Public Health and Environmental Laboratories

What conditions are on the newborn blood spot screening panel?

The state of New Jersey screens for over 60 disorders. For a complete list of all disorders screened for in New Jersey, please follow this link.

What is the chance that a baby will have one of the conditions detectable through newborn blood spot screening?

Five percent of newborns will have one or more out-of-range (screen positive) results for the 60+ conditions being tested.  Being screen positive requires follow-up testing but does not necessarily indicate that the newborn has the condition. The prevalence of each disorder differs. To learn more about each condition, please visit: Baby's First Test

When should newborn blood spot screening be collected?

Newborn screening should be collected at 24-48 hours of a newborn’s life. For a newborn that is in the NICU, blood spot screening should be collected again at 7 days, 14 days, and at discharge or 42 days, whichever comes first.

Why is it necessary to wait 24 hours before collecting a newborn blood spot specimen?

Blood spot specimens collected before 24 hours of age do not provide clear results and will be marked “unsatisfactory” on the newborn screening report.  A new specimen must be collected.  However, if a newborn is being transferred to another hospital or requires a blood transfusion before 24 hours of age, please collect the first specimen before those events.  Some of the tests can be run using an early specimen.

What if the newborn screening is not collected on time?

Submit a specimen as soon as possible.

What is the maximum age at which a child can be screened?

There is technically no limit on the age in which an individual can be screened. The Newborn Screening Laboratory will test all submitted specimens, however, the cutoffs used to evaluate results are appropriate for newborns and not older infants.

How do I order newborn screening kits?

For more information about ordering newborn screening kits, please follow this link to our page for providers where kit ordering instructions are provided:Click Here

How do I fill out the kit if the baby is adopted or in foster care?

For adopted children the contact information for the adoptive parents, adoption agency, and/or lawyer be included on the newborn screening card, rather than that of the birth mother. This will allow timely follow-up with the child’s caregivers in the event of an abnormal test result.

What address do I mail the newborn screening blood collection form to?

If the collection form is being sent from a birthing hospital in NJ, it will be picked up daily by a private courier.

• If you are sending via USPS/Post Office, the mail address is:
  New Jersey Department of Health Public Health and Environmental Laboratories
  Newborn Screening Lab - Receiving Unit 2nd Floor
  Attn: Supriya Kannan
  PO. Box 371 ; Trenton, NJ 08625-0361

• If you are sending via UPS/FedEx/DHL, the delivery address is:
  New Jersey Department of Health Public Health and Environmental Laboratories
  Newborn Screening Lab – Receiving Unit 2nd Floor
  Attn: Supriya Kannan
  3 Schwarzkopf Road  ; Ewing, NJ 08628

Who is responsible for the blood spot specimen collection for screening?

A trained health care provider will collect the blood spot specimen for newborn screening. This may be a nurse within the hospital nursery, an at-home birth attendant if an infant is born outside a hospital, or another trained health care provider.

Why is the infant’s gestational age and birth weight required?

Premature, low birth weight and sick newborns have been observed to have transient fluctuations in blood testing results.  The additional information will help interpret the test results.

Should I collect a newborn blood spot specimen before or after transfusion?

Some screening tests do not give accurate results after a transfusion.  Blood specimen collection prior to transfusion is recommended for any baby needing transfusion.  If that is not possible and the initial blood specimen was taken after a blood transfusion(s), repeat blood specimens must be taken at 5 and 7 days after an early transfusion and 120 days after last transfusion date.

I am having trouble collecting blood spot specimens. What should I do?

If you are struggling to collect quality blood spot specimens, please email us to request an in-service training (NJNBS.Outreach@Doh.nj.gov). Additionally, you will find useful information about specimen collection and blood spot quality on our page for providers: Click here

Is it okay to use cord blood for the newborn blood spot specimen sample?

No. Cord blood is only available before the acceptable time to collect a specimen.

