Pulse Oximetry:
What is it?
Pulse Oximetry, or pulse ox, is a test that measures the amount of oxygen in a baby’s blood. It is used, in some states, as part of the newborn screening panel to test a baby for heart defects. Right now, pulse ox is only mandatory in New Jersey, and Indiana. Other states are working towards this goal. All you have to do is ASK for your baby to be tested if you do not live in these states.
How does it work?
Pulse ox is a sensor attached to a band that is wrapped around a baby’s hand and foot then a sensor beams a red light through the blood and can measure the percentage of oxygen. If the percentage is less than 95%, or if the difference in percentage of the hand and foot is greater than 3%, this points to a possible heart problem or heart defects. (This is not 100%, it may be a respiratory issue or an infection, further testing will tell for sure)
When is it done?
A pulse ox test *should be done at 24 hours of life, then again before the baby leaves the hospital. It only takes a minute to show a reading, but the baby needs to be calm and warm. If the baby is fussing and cold, the reading could take longer to acquire. (The test is not painful and can be done while the mother holds the baby.)
What are heart defects?
Heart defects are a structural problem with the heart. When a baby is born with one, it is called a Congenital Heart Defect, or CHD. Heart defects affect 1 in 100 babies and there are about 40 different types of heart defects. Some are minor, like a heart murmur that the baby may grow out of, and others are serious, like Hypoplastic Left Heart Syndrome, where only the left side of the heart develops that requires immediate heart surgery.
Some heart defects are associated with genetic disorders, such as Down Syndrome, William’s Syndrome, and DiGeorge Syndrome, but the cause of most congenital heart defects is unknown. Though they cannot be prevented, technology and advancements in medicine have increased a baby’s chances of surviving most heart defects.
Why is pulse ox used for heart defects?
Pulse ox is the best test for heart defects because many defects do not show outward signs. Your doctor will give your baby a thorough physical before leaving the hospital, but pulse ox ensures that babies do not leave with an undetected heart defect.
Pulse ox cannot detect every single heart problem, so it is very important for parents to know the signs of a possible heart defect.
-bluish tint to the fingers, toes, fingernails, lips, face, or skin
-beaded sweat on the forehead during nursing
-heavy, labored, or fast breathing
-extreme jaundice
-poor feeding
-poor weight gain
-abnormal heart beat or heart murmur
The mother may feel her baby is always hungry because they feed, then stop, then feed, then stop. This is a sign that the baby cannot drink and breathe at the same time. Call a doctor immediately.
What if my baby tests positive for heart defects, what next?
Further testing will be run to make sure. The pulse ox test may be run multiple times to see if the oxygen percentage stays the same, then an echocardiogram will be run. An echocardiogram, or echo, is an ultrasound of the heart and is painless. It will be easier to see the heart if the baby is calm and quiet. You may be referred to a pediatric cardiologist who will check your baby himself for heart defects. If the defect is not serious, they will schedule you for a checkup after a period of time. If the defect is serious, your baby may be sent to a children’s hospital where further testing will be done, then if needed, surgery.
Where can I learn more?
To learn more about heart defects, visit: www.congenitalheartdefects.com or kidshealth.org.
To learn more about pulse ox, visit: www.pulseoxadvocacy.com, http://www.childrensnational.org/PulseOx/FAQ.aspx or www.nbs.in.gov
To see if you state mandates pulse ox, visit: www.pulseoxadvocacy.com/efforts-by-state
Contributer: Ruth Caruthers
Sources: 1in100.org, www.pulseoxadvocacy.com, www.congenitalheartdefects.com, http://kidshealth.org/parent/medical/heart/congenital_heart_defects.html