The newborn blood spot test (heel prick): what it checks

Around day 5, someone will prick your baby’s heel to collect a few drops of blood. It’s a quick test that screens for rare but serious conditions, and here’s what it covers.

When is it done?

The NHS says the test is normally done when your baby is 5 days old, though it may be earlier or later. It’s usually done by a midwife, often at home. A few drops of blood are collected from your baby’s heel on a card.

What does it screen for?

The NHS page lists these conditions:

cystic fibrosis
sickle cell disease
congenital hypothyroidism (CHT)
inherited metabolic diseases: phenylketonuria (PKU), medium-chain acyl-CoA dehydrogenase deficiency (MCADD), maple syrup urine disease (MSUD), isovaleric acidaemia (IVA), glutaric aciduria type 1 (GA1), homocystinuria (HCU) and hereditary tyrosinaemia type 1 (HT1)
spinal muscular atrophy (SMA), in some parts of England only

The NHS page describes the test as checking for rare but serious conditions.

Spinal muscular atrophy (SMA) is being introduced in stages. The NHS England page says it is currently available in some parts of England, and Scotland has started offering it as part of an evaluation. Ask your midwife whether it is offered where you live. SCID is not part of the routine test. It is being evaluated in some areas of England.

What is screened differs between UK nations. For example, the Wales and Northern Ireland pages list cystic fibrosis, sickle cell disorders, congenital hypothyroidism and six inherited metabolic conditions, while the Scottish guidance lists 11 conditions including HT1 and SMA. Ask your midwife what applies where you live.

Is it your choice?

The test is recommended for all babies, but the NHS says it’s your choice. You’ll be asked after the birth. If you decline and change your mind later, speak to your midwife, health visitor or GP. If the test was missed, tell them, and they can say whether your baby can still have it.

Getting the results

The NHS says results should arrive by the time your baby is 6 weeks old, or sooner depending on what the result is (this can differ in other UK nations). You may get them in a letter, or be told by phone or in person. They’re also recorded in the red book. If you haven’t had them by 6 weeks, speak to your midwife, health visitor or GP.

No conditions suspected. Most babies have this result.
Carrier result. A carrier baby doesn’t have the condition and will usually be healthy, but could pass it on to their own children. The NHS says it’s quite common to get this result. Your baby won’t need treatment but may need further tests.
Condition suspected. A health professional will contact you by phone or in person, and your baby will be referred to a specialist.

The NHS also says a test may sometimes need repeating, which doesn’t necessarily mean anything is wrong.

Questions people ask

Does the heel prick hurt?

Many babies cry for a short while. Ask if you can hold or feed your baby.

What if my baby needs a repeat test?

The NHS says this does not necessarily mean anything is wrong with your baby.

Does sickle cell show up if I had screening in pregnancy?

Yes. The NHS blood spot page lists sickle cell disease, so it is checked whether or not you had screening in pregnancy. See sickle cell and thalassaemia screening.

Who do I speak to if I haven’t heard?

Your midwife, health visitor or GP, if you haven’t had results by the time your baby is 6 weeks old.