Is it okay to use blood from a central line for the repeat newborn blood spot specimen sample?

A heel stick is recommended, but blood from a central line may be used if medically necessary.

Can newborn blood spot screening be done if a baby is born at home or in birthing center?

Yes. If a baby is born at home, the attending midwife will collect the blood spot specimen. If a baby is born in a birthing center, the attending midwife or another health care provider will collect the blood spot specimen.

Who is responsible for collecting a repeat specimen if the initial one was not suitable, or revealed a borderline elevation or deficiency?

Any trained health care provider at your hospital or birthing center.

How do I access newborn screening results for my patients?

Detailed instructions regarding signing up for and accessing eReports can be found here.

When will the results of the newborn screening be available?

Results are typically available about 2 days after the specimen is received in the laboratory. Laboratory results are reported by mail or are available online with eReports. Critical out-of-range results are phoned to the healthcare provider of record as soon as the results are known.

Who receives newborn screening results if they are normal (within acceptable limits)?

The hospital where the baby was born will receive normal newborn screening results.

Who receives newborn screening results if they are abnormal?

The hospital where the infant was born and the primary care provider listed on the newborn screening kit will always receive abnormal newborn screening results by mail and also by phone if it is critical.

Can I access newborn screening sickle cell results for older children to satisfy the National Collegiate Athletic Association (NCAA) guideline?

Yes. Parents asking for their child’s sickle cell results can submit a records release authorization form signed by the parent of the child to the newborn screening laboratory office. Results will be sent to the primary care provider who can then send them to the school or institution asking for them or can be sent directly to the athletic department. The records release authorization form can be found here: Sickle Cell Records Release Authorization Form

Can parents call the newborn screening lab to get the results of their newborn’s screening tests?

The state of New Jersey does not release newborn screening results directly to parents.  Screening results are sent to the hospital where the baby was born, and the specimen was collected.  The results are part of a baby’s medical record and can be obtained from the hospital. If parents are looking to access their child’s newborn screening results, they are advised to contact their baby’s primary care provider.

If you are an infant’s primary care provider, but were not listed on the newborn screening kit, you can request to receive newborn screening results by either providing the IEM form ID number found on the infant’s newborn screening kit (parents should have received this at the hospital) or by completing a records release authorization form. Be sure to have a parent sign the records release authorization form before submitting it to the New Jersey Newborn Screening Laboratory. The records release authorization form can be found here: Newborn Records Release Authorization Form

How do I get access to the newborn screening web application (eReports)?

Detailed instructions regarding signing up for and accessing eReports can be found here

Why is it necessary to retest some babies?

All newborns receive an initial screening test after birth. The Newborn Screening Laboratory checks all newborn screening kits for completion of demographic information and specimen quality. When collecting a blood spot sample, care must be taken to ensure that the demographic information and blood spot are collected properly to avoid inaccurate test results. Specimens that do not meet acceptable criteria are deemed unsatisfactory and require a repeat sample to be drawn. Examples of why a baby may require repeat screening include collection of blood spot specimen too early, collection of blood spot specimen after a blood transfusion, abnormal screening results or improper technique when collecting the specimen. To learn more about why a blood spot specimen may have been deemed unsatisfactory, please refer to this guide: Unsatisfactory Specimen Guideline

Why do some newborn screens have “false positive” results?

There is always the possibility of false positive or false negative result which could be due to several factors including:

• The process is only a screening test. If you clinically suspect a condition, get the appropriate testing done regardless of the screening result.
• The defining of specific cutoffs for disorders and the possibility of your baby’s blood spot screening results falling slightly within or outside the margin of these cutoffs resulting in a false positive report or a false negative report.
• The timing of when the blood spot specimen was taken can affect results of your baby’s screening resulting in a false positive or false negative report.
• The quality of the blood spot specimen can affect results of your baby’s screening resulting in a false positive or false negative report.

What is an unsatisfactory specimen?

