About the the screening:

The screening aims to identify babies born with a permanent hearing loss in one or both ears. This screening test is recommended for your baby, even if there is no history of hearing loss in your family. 

How is the test done:

There are two types of screening tests are available:

Automated Otoacoustic Emission (AOAE) test 

• soft tipped earpiece in the outer part of a baby’s ear to send clicking sounds to the inner ear. Using a computer, the person carrying out the test can see how the baby’s inner ear responds to sound. If there are no clear responses in one or both ears, following up to x2 AOAE screening tests, an AABR test is then carried out. If clear responses are not found, the baby is referred to audiology services for diagnostic tests and further follow up.

Automated Auditory Brainstem Response (AABR) test 

• An AABR is only required in certain circumstances, for example, if a baby does not have a clear response in one or both ears with AOAE testing, or has been admitted to a neonatal intensive care or special baby care unit. The AABR is a different type of test that measures electrical brain activity (rather than measuring acoustic energy within the inner ear). This screening test involves placing small sensors on a baby’s head, shoulder and nape of the neck. Soft headphones are placed over baby’s ears and a series of clicking sounds are played. A computer measures how the baby’s ears respond to these sounds.

Follow ups:

The person with parental responsibility should continue to be vigilant and check baby’s hearing, as they grow up, using the checklist contained in the Personal Child Health Record (PCHR or 'red book’). Any concerns about your baby’s hearing should be discussed with your health visitor or GP.

Key resources:

• Newborn hearing screening privacy notice:
  • The newborn hearing screening (English and translations) privacy notice describes how your personal information will be processed within the Smart4Hearing (S4H) service for the purposes of providing the Newborn Hearing Screening Programme in Northern Ireland.
    Contact details of Trust Data Protection Officers for the Smart4Hearing Privacy Notice are also available.
• Newborn hearing screening leaflets:
  • Newborn hearing screening (English and translations) | HSC Public Health Agency
  • Hearing tests for your baby - an easy read guide | HSC Public Health Agency
  • Newborn hearing screening interpreting services poster | HSC Public Health Agency
• Newborn hearing screening patient journey protocols:
  • Newborn hearing screening - Well baby protocol | HSC Public Health Agency
  • Newborn hearing screening protocol - babies in neonatal or special care baby units | HSC Public Health Agency
• Newborn Hearing Screening in Northern Ireland Annual Reports | HSC Public Health Agency
• Further information can be found on nidirect Newborn screening | nidirect

Newborn blood spot screening (the heel prick test): why is it important, what conditions are screened for and what does the test involve?

Who is this section for?

• Public – general information
• Parents/carers – reason for screening and what the test involves
• Professionals – conditions screened for and reasons for screening to provide advice to parents 

Is blood spot screening offered for all babies?

Newborn blood spot screening – often called the heel prick test - is recommended for all babies in Northern Ireland. It is the best way to check for some rare but serious health conditions. These conditions can make babies extremely sick or harm their development, but usually show no signs in the first few weeks of life. Through screening, babies with the conditions can be identified early, so that treatment can be started before they become unwell. 

What conditions are screened for in Northern Ireland?

We currently screen for nine conditions:

This is regularly reviewed and more conditions are likely to be added in future. 

What does the test involve?

Soon after birth, you will be offered blood spot screening for your baby. The test is usually done at five days old. It is simple, quick and the best way to find rare but serious conditions early so that they can be treated. Your midwife or health visitor uses a ‘clicker’ device with a tiny needle to prick baby’s heel and collects a few small drops of blood on a card that is then sent to the lab to be tested. Your health visitor will usually give you the results at the 6-8 week visit, but you may get them sooner.

If the conditions are rare, why are all babies offered screening?

The conditions we screen for can cause serious illness and problems with development. Most babies won’t have any of the conditions, but for those who do, early detection means that treatment can be started early – usually before a baby becomes sick. This gives them the best chance of good health, development and quality of life, and makes a huge difference for them and their families.

Nobody in my family has any of the conditions – should my baby have the test?

Newborn blood spot screening is recommended for all babies in Northern Ireland. These conditions can be present even if there is no family history. If you have questions, speak to your midwife or health visitor.

Is there an upper age limit for blood spot screening?

Blood spot screening can be offered before the first birthday, up to 364 days of age. If you know your baby has not been tested, or you aren’t sure, speak to your health visitor.

Is the screening programme monitored?

Newborn blood spot screening involves many people and organisations working closely together, including a specialised regional lab, IT systems, and healthcare staff in hospitals and the community. The Public Health Agency and partner organisations are responsible for making sure that everyone who lives in Northern Ireland has access to safe, effective, high quality and equitable screening programmes. The newborn blood spot screening programme takes part in a national UK system of quality assurance and performance management.