The newborn heel prick test involves a small prick on the baby's heel to collect a few drops of blood. It screens for rare but serious inherited and hormonal conditions, such as congenital hypothyroidism and phenylketonuria (PKU) [1]. The aim is to detect them early, before they cause permanent problems. Requesting a second sample does not necessarily mean a condition is present, but follow-up of any questionable result should not be delayed [2].
What is the newborn heel prick test and why is it done?
The newborn heel prick test is a simple blood test in which a few drops of blood are taken from the baby's heel after a prick. It is part of a broader program known as newborn genetic and metabolic screening. The test looks for inherited disorders [1]. In some countries it was called the "heel prick test," and its official name there later became the "newborn blood spot test" [2].
The test matters because these conditions are rare, and a baby with one may appear healthy in the first days of life. Some can cause lifelong health problems, and some can lead to early death if left untreated [1].
When a condition is identified early, follow-up and treatment can start immediately, before serious or permanent problems develop [1]. This improves long-term health and growth and helps prevent severe disability [2].
What does the newborn heel prick test detect?
The list of conditions differs between countries and between programs. The U.S. National Library of Medicine notes that testing varies by state, and that all states screen for at least 30 conditions [1]. The UK's National Health Service (NHS) lists a shorter set of conditions [2]:
| Category | Example | Brief description |
|---|---|---|
| Hormonal disorder | Congenital hypothyroidism | The baby's body does not produce enough thyroid hormone, because the thyroid gland does not work properly or did not form [2] |
| Inherited metabolic disorders | Phenylketonuria (PKU), maple syrup urine disease (MSUD), and homocystinuria | They cause a problem in breaking down substances from food, such as proteins [2] |
| Blood disorders | Sickle cell disease | A group of conditions that affect red blood cells and run in families [2] |
| Conditions affecting the respiratory and digestive systems | Cystic fibrosis | Causes problems with breathing, digestion, and growth, and increases the risk of infection [2] |
| Neuromuscular disorders | Spinal muscular atrophy (SMA) | A rare inherited condition that causes muscle weakness that worsens over time. It is currently available only in some parts of England [2] |
The MedlinePlus list related to screening also includes other conditions, including galactosemia, G6PD deficiency, congenital adrenal hyperplasia, and beta thalassemia [1].
Therefore, do not assume that every condition on these lists is screened for in every hospital. Ask the hospital where you give birth or your pediatrician which conditions the screening covers in Jordan, and which laboratory performs the tests.
When is the test done and how is it performed?
The test is done in the first days after birth, usually before the mother and newborn leave the hospital [1]. The exact timing depends on the program in use. In Britain, it is usually done when the child is 5 days old, though it may be somewhat earlier or later [2]. This is an example from another country and not a set timing in Jordan, so ask the birth team about the timing approved at your hospital.
The procedure is simple and is carried out by a health professional:
- The baby's heel is warmed and cleaned.
- The heel is pricked with a small device with a fine needle.
- A few drops of blood are collected onto a special card.
- The card is sent to the laboratory for analysis [2].
The child needs no preparation [2]. The test is usually done after the baby has started feeding, and the hospital sets the appropriate time according to its protocol.
Other tests done alongside the heel prick test
The screening program may include two other tests: a hearing test that measures the child's response to sound, and a pulse oximetry test that measures blood oxygen levels and helps detect congenital heart defects [1]. You can read about newborn hearing screening and diagnostics, and ClinicsJo's answer on essential examinations for the baby after birth.
Is the test painful or risky for the child?
The test is quick, and no known risks are associated with it. The baby may cry or be upset for a few moments [2]. Breastfeeding or holding the baby can help calm them, and keeping them warm and comfortable also helps [2].
Tell the doctor or nurse in advance if someone in the family has one of the conditions the test covers. This is important information, and it is advisable to report it as soon as possible [2].
How is the heel prick test result understood? Does a repeat sample mean disease?
The NHS divides possible results into three categories, which are useful for understanding the general logic of results [2]:
| Result | What it means | What follows |
|---|---|---|
| No signs of disease | The child is unlikely to have any of the conditions tested for. This is the result for most babies | No further tests needed [2] |
| Carrier of a condition | The child does not have the condition itself and is usually healthy, but may pass it on to their own children in the future. This result is relatively common | No treatment, but further tests may be needed [2] |
| Signs suggesting a possible condition | The test suggests a condition may be present. It is not a final diagnosis | A call from a specialist, then referral to a specialist for more precise tests and treatment if needed [2] |
Why might a sample be repeated?
The test sometimes needs to be repeated, and there are many reasons for this that do not necessarily mean the child has a problem [2]. So do not worry if you are asked to return, and do not postpone the appointment out of fear. A second sample provides a clearer picture.
On the other hand, the test is a screening tool and not a diagnosis. If the result suggests a possible condition, follow-up tests confirm whether the child actually has it [1].
Why should the heel prick test or its follow-up not be delayed?
