Key takeaways: Pulse oximetry screening checks oxygen levels in your baby’s right hand and a foot, usually after 24 hours of age. It helps find critical congenital heart disease (CCHD) before symptoms appear. A failed screen leads to more testing, often an echocardiogram.
Critical congenital heart disease (CCHD) refers to serious heart defects that usually need surgery or other procedures in the first year. Some babies with CCHD look healthy at birth. Pulse oximetry screening helps find some of these babies before they get sick.
How the Screen Works
A small sensor is wrapped around your baby’s right hand and one foot. It uses light to measure the oxygen level in the blood. It doesn’t hurt and takes just a few minutes. Screening is usually done after 24 hours of age, or shortly before discharge if your baby goes home earlier.
From the author
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Results
- Pass: oxygen levels are in the normal range in both locations, and the difference between hand and foot is small.
- Repeat: borderline results may be retested.
- Fail: results are low or the difference between hand and foot is too large. Your baby will be evaluated, often with an echocardiogram (heart ultrasound).
The AAP endorsed updated screening steps in 2020 that simplified the process and reduced the number of repeat screens.
What a Failed Screen Means
A failed screen doesn’t always mean a heart defect. Other causes include lung problems, infection, or persistent pulmonary hypertension. Your care team will look for the cause.
Limitations
Pulse oximetry doesn’t catch every heart defect. Some babies with heart problems pass the screen. Know the warning signs after you go home.
Call 911 or seek emergency care if your baby has: blue or gray color of the lips, tongue, or skin; trouble breathing or fast breathing; sweating or tiring during feeds; poor feeding; unusual sleepiness; or cold, pale, or mottled skin.
The Bottom Line
Pulse oximetry is a quick, painless screen that helps find critical heart defects early. A failed screen means more testing, not a diagnosis. Watch for warning signs at home too.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Related Articles
- The Newborn Hearing Screen and Heel-Stick Test: What a “Refer” Result Means
- Heart Murmurs in Babies
- Your Newborn’s First 24 Hours: What Happens in the Hospital, Hour by Hour
- Your Newborn Discharge Checklist
Sources
- Martin GR, Ewer AK, Gaviglio A, et al. Updated strategies for pulse oximetry screening for critical congenital heart disease. Pediatrics. 2020;146(1):e20191650.
- Centers for Disease Control and Prevention. Critical congenital heart defects screening. https://www.cdc.gov/heart-defects
- Plana MN, Zamora J, Suresh G, Fernandez-Pineda L, Thangaratinam S, Ewer AK. Pulse oximetry screening for critical congenital heart defects. Cochrane Database Syst Rev. 2018;3(3):CD011912.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
