The Newborn Heel Stick Test

As a part of your baby’s first health screening, a doctor or nurse takes just a tiny drop of blood from her heel — but it’s packed with important information.

Here’s why the heel stick test is performed, what to expect during the (very quick) procedure and how you can help keep your new bundle comfortable. 

What is the newborn heel stick test?

The newborn heel stick test is a test given to babies 24 to 48 hours after birth to screen for serious health conditions, including many metabolic and hormone disorders that don’t show symptoms at birth but can be dangerous if untreated. 

The test involves pricking a baby’s heel to take a tiny sample of blood. The blood is then sent to a lab for analysis. If the screening reveals any abnormalities, you’ll be notified and sent for follow-up testing. (If the screening comes back normal, you probably won’t hear anything.)

Heel stick tests are conducted within before a baby leaves the hospital. Babies born at home should be taken to a local hospital for screening within 24 to 48 hours after birth. Some states also require babies to get a second heel-stick test one to two weeks later. 

Why is the heel stick test done?

Blood screenings are the only way to identify certain rare problems with how your baby absorbs nutrients and detect blood- and hormone-related illnesses. Many of these diseases don’t show symptoms when a baby is first born but require immediate treatment to prevent serious complications or disabilities from developing later on. 

For example, babies that test positive for hypothyroidism need to start thyroid-hormone treatment right away to ensure proper growth and brain development, and those with phenylketonuria (PKU), an inherited disorder passed down from both parents that can cause mental disability and other symptoms, need a special formula that is low in an amino acid called phenylalanine. 

A positive result on the heel-stick test doesn’t necessarily mean that your baby has a disorder. Your pediatrician will likely repeat the screening or request a more specific diagnostic test to be sure. In the meantime, your baby may start treatment just in case.

What does the newborn heel stick test look for?

All 50 states and U.S. territories screen for hypothyroidism, phenylketonuria, galactosemia and sickle cell disease. Currently, 32 states and the District of Columbia require heel-stick screening for another core condition, severe combined immunodeficiency. 

Many states make it a practice for all newborns to be tested for up to 35 core and 26 secondary diseases, as recommended by the U.S. Department of health and Human Services, for a total of 60 newborn tests. 

You can visit Baby’s First Test to learn which tests are legally required or universally offered in your state. If you’re concerned that your baby won’t be getting some tests, discuss it with your doctor at a prenatal appointment. You may find out that your hospital conducts the test even though they’re not mandated. If not, your doctor may be able to order additional tests for you, although they may not be covered by insurance.

Although the heel stick test finds many disorders, discuss specific concerns with your doctor if:

• You have a family history of an inherited disorder
• An infant in your family may have died from a disorder.
• You have previously given birth to a child with a disorder.
• Your family has an ethnic predisposition to certain genetic disorders (such as sickle cell disease).

If a heel-stick screening or a more specific diagnostic test shows that your baby has one of the conditions being tested for, you may need to work with a specialist to get the best treatment. Many of the disorders can be treated with dietary restrictions, supplements and medications — and of course, good medical supervision. 

Is the heel stick test standard?

All 4 million babies born in the U.S. each year are required to receive a heel stick test before leaving the hospital. You don’t have to ask for it — it’s a normal hospital procedure that’s conducted for every newborn, even if you don’t have insurance.

Though the thought of your brand-new baby having her heel pricked might make you wince, this test is conducted to protect baby’s health. And while it’s normal for babies to cry after the prick, research shows there are steps you can take to comfort your new bundle, like holding your baby skin-to-skin, breastfeeding during the procedure, wrapping your baby tightly in a blanket, or offering a pacifier. Within a minute or two, she’ll be feeling like her cute, sweet self again.