Newborn Metabolic Screening


The State of Maryland and the Office of Children and Youth with Specific Health Care Needs are dedicated to screening newborn infants for conditions that can cause serious illness, developmental delays, and even death if not detected in the first few weeks of life.
In 1965, Newborn Metabolic Screening using dried blood spots was started to determine if babies have a condition called Phenylketonuria or PKU for short. PKU is a metabolic disorder that causes major developmental delays if too much protein is eaten. Since 1965, over 250 babies in Maryland have been identified with a form of PKU.
Although the Newborn Metabolic Screen is still commonly called the “PKU” test, the testing has been expanded to include over 60 different conditions. These conditions include:
  • Inability to break down the sugar in breast milk and most formulas
  • Inability to break down different proteins
  • Inability to break down different fats for energy
  • Inability to fight infections (severe combined immunodeficiency disorders)
  • Presence of abnormal red blood cells or sickle cell disease
  • Abnormal thyroid function (congenital hypothyroidism)
  • Abnormal adrenal glands (congenital adrenal hyperplasia)
  • Cystic fibrosis
Oner additional condition was recently  added to the Maryland Newborn Screening Panel: 
  •  X-linked Adrenoleukodystrophy (X-ALD or ALD)- Screening began in December 2023
    • Condition in which very long chain fatty acids cannot be broken down.  These fats build up in the body and primarily affect the nervous system and adrenal glands.  X-linked conditions affect males more severely, but women carriers can suffer symptoms in adulthood. 

The goal of newborn metabolic screening is to identify babies who may have one of these conditions as soon as possible to help prevent problems. Babies who are born and live in the State of Maryland are screened in the hospital 24-48 hours after birth and again in their pediatrician’s office at about 2 weeks of age.

To learn more about newborn metabolic screening, click on the links below.

For Parents

For Providers


Newborn Screening Legislation

 Office of Children and Youth with Specific Health Care Needs
201 West Preston Street - Baltimore, MD 21201
Tel (410) 767-6730   Fax (410) 333-5047

February 2024

NBS Highlights

Newborn Metabolic Screening is celebrating 50 years of screening
newborn babies across
the country!
The first condition included in Newborn Metabolic Screening was Phenylketonuria or “PKU” which is why many people still refer to the Newborn Metabolic Screen as the “PKU test”.

Newborn Screening

Follow-up of Abnormal Results:

Newborn Screening Follow-up Program Manager:
LaPortia Barrows, RN
Nurse Consultants:
Monique Veney, MSN, RN
Luz del Valle Sanchez, MSN, RN


If a Parent Refuses NBS for Their Baby 

This refusal must be documented in writing with a parent’s signature indicating they have been informed of the risks and benefits of newborn bloodspot screening and have chosen not to have their baby tested.
Click here for the form: REFUSAL FORM
(If your hospital has approved your own refusal form this may be substituted)
The NBS Follow-Up Unit must also be notified within 12 hours of refusal.  We will contact the family and discuss risks and benefits of newborn bloodspot screening.  Please call 443-681-3916 or fax refusal form to 443-681-4505.

 Advisory Council on Hereditary and Congenital Disorders​