Do we 'really' need a newborn screen on 'every' baby??!

Many countries have some version of the newborn screen, and even in the US, every state has slightly different newborn screens. Basically though, it's when a little bit of blood is taken from every single baby that's born, NICU or full-time baby, from the heel, so a little heel stick, that blood is sent to the state lab, and then the state tests it for a whole panel of different diseases which are basically inherited. There's always a lot of conversation about which diseases should actually be on the newborn screen, but basically each state can decide that, and the diseases have to satisfy a few criteria. So first of all, it has to be a disease that can't be diagnosed by a physical exam. So there isn't a newborn screen for Down syndrome because you can diagnose Down syndrome nearly all of the time just on physical appearances. Two, the disease has to have a readily available test which is not super expensive, because remember, you're doing it on every single baby born in the state. Third, the disease has to be serious enough that it's going to cause health problems early in life. So we would check for eczema, for example, which isn't necessarily a severe health problem, or we wouldn't check for an increased risk of breast cancer because that isn't going to affect the child early in life. And fourth, it has to be a disease that if we do catch it early enough, there is a treatment or there is a way to prevent it that it will majorly change the outcomes for those infants. And this is probably the most key part of newborn screening. So for example, checking for hypothyroidism is a great example of a perfect test for the newborn screen. It's easy to pick up. And if you do actually catch the hypothyroidism, you can give replacement thyroid hormone to the babies and those babies will then be unaffected. If you miss them and they don't get the replacement thyroid hormone, then it can lead to severe developmental disabilities. In every country, a state organization kind of determines which sort of tests should be on the screening panel. Obviously, in different states, especially in different countries, there's going to be a slightly different combination of genes and some diseases are going to be more common than others. Currently, there are 29 recommended inborn errors of metabolism to be tested on the newborn screen. As you all probably know, PKU, so phenylketonuria, methylmalonic acidemia, and propionic acidemia, all pretty common inborn errors of metabolism are all on that screen. I just want to say two more things about newborn screens. The first one is, is by definition, they are screening tests and by definition screening tests, you want to pick up every single person with a disease. So that also means that you're going to end up with a lot of false positives. So a lot of people that it says that they have the disease, but they don't really. All I can say is, is that you have to assume that this is like a Peter Cried Wolf situation. Assume that every single one is a true positive and follow it up accordingly, because otherwise you will end up missing some true positives. And the second thing I'll say is that the newborn screen can sometimes take a week or two to come back. And some of these diseases can present before the newborn screen comes back. So don't assume that the baby doesn't have it because it's on the newborn screen. You learn anything from this video, then please press like and write to us and tell us where you're from. If you're interested in neonatal education, then please subscribe to the channel. We are so thankful that you are here and we're building this community together. Thank you so much.