Vaccinations, hearing screening, heel pricks, things parents of newborns need to know!

Author: Li Guiying, deputy chief nurse, Beijing Anzhen Hospital, Capital Medical University

Reviewer: Liu Li, Chief Physician, Beijing Children's Hospital, Capital Medical University

We often say that children are the apple of their parents' eyes. It is usually the greatest wish of parents that their baby has a healthy body. In order to ensure the health of the baby, some necessary measures are often taken from birth.

For example, for the hepatitis B vaccine, for ordinary newborns, the first dose should be completed within 24 hours after birth, and then the second and third doses should be given one month and six months after birth respectively. The injection site is the deltoid muscle of the upper arm.

For some high-risk newborns, such as those whose mothers are hepatitis B patients, in addition to the hepatitis B vaccine, the baby must also be injected with hepatitis B immunoglobulin after birth. The purpose is to better improve the baby's specific immune ability, and at the same time cooperate with the hepatitis B vaccine to fight against hepatitis B virus infection.

In addition, the BCG vaccine for preventing tuberculosis is also administered within 24 hours of the birth of the child, subcutaneously under the deltoid muscle of the left upper arm.

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BCG, as a live attenuated vaccine, may cause normal reactions such as redness, swelling, nodules, and blisters after vaccination, so parents do not need to worry too much. However, if the redness and swelling are more than 5 cm and the blisters are severe, you should seek medical attention in time. In contrast, the hepatitis B vaccine is a genetically recombinant vaccine, which means it does not contain viral components and will not cause hepatitis B. It is relatively safe and usually does not cause such special reactions.

Another very important examination for newborns is hearing screening.

Newborn hearing screening is an objective, rapid and non-invasive examination performed on newborns in their natural sleep or quiet state after birth using electrophysiological tests such as otoacoustic emissions, automated auditory brainstem response and acoustic impedance.

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The purpose of this screening is to screen children for hearing impairment at an early stage. If there is a hearing impairment, it will not only affect the child's cognitive, speech, and mental development, but also bring a heavy burden to the family and society, so hearing screening is very important.

Generally, hearing screening is performed 2-3 days after the baby is born. If the screening is passed, the parents will be given a screening card to inform them that the hearing is passed; if it is not passed, it is recommended to take the baby to the corresponding institution for a re-examination within 42 days.

Modern science and technology can now perform early hearing testing and diagnosis on newborns and infants. For infants and young children who are clearly diagnosed with permanent hearing loss, most of them can return to society if they receive scientific intervention and rehabilitation training within 6 months of birth.

In addition, heel blood should be collected after the baby is born, mainly to check for three genetic diseases, namely phenylketonuria, congenital hypothyroidism, and congenital adrenocorticism.

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Phenylketonuria is an autosomal recessive genetic disease, which is the most common inborn error of amino acid metabolism. Once diagnosed, low-phenylalanine diet and specially formulated milk powder should be given. In addition, there are some corresponding drugs.

Congenital hypothyroidism is caused by thyroid dysplasia and thyroid secretion disorders. When the disease occurs, symptoms such as mental retardation, laziness, short stature, slow heart rate, constipation, etc. may gradually appear. Once diagnosed, it is necessary to give medication under the guidance of a doctor, such as levothyroxine.

Congenital adrenal hyperplasia is an autosomal recessive genetic disease. It is caused by the congenital deficiency of adrenocortical hormone biosynthesis enzymes and proteins. It can generally be treated with glucocorticoid and mineralocorticoid replacement therapy, such as hydrocortisone and deoxycorticosterone acetate.

These three diseases are hereditary diseases that will affect the baby's growth and development. Screening through heel blood is simple and fast, and can achieve early detection, early diagnosis and early treatment.

Another thing you need to know is that there are requirements for the time of heel blood sampling. The baby needs to be fully fed for 72 hours before the blood can be drawn, otherwise the result may be a false positive. If the result is positive, another test is required to confirm the diagnosis.