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National Newborn Screening Awareness Month

Newborn Screening: A Few Drops of Blood Can Save a Baby’s Life

First Written For News-Herald Media

September is National Newborn Screening Awareness Month, and 2013 is the 50th anniversary of newborn screening nationally. The first newborn screening test was for PKU. Wisconsin began testing for PKU in 1965.

MADISON — Welcoming a new baby to your family can be one of the most exciting and information-overloaded times in your life. But there is one piece of information you need to be sure to ask your baby’s health care provider about: What are my baby’s newborn screening results?

Newborn screening is a test performed on a few drops of blood from a baby’s heel.

Between 24 and 48 hours after a baby is born, hospital staff (or a midwife for home births) will prick the baby’s heel and a few drops of blood are put on a special newborn screening collection card. The card is sent via courier to the Wisconsin State Laboratory of Hygiene’s Newborn Screening Laboratory at the University of Wisconsin-Madison, where scientists test the dried blood spots for 44 rare, serious disorders that, if not treated quickly, can lead to severe health problems and sometimes even death.

If a baby tests positive for one of the disorders, the state lab immediately contacts the baby’s doctor. More tests will be done to confirm the screening result.

Depending on the situation, the baby’s doctor may start treating the baby for the disorder while this additional testing is being performed. Some of the disorders screened for include cystic fibrosis, phenylketonuria (PKU), hypothyroidism, sickle cell disease, severe combined immunodeficiency (SCID) and galactosemia.

Treatment of the disorders varies from special diets to medication to surgery.

“We screen nearly 70,000 infants a year for these rare, serious disorders and about 125 to 130 will have one of the 44 disorders,” says Mei Baker, a UW-Madison pediatrics associate professor and co-director of Wisconsin’s Newborn Screening Laboratory. “For those babies, a few drops of blood from their heel saved their life and gave them a chance for normal growth and development.”

If a baby’s newborn screening results are normal — and that’s the case for 99.9 percent of babies — the test results will be sent to the baby’s health care provider within a week after testing is completed.

Even though the vast majority of babies have normal newborn screening results, it’s still important to screen all of them.

“Nearly all of the 44 disorders are unrecognizable at birth, at least by routine physical examination,” says Patrice Held, co- director of the Newborn Screening Laboratory. “We have an opportunity to identify and treat babies with these disorders before they develop serious health problems.”

Another component of newborn screening in Wisconsin is hearing screening. The baby’s hearing is tested at the hospital or by a midwife after a home birth.

In Wisconsin, newborn screening testing is mandatory, but parents can opt out for religious reasons. The comprehensive program is administered by the Wisconsin Department of Health Services and the Wisconsin State Laboratory of Hygiene. The program also includes physician consultants, genetic counselors and nutrition professionals from around the state.

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Wisconsin Medicaid Input Needed

The Wisconsin Department of Health Services, which administers the state Medicaid/BadgerCare program, is asking the public to submit cost-saving ideas via email to help them close their $500 million budget deficit.

This is an excellent opportunity for us to begin the process of educating all of the newly-appointed policy makers at DHS about the many reasons why creating a DHS provider category to reimburse for Licensed Midwife services in out-of-hospital settings will not only save the state significant amounts of money but improve outcomes and access for low-income mothers as well.

Please forward this message to your clients, family, and friends and ask them to send an email using one or more of the talking points below, in their own words, and submit their comments to:

DHS Deputy Secretary Kitty Rhoades at:

Kitty Rhoades
608 266-9622

It is especially important for DHS to hear from Medicaid/BadgerCare families who would have given birth with at home or in a birth center with an LM but who went to the hospital instead, thereby costing the state thousands of dollars in unrealized savings.

Please be sure to forward this email to anyone you know who was in that situation, and please email DHS about any Medicaid/BadgerCare clients you have had to turn away!

(While we are aware of the hardship that lack of access to LM services creates for Medicaid/BadgerCare families who choose to self-pay, unfortunately, that is not an issue that will move officials at DHS. Their main focus right now is on finding effective ways of cutting costs to Medicaid and BadgerCare).

Please choose one or two of these points to include in emails to DHS:

Licensed Midwives, who undergo specialized training to deliver babies in out-of-hospital settings, provide safe and cost-effective care that is proven to reduce low-birth weight and preterm births, two of the leading causes of infant mortality as well as the long-term costs associated with maternity care.

Each time a Medicaid/BadgerCare mother who seeks to give birth at home or in a freestanding birth center under the care of a Licensed Midwife is denied access to her services, it costs the state thousands of dollars in unrealized savings.

Licensed Midwives in northern parts of the state are reporting that Medicaid women who have been denied their services are being  airlifted to give birth in Minnesota hospitals due to the closing of OB units in Wisconsin and the severe shortage of OB providers in many rural and low-income areas, costing the states thousands of dollars each year.

Research shows that mothers who deliver under the care of a Licensed Midwife experience as much as a five-fold decrease in cesarean surgery. Cesarean surgeries now account for over 1/3 of deliveries nationwide, many of which are both preventable and a major contributing factor to the rising costs of maternity care.

Washington State, whose Licensed Midwife program is approximately the same size as Wisconsin’s, commissioned an independent audit of the program which found that LMs saved the state $3.1 million per budget cycle while providing excellent outcomes for low-income mothers and babies.

Economist David Anderson calculated that a modest increase in out-of-hospital maternity care nationwide would save the health care system over $9 billion annually through reduced costs, improved outcomes, and increased competition in the maternity care market.

Please briefly share any personal stories you may have about how giving birth in the hospital instead of at home cost Medicaid/BadgerCare or your private insurance company additional money. Please DO NOT tell your birth story, however!

Many thanks for your support for adding LMs to the list of authorized Medicaid/BadgerCare providers in Wisconsin!