Time is critical with these conditions. Early diagnosis allows treatment to begin immediately, before serious or permanent problems appear [1]. When a result suggests a possible condition, the U.S. National Library of Medicine states that prompt follow-up is important, and that if the condition is confirmed, treatment starts immediately [1].
In practice, this means the following:
- Do not ignore any call from the hospital or laboratory about your child, and respond the same day if possible.
- Make sure your correct phone number is recorded in the newborn's file.
- If you have not received any result and have not been told when to expect it, ask directly. In Britain, for example, results are expected within 6 weeks, and anyone who has not received one should contact the responsible body [2]. Ask the hospital about the timeframe used in your facility.
- Keep the result in your child's health record and bring a copy to doctor visits.
What if I missed the test or it was not done for my child?
Do not assume the opportunity is lost. The NHS recommends that parents tell the doctor or nurse if the test was not done, because it may still be possible after the usual timing [2]. You can find an answer on ClinicsJo about what to do if a child misses a routine checkup or a newborn screening. Consult a pediatrician or the nearest Ministry of Health mother and child health center.
When should you see a doctor and when should you go to the emergency room?
A normal heel prick test result does not replace monitoring your child's condition. Always keep an eye on your baby, and see a doctor if you notice the following:
- An abnormal result, or a request to repeat the test or see a specialist.
- Poor feeding or repeated refusal of food.
- Unusual lethargy, or excessive sleepiness that makes it hard to wake the child for feeding.
- Repeated vomiting, diarrhea, or noticeably slow weight gain.
- A family history of one of the inherited conditions the test covers [2].
Call an ambulance on 911 or go immediately to the nearest emergency department if the baby has difficulty breathing, bluish lips or face, seizures, fainting, or no longer responds to you. These are emergencies that cannot wait for a clinic appointment.
How do you find the right doctor or clinic in Jordan?
If you have questions about the test or its result, the appropriate specialist is a pediatrician or a neonatologist. You can browse pediatricians in Jordan or neonatologists in Jordan, then narrow your search by governorate. For example: neonatology in Amman, in Irbid, and in Zarqa. Similar pages are available for other governorates, as well as for pediatric care such as pediatrics in Amman.
When reading a doctor's profile in the directory, pay attention to:
- The listed specialty (pediatrics, neonatology), years of experience, and declared qualifications.
- The clinic's location, working hours, and the contact or booking methods listed in the profile.
- The services listed, such as newborn care.
ClinicsJo does not provide remote medical consultations and does not rank doctors by medical quality. Instead, it displays profiles so you can contact the doctor directly. Questions worth asking during the visit include:
- Which conditions did the test performed on my child cover?
- When and how will I learn the result?
- If a second sample is requested, what is the reason and when should it be taken?
- Do we need additional tests or follow-up with a specialist?
- Does a family history of an inherited condition affect a future pregnancy or my child's siblings?
After the test: monitoring your child's growth and care
The test is one step in the journey of infant care. Once you are reassured by the result, keep up with routine checkup appointments, and read about the basics of infant care in the first months and infant developmental milestones through the first year. Another early-life screening is the early detection of developmental hip dysplasia, and it is best to ask your doctor when it should be done.
Finally, keep your child's health record and bring it to every visit, as it includes the heel prick test result, the hearing test, and vaccinations. If you have any concerns after the result, consult your pediatrician without delay.
Frequently asked questions
Is the heel prick test mandatory for every newborn?
Testing is recommended for all newborns because it is the best way to detect rare conditions early. In some countries, the decision is left to parents after an explanation. In Jordan, ask the hospital or your pediatrician about how screening is done at your birth facility, and do not postpone it without a reason.
Does a request to repeat the sample mean my child is sick?
No, not necessarily. There are many reasons a sample may need to be repeated, and the second result may be completely normal. The important thing is not to ignore the request and to provide the sample at the time set by the doctor or laboratory, because a repeat gives a more accurate picture of the child's condition.
Is the heel prick painful or dangerous for the baby?
The test is quick, and no known risks are associated with it. The child may cry or be upset for a short moment. Holding or breastfeeding the baby, and keeping them warm and comfortable, can help calm them. No preparation from the mother or child is needed.
What conditions does the heel prick test detect?
The list varies by country and program. Examples include congenital hypothyroidism, phenylketonuria (PKU), other inherited metabolic disorders, cystic fibrosis, and sickle cell disease. Ask the hospital where your child was born which conditions the screening covers specifically in your area.
What should I do if I have not received the heel prick test result?
Do not wait silently for a long time. Contact the hospital where your child was born, your pediatrician, or the nearest mother and child health center. Ask about the result and when it will arrive, and make sure the phone number on record is correct. The absence of news is not proof that everything is normal.
Does the heel prick test replace a visit to the pediatrician?
No. The test looks for a specific set of conditions only and does not detect every health problem. Regular follow-up with a pediatrician remains important for monitoring growth, nutrition, and vaccinations. If the baby shows any worrying symptoms, see a doctor immediately even if the screening result was normal.
Sources and references
- Newborn Screening: MedlinePlus — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.
- Newborn blood spot test — NHS (UK National Health Service). Accessed: 2026-10-26.
