Newborn Heart Screenings: Checking the Health of the Littlest Sweethearts

posted by Jeannette Hasley on Monday, February 4, 2019

While your newborn is busy melting hearts, our health care team is focused on the health of your baby’s heart.

At Spencer Hospital’s Birth Center, we strive to provide families with a safe and memorable birth experience while simultaneously providing them with all of the latest standards of care for both mom and baby. One of those health care standards is conducting a screening exam on baby for Critical Congenital Heart Disease. (CCHD).  

Congenital heart defects are the most common type of birth defect in the United States, effecting about 40,000 births annually. While the CCHD screening cannot detect all heart issues in newborns, it is successful in catching many cardiac health concerns in newborns in an early stage, when treatment plans can quickly be made to address those health issues. The CCHD screening can detect problems which range from abnormities in the heart rhythm to other structural heart problems.

The concerns a newborn with CCHD may experience can range from being mild to severe. Babies with severe CCHD may experience life-threatening symptoms which would require intervention within the first days or first year of life, with a possibility of needing multiple heart surgeries over a period of time. Conditions may include abnormal or absent chambers of their heart, holes in their heart, abnormal connections in their heart, or possibly abnormalities in the squeezing of their heart.

Sometimes a baby with CCHD will initially look and act healthy, but within a few hours or days after birth, serious complications arise. The combination of the CCHD screening and the nursing assessments soon after the baby’s birth can help identify issues in a timely manner.  Symptoms of CCHD for a newborn can include trouble breathing, loss of healthy skin coloring, cyanosis (which is bluish color to the skin or lips), swelling of the baby’s face, hands or feet, or possibly sweating around the baby’s head or a baby that gets tired easily during feedings. Some babies with CCHD also may have poor weight gain.

The babies are screened for CCHD with pulse oximetry. This is a non-invasive test, meaning your baby won’t be poked or prodded, which is able to measure how much oxygen is in the baby’s blood. The pulse oximetry device is placed on baby’s right hand and either foot. The nurse then monitors to determine what the oxygen saturation is in both locations - the baby’s hand and the foot - and also if there is a variance in oxygen levels between the hand and foot.

If baby’s oxygen saturation is greater than 95 percent and the difference between the right hand and baby’s foot is not greater than 3 percent, the screen is considered negative for critical congenital heart disease. If a newborn has oxygen saturation of less than 90 percent in either or both extremities, or if the difference between the right hand and the foot is greater than 3 percent, the screening is repeated every hour for three additional screenings.  If the results remain similar, it’s considered a positive screen and the baby’s primary care physician is notified of the results. The baby will likely be referred to have an echocardiogram. Depending on the significance of the positive screening, the baby may have to stay in the hospital until the echocardiogram can be done.

It’s important to remember a health screening can detect many concerns, yet will not will not capture and detect all problems, so we encourage parents to ask questions of their physician if they have concerns about their baby’s health. We encourage parents to remember that screenings are done to help assure the health of your baby and if there are concerns, to discover and address them quickly so you can focus on your little one’s other needs and his or her heart melting charms. 

About The Author

Jeannette Hasley

Jeannette L. Hasley is our Director of Obstetrics. Jeannette earned her bachelor’s degree from the University of Iowa. She started her nursing career in Denver, Colorado where she quickly learned that she had a deep passion that would be fueled by caring for women during labor and delivery. ... read more