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Center for Congenital and Inherited Disorders

Fingers holding a baby's foot

Iowa Neonatal Metabolic Screening Program

What is neonatal (newborn) metabolic screening?

Neonatal metabolic screening, also called newborn dried blood spot screening or heel stick screening, is a blood test that screens for certain treatable metabolic and inherited disorders performed shortly after a baby's birth. Currently, Iowa law requires all newborns and infants born in the state of Iowa will be screened for the following:

The Iowa Neonatal Metabolic Screening Program (INMSP) identifies babies who may have one of these disorders and alerts the baby's health care provider to the need for further testing and special care. With early diagnosis and treatment, complications from these serious disorders can usually be prevented.

How is my baby screened?

All of the screens are performed from a few drops of blood obtained by pricking the baby's heel at least 24 hours after birth or just before the baby is discharged or transferred from the hospital. The blood is collected on an absorbent paper collection form, which is then sent to the State Hygienic Laboratory.

Babies born outside of hospitals need to be screened as well, preferably 24 hours to 5 days after birth. Parents can arrange the screening with their health-care provider, local hospital, or public health nursing agency.

How do I receive the results?

Parents are usually not notified if the screen results are in a normal range. Your licensed health care provider will be informed when the screening results are completed and you may ask them about the results. Generally, parents are notified only if rescreening is needed.

If your health care provider asks you to bring your baby in for rescreening, do so as soon as possible. Rescreening does not mean there is anything wrong with your baby. It simply means that another sample must be obtained so that the complete set of screening tests can be performed. Some reasons for rescreening may include:

  • Unsatisfactory specimens:  There was something wrong with the sample and it needs to be recollected.
  • Early collection:  The sample was drawn before the baby was 24 hours old.
  • Transfused:  The baby received a blood transfusion before the sample was collected. Blood transfusions can lead to inaccurate screening results.

  • Abnormal test result:  An abnormal test result means there "may" be a disorder present. Your doctor will work with you to determine if further evaluation is needed.

Many of these disorders cause irreversible damage in a short period of time, so if you are asked to rescreen your baby, do so immediately.

Can I refuse the screening for my infant?

You may refuse screening. If you refuse, you must inform your health care provider and accept the legal responsibility for the consequences of this decision. Your health care provider will notify the newborn screening program that you have waived the screen.

What is the cost of the screening?

The cost of newborn metabolic screening is established in Iowa law. The current fee is $112, and includes expenses for equipment, supplies and staff of the laboratory, a courier service that delivers the samples to the laboratory for same-day testing, and professional follow up staff that include nurses and physician specialists. This fee is usually covered in your hospital bill from having your baby and will most likely be covered by your insurance company. There is no charge for a rescreen sample if one needs to be collected.

Who to contact for more information?

Where do I get more information?

What is Newborn Metabolic Screening?