Diseases such as hepatitis B, rubella, HIV, syphilis, gonorrhea, chlamydia, and group B streptococcus in the mother have a potential impact on the baby.

An "Apgar scores" is a test given to a baby immediately following birth that is used to quickly evaluate the baby's physical condition and need for short-term care or assistance. This test assigns a numerical values (0 to 2) to each of 5 criteria: 1) heart rate, 2) breathing, 3) activity and muscle tone, 4) response to stimulation, and 5) skin color; a score of 8 to 10 indicates the best possible condition.

The Apgar test is usually given twice: first, one minute after birth; then again at 5 minutes following birth. If the first two scores are low, the test may be given a third time, 10 minutes after birth. Apgar scores are often low following cesarean section and in premature babies who tend to have low muscle tone. Slightly low scores are also common in healthly babies especially during the first few minutes of life. Low scores do not predict long-term health or intellectual capabilities.

The genitals are checked in boys to make sure that the testicles are normal (have descended into the proper location), and to examine the circumcision (if performed).

In girls, the genitals are checked for any discharge (infant girls can develop yeast infections).

The collarbones are checked for fractures that can occur during birth. The hips are checked for a birth defect called congenital hip dysplasia that can cause arthritis later.

Newborn reflexes are checked to make sure that the nervous system is developing properly (includes the "Moro" or startle reflex, and the "suck reflex").

If left untreated, phenylketonuria (PKU) will cause mental retardation. Babies with this disease cannot break down their food properly, which leads to a buildup of a substance called "phenylalanine" in the blood.

PKU occurs in one in 10,000 babies. The diagnosis is made by a blood test called the Guthrie test. The cost of the test is about $1.

Low thyroid hormone (Congenital Hypothyroidism) does not cause symptoms early on. Later, untreated children will become mentally retarded, have very short height, puffy skin and a large tongue.

If blood tests are done too soon (less than 24 hours after birth) the results may be inaccurate (may suggest that the child has the disease when he/she really does not). Also, premature infants may have falsely positive results (it may appear that the child has the disease when he/she does not).

This condition occurs in 1 out of every 3,000 children. The screening test costs $2.

Galactosemia is complicated illness that is caused by the inability to break down certain food. Early symptoms include poor feeding, failure to thrive, blood clotting problems, and infection. Later problems include retardation or learning problems, cataracts, and female infertility.

The screening must be done before any blood transfusion is given to the baby. Blood transfusions can cause falsely negative test results (test suggests that the child does not have the disease when he/she really does). Also, if the specimen is exposed to heat (as can happen in summer months), a false positive test can result (test suggests that the child has the disease when he/she really does not).

Galactosemia occurs in 1 out of every 50,000 children.

Problems resulting from sickle cell anemia include infection, anemia (low blood counts), and pain due to poor blood flow. Sickle cell disease (SCD) occurs in 1 out of every 100 African Americans. The severity of the disease varies. It is important to diagnose early because people with the disease are prone to infections, and early antibiotics and supportive medical care can be lifesaving.

If left untreated, girls will start to develop male traits (deeper voice, body hair) at puberty. If treated, infants will develop normally. Treatment includes steroid hormone replacement.

This conditions occurs in 1 out of every 30,000 children.

There is a high false positive rate (the test indicates the child has the disease when they really do not), especially in premature infants.

Babies with MSUD will stop eating and go into coma at about 8 days of age. Treatment involves special diet, although even with the diet children still have symptoms. Screening for MSUD is controversial because of the low occurrence (one in 80,000 or less) and the fact that many babies develop symptoms before the result of the screening test is available. The disease occurs with increased frequency in Mennonite populations.

Left untreated, babies will develop mental retardation and eye and blood clotting problems. Treatment involves special food and supplements with pyridoxine. If treated, the mental retardation can be avoided and the other problems can be delayed.

If done very early-on, the test may be falsely negative (test suggests that the child does not have the disease when he/she really does). Premature infants have higher false positive rates (the test suggests that the child has the disease when they really do not). Homocysteinuria occurs in one in 100,000 children or less.

The treatment is inexpensive and well-tolerated. Treatment prevents most of the symptoms. The only issue about screening for this disorder is that it is very uncommon (one in 120,000).

The test is inexpensive and is very accurate.

This technology can also be used for more accurate testing of diseases like PKU (see above). The instrument is very expensive and the testing is not offered by all states. To see the other diseases that can be tested using this technology go to:http://genes-r-us.uthscsa.edu/nbsdisorders.pdf

People with the disease may develop life-threatening lung infections at an early age. A positive CF screening blood test identifies infants who need further testing to see if they truly have CF. CF occurs in about 1 out of every 3,300 caucasian births, 1 in 15,300 African-American births, and 1 in 32,000 Asian-American births.

The list of inborn errors of metabolism (rare genetic diseases) currently includes more than 50 diseases. Many of these are extremely uncommon (less than one in 100,000 babies), and testing for them is only typically required if there is a family history or suspicion of a problem.

Because this type of genetic testing is still being developed, more diseases and tests are often discovered. The website referred to in the comment is updated on a monthly basis.

Because of the increase in Hepatitis B in the U.S. population, guidelines have been revised to start the Hepatitis B immunization series immediately. In total, three doses are given. The first before hospital discharge; the second dose is generally given at age 1-2 months; and the third dose no earlier than age 6 months.

Babies delivered to Hepatitis B positive mothers will need to be tested after the third dose to be sure the vaccination was successful. This test generally takes place at a routine well-child visit somewhere between 9 and 18 months of age.

Safety precautions include avoiding direct sun, using warm but not hot water for bathing, use of proper car seats, no smoking in the home, precautions with pets and young children, use of smoke and carbon monoxide detectors in the house. It is important to avoid exposing a newborn to a sick person because infants can get serious infections even when exposed to just s mild cold.

A high fever in a newborn has to be treated aggressively and the evaluation should include a spinal tap, blood tests, and a urine sample.

If on formula, allergies to cow's milk can develop within days to months after birth. This allergy can cause hives, asthma, colic, sleeplessness, blood in the stool, and poor growth. Let your pediatrician know if any of these events seem to be occurring. More information can be found at:

http://www3.niaid.nih.gov/topics/foodAllergy/understanding/children.htm