Newborn Blood Spot Card Screening

​​​​​​​​​​​​​​​​​​​​A small amount of blood is collected on all babies shortly after birth with a heel-prick collection on a blood spot card. The card is sent to BC's Newborn Screening lab where it is tested for over 25 treatable disorders. A baby with one of these rare disorders usually looks healthy at birth but if not diagnosed and treated early, could develop serious health issues, intellectual disability, and in some cases may even die.  

​​The newborn screen allows for early diagnosis and treatment, giving babies the best chance to live longer, healthier lives. ​

Every newborn baby born in BC and the Yukon is offered screening. A newborn's blood spot card is collected between 24 and 48 hours of age, either in hospital before discharge, or at home (if a home birth with registered midwife). 

In BC, there are about 60 babies born each year (one out of every 750) who are found to have one of these rare disorders.​​

Parent info​rmation sheet

Download the Parent Information Sheet: A Simple Blood Test Could Save Your Baby’s Life. 

​​The Parent Information Sheet is also available in the following languages:​​​

​Frequently asked questions (FAQs)

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Why is my baby screened?

​A small spot of your baby's blood can be used to get important information about their health. A newborn baby can look healthy but have a rare and serious disorder that you and your doctor or midwife may not know about. Newborn screening finds babies who may have one of these rare disorders. When these disorders are found and treated early, the chances of serious health problems are prevented or reduced. If not treated, these disorders can cause severe intellectual disability, growth and health problems and in some cases sudden infant death.  For most families, the diagnosis is unexpected, because no one else in their family is affected and the baby appears healthy at birth.    ​

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How is my baby screened?

​​Your baby's heel is pricked and a few drops of blood are taken and put onto a special filter paper which is part of the blood spot card. When the blood sample is dried, the card is sent to the newborn screening laboratory at BC Children's Hospital for testing. The same blood sample is used to screen for all disorders on the newborn screening panel.

The sample is collected at the birth hospital or by a registered midwife if the baby was born at home. The ideal time to collect the sample is when the baby is 24-48 hours old.  ​

During the heel prick there may be some minor discomfort. There are ways you can make your baby feel comfortable and soothed during the collection such as breastfeeding, skin to skin contact or holding your baby close.  

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What if my baby goes home from hospital before 24 hours old?

​​A blood sample will be taken in the hospital before leaving. A sample collected prior to 24 hours will still provide a reliable result for over 80% of disorders being screened. You will be given instructions on how to have a repeat sample (i.e. a second blood spot card) ​collected within 2 weeks. The purpose of the second sample is to double check the few disorders that can be missed on the first (early) screen.​

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Can I wait and have my baby tested later?

​The earlier these treatable disorders are found, the better the outcome for babies with these disorders. It is strongly advised that your baby not leave the hospital without a blood sample being taken. After a discussion with your care provider, if you decide you do not want your baby to have a blood sample taken before they leave the hospital, you will be asked to sign a deferral form.

If your baby is under the care of a Registered Midwife, the midwife may review options with you to have the blood sample drawn at home.​​

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Can parents decline newborn blood spot card screening?

​Newborn blood spot card screening is considered standard of care and is highly recommended for all babies born in BC and in the Yukon, but it is not mandatory.  It is important that parents/legal guardians are making an informed decision when considering declining the newborn screen. Talk to your primary care provider during the pregnancy about the purpose and benefits of the screen.  Things to consider when making your decision: ​

  • The screen tests for more than 25 treatable conditions which cause serious, long term health issues, problems in development, and in some cases loss of life, if not treated early.   

  • The screen allows for early diagnosis and treatment, giving babies the best chance to live longer, healthier lives.

  • Every year, about 60 babies in BC and the Yukon are born with one of these treatable conditions.

  • For most families, the diagnosis of a baby with one of these conditions is completely unexpected. This is because in most cases no one else in their family is affected and the baby appears healthy at birth. 

  • The test is done by taking a few drops of blood from the baby's heel. During the heel prick, there may be some minor discomfort. But there are ways you can make your baby feel comfortable and soothed during the collection such as breastfeeding, skin to skin contact or holding your baby close. 

