent contact information (phone number
and address) is current.
Advise parent to select a pediatrician and
attempt to make the first appointment prior to leaving the hospital. Enter
pediatrician contact information on the collection kit.
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What if a parent is requesting early discharge to
socially isolate themselves and their newborn?
Collect the first screen
immediately prior to discharge.
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For 2nd screens, what if our facility is
unable to provide a location to collect the specimen?
If necessary, explore the
availability of other collection locations such as an outpatient clinic or reference
laboratory. If no alternative can be
identified, ensure a screen is collected as soon as can be safely scheduled.
The American Academy of Pediatrics (AAP) recommends
pediatricians continue to see newborns and infants for preventive care. AAP
CoVID-19 guidance includes:
- Delaying care for newborns
and other vulnerable children during this time could have devastating
consequences for their health.
- Be flexible to determine the
best way to schedule patient visits to minimize the risk, including spacing out
visits, modifying clinical space, or rescheduling visits for older children
until a later date.
- Pediatricians may choose to
limit well visits to early morning while reserving the remainder of the day for
sick visits.
- Pediatricians are encouraged
to dedicate specific rooms for sick visits and well visits; or for those with
multiple practice sites to consider using one office location to see all well
visits (staffed by those in higher risk categories).
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What if a 2nd screen cannot be collected
in the recommended timeframe of 7-14 days of age?
Collect the 2nd screen as
soon as conditions allow. This ensures the earliest possible interventions for
affected babies. DSHS does not reject
specimens collected on older children, but NBS testing methodologies have been
designed to minimize the number of false negative and false positive results in
newborns and young infants.
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What if the 1st screen was out of range or
unsatisfactory?
It is imperative to
ensure that another screen is collected for newborns with an out of range or unsatisfactory
1st screen. Having an unsatisfactory screen is like not being
screened at all. In some situations, newborns with out of range first screens may not require
diagnostic evaluation if a second screen is normal.
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What if the parent refuses the 2nd screen?
Parents can only refuse to have their child screened if the screening conflicts
with a parent’s religious tenets or practices (see Texas Health & Safety
Code Sec. 33.012). To refuse, a parent must sign a form stating he/she has a
religious objection to newborn screening. Points to consider before refusing a
second newborn screening:
- DSHS has implemented a
two-screen system to maximize the effectiveness of testing for all disorders on
the Texas Newborn Screening Panel.
- The second screen routinely
detects babies at risk for severe medical complications. These babies sometimes
have a normal first screen.
- Some disorders (like cystic
fibrosis) rely upon both newborn screens to reduce the number of babies who
would otherwise require additional testing with a specialist to determine
whether they have the condition or not.
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Our facility has new staff assisting with specimen
collection and out of range result follow-up coordination. What resources are
available for quality assurance?
Healthcare provider
guidance on specimen collection, transport and result reporting can be found at:
dshs.texas.gov/lab/nbsHCRes.shtm
Please completely and accurately fill out all information requested
on the collection kits. Incomplete or inaccurate demographic information can result in specimen rejection,
incorrect results, or delay in initiation of follow-up on out of range results.
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Questions?
Corona
Virus in Texas:
Newborn Screening Laboratory:
1-888-963-7111 ext. 7333 or 512-776-7333
Clinical Care Coordination:
1-888-963-7111 ext. 3957 or 512-776-3957
Newborn@dshs.texas.gov