Even though neonatal mortality is a serious problem, there has been little attention paid to understanding its causes and determinants especially in developing countries like India. The lack of interest in neonatal death has due to variety of factors. Significantly, the causes of Neonatal are usually unattended by health personnel.

What is Neonatal Disorder?

Neonatal Disorder is related to or affecting the infants during the first month after birth. 1 in every 1000 newborns in India, i.e. 30 children in a day, suffers from neonatal disorders. Infants born with any of these diseases are apparently healthy looking and by the time symptoms appear, the problem is almost irreversible meaning could not be treated. Though family history, history of recurrent abortions, previous child with mental retardation, history of sudden infant death in previous in previous sibling, mother with significantly low intelligence etc is high risk factors; it is commonly observed that some of the disorders mentioned above are fairly common in healthy families without any history.

What is Newborn Screening?

Newborn Screening is a simple blood screening used to identify many life-threatening genetic illnesses before any symptoms begin.

Why should any child have Newborn Screening in India?

Newborn Screening is important because a baby with one of these illnesses will appear perfectly healthy and by the time symptoms are visible, irreparable damage can occur. Damage such as mental retardation or many times, death. The screening of a newborn is almost imperative in India because if a child is diagnosed with such disorder when the damage has already occurred, then the cost of bearing such child is very high. Moreover the child with such disorder requires special diets, which is unavailable in India.

If a family never had any birth defects in the family, why should they go for this screening?

Parents who have already had healthy children don't expect any problems with birth defects and they are almost always right. Since these disorders are not very common, the chances are excellent that your child may NOT have one of these disorders. However, the few children who are born with these problems are generally from healthy families. By screening every baby after birth one can be sure that each infant who has a disorder can be identified and started on early treatment.

What is a child's chance of testing positive for one of the disorders?

The baby's chances are 1 in 1,000 births.

How are the screenings done?

All of the screens are performed on one tiny sample of blood obtained by pricking the baby's heel. After the infants' heel is stuck the drop of blood that forms is placed on an absorbent card and allowed to dry. Once it is dried it is mailed directly to the lab.

How soon after birth should a child be screened?

The sample is usually taken on the day of discharge from the hospital or no later than 48 hours of age. The blood is allowed to dry on a piece of absorbent paper, which is sent for screening to a special newborn screening laboratory.

How a child can be affected, if not screened at proper time?

The child can have the following disorders:

1. Mental Retardation

2. Recurrent Chest Infection

3. Anemia

4. Seizure/ fits

5. Jaundice

6. Milk Intolerance

7. Vision & hearing loss, skin infections

8. Development & growth abnormalities, masculinization in females, death

9. Poor growth, low metabolic rate

10. Severe brain damage, cataracts, osteoporosis

11. Pneumonia

What does one do if a child's results are positive for one of these disorders?

This question is a very individual one and can only be answered by a trained professional who has detailed information from your family's health history. The physician or a genetic counselor at a center where a child is evaluated will help answer this question.

A baby seems very healthy. Are the screenings still necessary?

Yes. Most infants with birth defects screened by this program show no obvious signs of disease immediately after birth. In each of these disorders there is an "invisible" problem in one of the many chemicals, which are produced naturally in the baby's body. With special laboratory screenings one can identify the infant who may have one or more of these disorders and can alert the doctor to the need for special care of the infant. Usually this can be done before the problem has time to cause damaging effects.

"By intervening early in a child's life, you can reduce morbidity and mortality. Basically, you're going to save the lives of children and prevent mental retardation and severe physical disabilities. People think it costs money, but you really save lives. Although there are steps you can take to prevent birth defects, remember that a birth defect can happen even if you or your partner have no history of birth defects in your families or if you've had healthy children in the past. Moreover this assignment of educating the young parents goes to the doctors specially the Pediatrics, GP and the Gynecologist, who advocate such tests to the parents who are oblivious to such Neonatal disorders", stated Dr. Sanjeev K. Chaudhry, CEO SRL Ranbaxy - India's largest Pathology Laboratory Network.

Dr. Sanjeev K. Chaudhry