- Heel Edge
- Risks and Complications
What is a heel stick?
Heel stick is the most common and minimally invasive method to draw capillary blood from an infant for medical testing. Capillaries are tiny blood vessels which carry blood to the tissues and connect arteries to the veins. A sharp device known as a lancet is used to prick the baby’s heel to obtain blood samples.
What does a heel stick test for?
Heel stick blood samples are used for tests such as:
- Complete blood counts
- Liver function tests
- Toxicologic tests
- Bedside glucose monitoring
- Blood gas analysis
- Newborn screening tests
Newborn screening is one of the primary reasons for a heel stick. Newborn screening is a state-mandated program in the US, though efforts are underway to develop a national newborn screening program.
A screening heel stick is usually performed within 48 hours after a child’s birth or as soon as possible. Early detection of any genetic disorders can help with effective treatment or even prevention of disease in certain cases. More than 95% of American newborn babies undergo screening for up to 50 genetic disorders which include:
At what age do you stop doing heel sticks?
The heel stick method can be used until a baby is four to seven months old, when babies are normally able to place their toes in their mouth. Heel sticks must not be done once the babies start bearing any amount of weight on their feet.
Why is blood taken from a baby’s heel?
The heel is a viable source of blood whenever capillary blood is acceptable as a sample for testing. A heel stick is a simple and safe way to draw blood in newborns in situations that include the following:
- Only a small blood sample is required for testing.
- Multiple and frequent blood tests are required.
- Other sources, like a venous or umbilical catheter, are not already available.
When is a heel stick not done?
A heel stick is not performed in the following situations:
- If the baby’s sampling area in the heel has any
- If blood volume required for testing is relatively larger
- Certain types of blood tests such as
- Coagulation tests
- Blood cultures
- Chromosomal analyses
- Immunoglobulins and titers
What is the correct site for an infant heel puncture?
The safest sites for an infant heel puncture are the edges of the heel on the inside (medial) and outside (lateral). The curve in the back of the heel should not be used for a heel stick in order to prevent injury to the calcaneus bone, which is close to the skin in the posterior heel. Previous puncture sites must also be avoided.
How do you do a newborn heel stick?
A pediatrician or a nurse trained in pediatric care performs the heel stick in a newborn infant.
Anesthesia is not required but the doctor makes the baby comfortable with:
- Reduced ambient light and noise
- Oral sucrose administered with a filler or a pacifier dipped in sugar solution
- The doctor may apply a heel warmer to warm the heel for five minutes before the procedure.
- Cleans the heel stick site with an antiseptic solution
- Holds the heel between their thumb and forefinger
- Applies light pressure on the heel
- Places the lancet on the appropriate spot and activates it
- Applies mild pressure to squeeze out a blood drop
- Wipes away the first drop as it can contain some of the antiseptic solution and interfere with the test results
- Collects the blood in a collection tube
- Blots blood drops in filter paper used for testing
- Applies pressure to stop bleeding
- Places a bandage over the heel stick site
What is the most serious complication of an infant heel stick?
Complications can mostly be avoided by employing proper care during a heel stick. Improper heel stick technique can cause damage to the calcaneus bone and soft tissue. Other potential complications include:
Health Solutions From Our Sponsors
Top What Does A Heel Stick Test For Related Articles
Get the Facts About Bottle FeedingDo you need to warm a bottle? What's the best way to burp your baby? Find out what you need to know about bottle feeding and infant formula.
Common Infant IllnessesWatch this slideshow to see common symptoms and home treatment for infant and childhood illnesses including fever, nausea, constipation and more.
How Long Can a Newborn Go Without Peeing?A newborn baby usually passes urine for the first time within 12 to 24 hours after birth. Not peeing in the first 24 hours points to some urinary tract problem. As the mother and her baby need to stay in the hospital for 24 to 48 hours after a normal delivery, it becomes easy for the doctors to diagnose the condition early.
Infantile Acropustulosis PictureThis cutaneous disorder is characterized by recurrent episodes of intensely pruritic pustules and papulovesicles on the hands and feet. See a picture of Infantile Acropustulosis and learn more about the health topic.
Jaundice (Newborn, Kernicterus)Jaundice in infants occur when the baby's liver may not be developed enough to efficiently rid the body of bilirubin. Symptoms of jaundice include yellowish colored eyes, and yellowing of the skin. Some babies are more at risk to develop jaundice. Kernicterus is a type of brain damage that occurs when a baby has jaundice and is not treated. Treatment of infant jaundice is generally with phototherapy so that kernicterus should not develop.
New Parents MistakesParenting a child isn't easy. Explore the top 10 mistakes that new parents make. Discover newborn parenting tips for breastfeeding, learn to deal with crying babies, child's fevers, and more.
Newborn Infant Hearing ScreeningA newborn infant hearing screening is performed before a child is discharged from the hospital. If an infant doesn't pass the test, a rescreen is performed. Detecting hearing loss at an early age increases a child's chance of having a healthy and more productive life. There are two methods of testing hearing in infants: auditory brainstem response (ABR) and otoacoustic emission (OAE). Both tests are accurate, automated, and don't require a visible response from the infant.
Newborn Jaundice (Neonatal Jaundice)
Jaundice in newborns and babies (neonatal jaundice) usually occurs because of a normal increase in red blood cell breakdown and the fact that their immature livers are not efficient at removing bilirubin from the bloodstream.
Symptoms of jaundice are fever, poor feeding, and looking ill. Newborn jaundice is very common and is caused because the newborns liver isn’t mature enough to remove bilirubin from the blood.
Treatment of jaundice in newborns include phototherapy, tanning booths, and other treatments.
Urine Blockage in NewbornsThere are many syndromes and defects that may cause urine blockage in newborns. Defects in the urinary tract that may cause urine blockage include vesicoureteral reflux, ureteropelvic junction obstruction, bladder outlet obstruction, posterior urethral valves, nerve disease, and ureterocele. Syndromes that may cause urinary blockage include congenital heart defects, esophageal atresia, and prune belly syndrome. Treatment for urine blockage in newborns depends on the cause of the blockage.
What Is a Heel Stick Test?The heel-stick test is a simple method to collect a newborn baby’s blood by pricking their heel to screen for certain diseases. It is usually performed as soon as possible after the baby’s birth. During this test, a small amount of blood is collected with a capillary or on a filter paper. It is also called a newborn blood spot test.