Newborn Health is a Nation’s health
India records overwhelmingly high birth rates and despite more than 27 Million babies is estimated to be born each year; the infant care services are grossly inadequate. September being the “Newborn Screening Awareness Month” Globally, it is essential that further emphasis is given in education and awareness in the Indian society on this essential topic of New Born Health and Screening ensuring monitoring of infants’ health immediately after the birth even before the symptoms of any diseases are shown. Newborn screening helps in identifying several metabolic and genetically acquired diseases with just a prick of the heel. Therefore, instead of neglecting this poignant topic of discussion from the mainstream media, there is a need to emphasize on the necessity to make Newborn Screening a mandatory procedure in the country.
In a typical newborn screening test, a simple heelprick is done that yields up to four-five drops of a newborn’s blood which isplaced on a dry filter paper and transported to laboratories that run tests forvarious diseases. This procedure is adopted to detect additional 45 disordersthat include improper metabolism of fatty acids, organic acid and amino acids.
For premature babies, the test is first conductedduring this period and another one repeated once the baby is full-term. A typicalNBS test is conducted by pricking a baby’s heel to extract a small quantity ofblood which is then screened to detect any abnormalities which may be a sign oftreatable medical condition. Another test is the hearing test which isconducted usually when the baby is asleep using special equipments. Babies whodo not have any family history of disabilities and disorders are also diagnosedwith critical medical conditions. Therefore, it is advisable for parents tomandatorily take their babies for a newborn screening test within hours ofbirth. It is basically a preventive pediatric screening service provided to allnewly born children to assess the possibility of genetic disorders in the areaof ‘Inborn Errors of Metabolism’. However if it is detected early enough, itcan be easily treated. The treatment and care is for lifelong.
A baby born with genetic disorders may not show anysymptoms immediately after birth. However, the baby usually develops seriousproblems later in life if he or she is not treated at the right time. Newbornscreening helps to diagnose these babies early so that treatment can beinitiated as soon as possible.
If the abnormalities or diseases are detected within2-3 days of the child’s birth, lot of these are curable. Identification is thefirst step towards finding a cure or a solution. Once the disorder is detected,further treatment is put into consideration with a needed of taking care of thebaby's diet.
Although treatments for some conditions are morecomplicated, it is still helpful to know about the condition early. A baby withsickle cell disease is at risk for harmful infections. Identifying these babiesat the right time means that they can receive a daily dose of penicillin, anantibiotic medicine, to help avoid infections and prevent serious problems.
Today Newborn screening has evolved from a simpleblood or urine screening test to a more comprehensive and complex screeningsystem capable of detecting over various conditions.
In many countries, hospitals have made these testsmandatory but it is a sad thing that in India there is no government fundedneonatal screening center. Therefore, it always comes as an extra financialcost on the parents wishing to perform the tests. Another huge pull down is thelimited awareness of NBS tests in India. Only a few hospitals inmetropolitan cities like Delhi, Mumbai and Bangalore perform these tests. Onthe other hand, Government of Kerala and some of the Central GovernmentHospitals have already initiated the active Newborn Screening procedures. Caremust be taken in implementing new programs and every time it needs to include athorough analysis of public health impact and cost effectiveness with an eye onthe future must be taken into consideration.
While the western world and developed countries Screenfor 50 to 70 disorders in their Universal New Born Screening programs usingImmunoassay and Mass Spectrometry platforms, many developing countries haveadopted a basic program to Screen at least 5 to 8 parameters using Immunoassayplatforms. Screening for at least 3 to 5 core parameters for CongenitalHypothyroidism, Congenital Adrenal Hyperplasia, Phenylketonuria, Galactosemiaand G6PD disorders should be made compulsory in India for every baby born inIndia as a part of Child Health program.
If the child is born in a hospital, the staff willtake care of everything from taking the blood samples, to sending them fortesting and the results will be reported back to the hospital itself. If youhave given birth at home then positively take your baby for the tests no laterthan the seventh day of his birth.
Today most parents opt out of newborn screening testthinking it is unfair on their part to let a newly born infant to undergo theperils of an intensive screening process. However, quite contrary to suchlargely prevalent misconceptions, identifying conditions that can affect achild’s long term health or survival in the critical first few hours of aninfant’s life will significantly help in preventing death and disability.Newborn Screening (NBS) is one of the most effective ways to detect disabilityat an early stage.
Statistically, India witnesses the birth of ~27million babies annually, out of which 360,800 infants are detected withmetabolic disorders. Given the current scenario, where high profile medicalfacilities are still a daydream for the rural population, preventive pediatricscreening tests like Newborn Screening should be made mandatory. This will helpthe parents to gift a good and healthy future for their bundle of joy.
By, Dr GSKVelu, Chairman & Managing Director, Trivitron Healthcare Group of Companies