When your baby is born they are immediately subjected to a bunch of different tests to determine their health and wellbeing.
And of course, whether they require medical attention.
Most babies are born completely healthy, with no need for any additional tests. Other than the routine check-ups performed on all newborns.
But since 1980, Malaysia has made some special newborn screenings mandatory for every newborn child.
According to Dr. Yin Hui Leong, Family Medicine Practitioner at Klinik Kesihatan Setapak and Medical Professor at USM, newborn screenings like the ones performed in the United States, are not a common practice in Malaysia.
Other than screenings for G6PD deficiency and congenital hyperthyroidism, the Ministry of Health Malaysia does not require hospitals to provide any other types of bloodwork or genetic testings for newborns unless necessary.
Parents may often confuse newborn screenings with regular health checks.
Here’s what you need to know.
Routine Health Check-Ups
When your baby is born you are given a health check booklet (Buku Rekod Kesihatan Bayi dan Kanak-Kanak).
This booklet holds all the doctor visits and doctor notes of your baby’s medical record including routine check-ups from newborn age all the way till six years old.
Depending on the hospital, this health booklet will generally have the standard medical checkups.
General condition, appearance, colour, skin, head/neck, ears, eyes (including red light reflex), lips, gum, palate, chest, respiration, heart, abdomen, spine, anus, genitalia, femoral pulse, hips, hands, feet, and Moro reflex (neurology).
The baby’s weight, height, head circumference are also measured, as well as their bowel movements.
Paediatricians will also record developmental milestones like when the baby is able to lift/hold up their heads, crawl, respond to stimuli and other important signs of health.
Your baby’s vaccinations, health shots (vitamin K), Apgar scores and nutrition are also monitored in this health checks.
Special Newborn Screenings
Newborn screenings are a common practice in places like the United States where babies are tested for genetic disorders as soon as they are born.
This is usually performed with a single blood test that can reveal if the baby has any of the 21 genetic diseases.
However, in Malaysian, newborn screenings are still not widely performed unless there’s a need to do so.
Blood tests are commonly performed in the case of jaundice or any other temporary neonatal ailments.
However, there are only two mandatory newborn screenings that must be carried out by every hospital after a baby is born.
Mandatory Screenings
G6PD Deficiency
G6PD deficiency is an genetic condition marked by a deficiency in an enzyme known as glucose-6-phosphate dehydrogenase.
This enzyme is responsible for ensuring that the red blood cells of the body are able to function properly.
When someone is born with a lack of this enzyme, they can experience something known as hemolytic anemia.
A condition that results in red blood cells breaking down faster than the body is able to replace them.
When exposed to certain stressors like infections, food (fava beans), medications (aspirin) or common household products (moth balls), the patient can experience deadly symptoms especially if they are babies.
Congenital Hyperthyroidism
Another genetic disorder that babies need to be screened for, congenital hyperthyroidism is also known as Neonatal Graves Disease.
The disease is caused a shortage of iodine in the diet of the mother and the affected infant.
Iodine is essential for the production of thyroid hormones, which is essential for growth and brain development.
Symptoms include low birth weight, small or abnormally shaped head, poor weight gain (failure to thrive), enlarged liver and spleen, swelling of the front of the neck due to large thyroid (goiter), fast heartbeat, which can lead to heart failure, and high blood pressure.
Optional Screenings
Some hospitals and clinics have also implemented optional screenings like hearing tests.
The ones available in the country include those for IEM (Inborn Errors of Metabolism) which includes screenings for amino acid metabolism, fatty acid oxidation, and organic acid metabolism disorders.
But there are also 21 other genetic, metabolic, hormonal and functional disorders that can be detected with newborn screenings.
These include, PKU, hypothyroidism, congenital adrenal hyperplasia, biotinidase deficiency, maple syrup urine disease, galactosemia, homocystinuria, medium-chain acyl-CoA dehydrogenase deficiency and sickle cell anaemia.
However, as of now, these tests will only be performed if your paediatrician detects abnormalities during regular check-ups, or if the parents point out certain symptoms that need further testing.
There has been a recent push in recent years to expand newborn screenings to include other neonatal disorders.
But due to lack of manpower, resources and funding, this remains to be seen.
However, you can still get your little one tested if you have the financial means to do so.
Many private clinics offer full newborn screenings not offered in government hospitals. They can be quite costly though.
Opting for Newborn Screenings
Screenings are different from tests in that they aim to catch a disease or disorder before symptoms show.
Newborn screenings allow medical professionals to stop a congenital disease before it progresses whereas tests are meant to confirm diagnosis.
Typically, it may not be necessary for you to get all the newborn screenings available.
But it is important to watch out for any alarming signs so you can immediately inform your baby’s paediatrician, if needed.
This is also why you should be extra diligent about taking your newborn for their regular check-ups.
A doctor can quickly find out if anything’s wrong and help your baby recover so they can grow up healthy, strong and happy.
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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