  • Once the newborn screening test results are completed, a parent/legal guardian can request to have the leftover sample either destroyed or returned to them by completing one of the following forms (Release of leftover form or Directive to destroy form).  Otherwise, the sample will be stored in a secure location for 10 years before being destroyed.  To review the purpose of why the leftover sample is stored please see the question below (Why are newborn screening samples stored for 10 years after the newborn screening tests are done?)

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Do parents have to pay for newborn screening?

​​Newborn screening is free for all babies born in British Columbia and the Yukon, including those who are not residents and do not have MSP coverage. ​

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Can babies immigrating from another country without newborn screening have screening done?
​Yes. The baby's family physician or pediatrician can arrange the newborn screening test. Please keep in mind that the newborn screen is most accurate in the newborn period, and most of the diseases become evident in early infancy. ​
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What are the possible results of newborn screening?

​The newborn screening result will tell you if your baby's chance of having one of the disorders is increased or decreased. For babies with an increased risk (screen positive) follow up “diagnostic testing" is needed to confirm a diagnosis. ​

Screen NEGATIVE result: (low risk)

  • ​This is the most common result.

  • ​A negative screen result is a very reassuring. It means that the chance that your baby has one of these disorders is very low and no follow up testing is needed.

  • Rarely, the screening test may miss a baby with one of these disorders. 

Not Reportable / Unsatisfactory Result:
  • In some cases, the sample collected is not of sufficient quality or quantity so cannot be used to provide a reliable newborn screening result. A repeat sample is required.  
  • An unsatisfactory result does not mean that the baby has a higher chance of having a disorder. 
Screen Positive Result: (increased risk)
  • ​A less common result.
  • A positive screen result does not mean your baby has one of the disorders, but the chance is increased, and further testing is needed. 
  • Follow up testing will be arranged by your primary care provider or a specialist at BC Children's Hospital depending on the disorder. 
  • The following link​ will take you to information sheets on the individual conditions where you can find information on the next steps.  
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How do I find the results of the screening?

​You can review your baby's screen results with your doctor or midwife. 

If the result is screen negative (i.e., low risk), then the report is sent directly to the doctor or midwife listed on the collection card as well as to the birth hospital. ​

If the result is screen positive (i.e., increased risk), the result is called out immediately to your doctor or midwife by a member of the newborn screening program. The result and recommended follow up plan will be discussed with your care provider. Your doctor or midwife will then follow up and discuss the recommended plan with you. 

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What disorders are screened for on the blood spot card?

​In BC and the Yukon, babies are screened for more than 25 rare but treatable disorders. These primary disorders are specifically chosen to be on the screening panel because clinical evidence supports that early diagnosis and treatment improves health outcomes. The disorders screened fall into the following categories:​

  1. Metabolic disorders:

    • When the body is not able to properly break down fats, proteins, or sugars. 

  2. Endocrine disorders:

    • The body makes too much or too little of certain hormones.

  3. Hemoglobin disorders:

    • A problem with the protein that carries oxygen in the red blood cells.

  4. Cystic Fibrosis:

    • ​A disorder which causes problems in growth, digestion, and breathing.

  5. Severe Combined Immunodeficiency (SCID):

    • ​The body is unable to fight infections.

  6. Spinal Muscular Atrophy:

    • A progressive problem causing nerve loss and muscle weakness. ​

For a list of the individual conditions screened and an information sheet summarizing the condition please click this link. 

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Will newborn screening pick up other conditions not on the screening panel?

The goal of the newborn screen is to identify the treatable disorders on our screening panel. However, given the nature of the testing methods used, some secondary conditions may be picked up. The most common secondary condition is nutritional vitamin B12 deficiency. In addition, newborn screening may identify healthy carriers of hemoglobinopathies or cystic fibrosis.  ​

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What if your baby is a carrier?

​Screening for different disorders may tell if your baby is a carrier. This is also known as having a trait for one of these disorders. Babies who have these traits are no more likely to get sick than any other baby. They do not need any special medical treatment. For more information on the most commonly identified traits, download the following information sheets:

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What if the results of follow up diagnostic testing show that your baby has one of these disorders?
​​You will be referred to a doctor specializing in the disorder. The doctor will meet with you, review the disorder and treatment plan and answer your questions. ​
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What happens to the blood spot card after the newborn screening tests are done?

