Some ways that doctors examine newborns during their first 48 hours:
Why it's done: To immediately assess a newborn's health. It's performed at one minute, and again at five minutes after birth because it takes time for a baby to adjust to his new environment outside the womb.
What's involved: Five features are scored: heart rate, breathing, muscle tone, reflexes, and color. Each category is given a score between 0 (lowest) and 2 (highest). A total score of 7 to 10 indicates that the newborn is in good condition; lower scores may be cause for concern.
Why it's done: To prevent delays in speech, language, and mental development.
What's involved: Either the auditory brainstem response (ABR) test or the otoacoustic emissions (OAE) test is used. (Both tests are accurate, painless, and brief -- under 15 minutes.) With the ABR test, electrodes are pasted to the infant's head, neck, and shoulders to measure his brain's response to sound. With the OAE test, a soft rubber probe is placed in the baby's ear canal to measure his response to sound. Babies with hearing loss may be fitted with tiny hearing aids.
Why it's done: To test for this common condition in newborns, characterized by yellowing of the skin. Jaundice often will not require treatment, but in severe cases, it can lead to brain damage.
What's involved: Blood is drawn from a heel prick and tested for bilirubin, the red blood cells processed by the liver. (A high level indicates jaundice.) A new method of screening involves measuring the yellow tint of the skin with a handheld device, but the blood test is still considered more reliable. Advanced cases of jaundice are treated with phototherapy (exposure to a fluorescent blue light that breaks down bilirubin).
Why they're done: To test for various diseases and genetic disorders. The tests vary by state, but most screen for congenital hypothyroidism and phe-nylketonuria; both can cause mental retardation if not treated promptly.
What's involved: One blood sample from an infant's heel can be used to screen for as many as five conditions. Further tests and treatments depend on results.