An unsatisfactory specimen is a specimen of poor quality which cannot be accurately tested. For more information about types of unsatisfactory specimens and their codes, please refer to the following guideline: Unsatisfactory Specimen Guideline

I have received notification of one or more unsatisfactory specimens for an infant. Why does this happen?

In some cases, multiple specimens can be unsatisfactory for the same baby. It is important that the dried blood spots are of uniform size and quality to assure accurate results. A guide for the specimen collection procedure can be found here.  A specimen can also be obtained by asking parents to take the baby back to the place where the baby was born, where they obtain specimens every day.

Does a screen negative result mean the infant is not at risk for that condition?

Any negative screen means that a baby has a low risk of having that condition. Screening results are not diagnostic. Clinical indicators of a disorder should always be investigated, even if a baby has screened negative for a newborn screening disorder.

Why are specific values not reported for all tests?

Values are only reported for results that are out-of-range.

I did not receive a newborn’s screening results. Is no news good news?

All results are reported to the hospital/birthing center. Only abnormal or unsatisfactory results are sent directly to the primary care provider indicated on the form at the time of specimen collection. To access results, go to eReports or reach out to the newborn screening laboratory at NJNBS.Results@doh.nj.gov.

How do I know which specialist should be consulted based on the results of the screening?

The New Jersey Newborn Screening Follow-up Program provides information about where to get diagnostic testing and/or specialty evaluation and treatment.

What if I need to speak with someone at the newborn screening lab or follow-up?

Please refer to our Contact Us page which offers detailed contact information.

Is there a charge for repeat screening?

No. In the state of New Jersey, there is no charge for repeat screening kits.

Whose responsibility is it to advise parents about the screen?

Expecting parents should be informed about newborn blood spot screening by the health care providers they receive care from as early as before pregnancy and especially during pregnancy when parents are preparing for what to expect after the birth of their child. Obstetric providers play a key role in serving as a trustworthy and reliable resource for parents about newborn screening during pregnancy. Additionally, primary care providers are encouraged to educate expecting parents about newborn screening as well.

What do I do if a baby’s parents refuse the newborn blood spot screening?

The New Jersey Administrative Code (Click here) requires screening to be performed for all infants born in New Jersey unless the parents refuse for religious reasons. If the parents refuse it must be documented in the medical record as a refusal for religious beliefs and reported to the Newborn Screening Laboratory.  Providers should be sure to inform parents about newborn screening and its potentially lifesaving benefits prior to parents’ making this decision. 

Where can I get educational information?

You can get educational information by requesting an in-service training by contacting our Program Specialist (NJNBS.outreach@doh.nj.gov) or call (609) 530-8371. You will also find educational information about newborn screening on our page for providers  .

What if a baby has moved here from out of state?

All states perform newborn screening. However, each state’s newborn screening panel is unique in terms of which specific disorders are screened for. Therefore, if a baby has moved to New Jersey from another state, they have most likely already received a screening in the state they were born in.

Why shouldn’t newborn screening be referred to as the “PKU” test?

Health care providers are advised not to refer to newborn screening as the “PKU” test because screening for PKU, phenylketonuria, is only one out of a whole panel of disorders screened for. Therefore, referring to newborn screening as the “PKU” test is outdated and misleading.

What if there is a family history of a disorder?

If there is a family history of a disorder, the parent may ask that the health care provider completing the newborn screening specimen collection kit write this information in the remarks box located on the kit.  Depending on the disorder, diagnostic testing by the primary care provider or a specialist may be necessary in addition to the newborn screening.

Can the testing of a specimen be expedited?

The newborn screening laboratory tests every specimen the day it is received in the laboratory.  If you need results before they have been reported, please call 609 530-8371.

Who is responsible for ordering confirmatory testing?

The baby’s primary care provider or, if necessary, a specialist is responsible for ordering the follow up, confirmatory, or diagnostic testing after receiving positive or out-of-range results from a newborn screening.