​After the tests are done, a very small amount of dried blood is left on the card. The amount left depends on how much blood was collected and whether more tests were needed to make sure the results were accurate. The amount left is usually smaller than a dime.

When testing is completed, the card with the leftover blood is kept in secure storage by the BC Newborn Screening Program for 10 years. This is consistent with the period of time in which the card has any potential clinical use. Cards are stored in one of two secure locations: BC Children's Hospital laboratory storage or off-site secure storage.​

S​tored blood spot cards can only be accessed by the Medical Director and senior staff of Newborn Screening BC. All staff that access stored cards have received privacy and confidentiality training.​

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Why are newborn screening samples stored for 10 years after the newborn screening tests are done?

​Blood spot cards are kept for clinical purposes such as:

  • ​Re-running a test if the first test result was not clear. This means the test can be repeated without having to get another blood sample from the baby.

  • Trying to find the reason for a health problem that has developed later in a child's life or trying to find the cause of an unexplained illness or death of a child. Sometimes testing the leftover blood spot sample will help to find the cause. In these cases, testing would only be done with the consent of the parent(s) or legal representative(s).

  • Checking the quality of testing done by the laboratory to make sure that results are accurate.

  • Developing better tests for the disorders currently screened or for developing new tests to screen for other treatable disorders.

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Can blood spot cards be used for health research?

Yes blood spot cards can be used in research projects that have been approved by a Clinical Research Ethics Board to ensure high ethical standards.  In accordance with BC Freedom of Information and Protection of Privacy Act (FIPPA), the stored bloodspot samples are anonymized, meaning that all information that identifies the baby (e.g. name, date of birth, and personal health number) is removed to protect privacy.  Identifiable information is only provided for clinical research projects if the family has requested this with written informed consent.​

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Are the baby's blood spot cards ever released to third parties?

​Blood spot cards are treated the same as hospital records or medical files held by doctors and hospitals in relation to the powers of the Court. On rare occasions the Court or other legislative authority (e.g., Coroner's Act) may order access to a blood spot card or related information. Without legislated authority, blood spot cards are not released to third parties. ​

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Can I have newborn screening on my baby done and also decline storage of my baby's leftover blood spot card?

​Yes. Parent(s)/legal guardian(s) who do not wish their baby's blood spot card to be stored with Newborn Screening BC can either have the card destroyed or returned using one of the following forms:​

Option 1: Directive to Destroy Leftover Newborn Screening Blood Samples.

Option 2: Release of Leftover Newborn Screening Card 

Both parent(s)/legal guardian(s) must sign the request to return or destroy their baby's card. If the baby has only one parent/legal guardian, that parent/legal guardian must sign the form to say they are the only parent/legal guardian. Return the completed form by mail. Once the form is received, the request will be processed.

Option 1: Directive to Destroy Leftover Newborn Screening Blood Samples

  • The filter paper and blood spots are destroyed.

  • A letter is sent to the parent(s)/ legal guardian(s) to tell them the blood spots have been destroyed.

  • Destroying the card means that the card will no longer be available for any clinical purpose, including further tests if the baby or child develops an illness later in life.

Option 2: Release of Leftover Newborn Screening Card

  • The card will be heat treated (autoclaved) prior to returning to remove any potential biohazard from the dried blood spots. As a result the card will no longer be useable for biological testing.

  • The card will be mailed to the address provided on the form.​

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How is privacy and confidentiality of personal information secured and maintained?
​Newborn Screening BC collects, uses and discloses personal information only as authorized under section 26 (c) of the BC Freedom of Information and Protection of Privacy Act and other legislation. We take all reasonable steps to make sure personal information is treated confidentially, is used only for the intended purpose and securely stored. For questions regarding collection, use or disclosure of your baby's personal information, please contact the Medical Director, Newborn Screening at 604-875-2148 or business address:​

BC Children’s Hospital Newborn Screening Laboratory
Department of Pathology
4480 Oak Street, Room 2F27
Vancouver, BC V6H 3V4

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