this program aims to find solutions to

your medical queries it seeks answers to

common health problems that have been

hounding you we will help you out in

finding answers to your medical concerns

I'm angel Jaco and this is med talk your

weekly on air health consultation here

on the solar news channel

welcoming a newborn to your family can

be one of the happiest moments in your

life yet the excitement is usually

coupled with apprehensions and fears or

the vulnerability of the baby this is

the reason why newborn screening or NBS

has been instituted in the Philippines

newborn screening is a blood test that

the screen will borns for Continental

diseases or what we call the inborn

errors of metabolism and most of this

diseases can cause something as mild as

a mild mental retardation or growths

panting but can be as proudly as death

the process involves taking a few drops

of blood from the baby's heel blotted on

a special absorbent filter card ideally

on the 48 to the 72nd hour of life most

disorders are unrecognizable at birth

but with MDS there is an opportunity to

identify and treat affected babies when

serious health problems occur you can

save lives not only save lives for those

who who for those children would have

the diseases that can cause mental

retardation you can help them live a

normal life

not challenged mentally or physically

what diseases can be prevented with this

vital procedure what complications may

arise if a baby does not undergo and Bs

find out the answers tonight on met doc

joining us tonight is dr. Carmencita

Bedelia director of the newborn

screening reference center of the

National Institutes of Health

Lucy Manila also with us is dr. Mary Ann

Chong head of the biochemical genetics

laboratory Institute of the human

genetics of the National Institutes of

Health UT Manila

you can join tonight's discussion by

calling our hotline at five four eight

four six seven eight good evening

doctors welcome to the show good evening

it is a newborn screening awareness week

yes and here on the show we'd like to

learn more about newborn screening so

what exactly is NBS the type edenian is

the approach meaning is a test that we

offer to babies shortly after 24 hours

of life so that we can identify

conditions that can lead to mental

retardation or death and I want to

qualify that we're not testing all

diseases we're testing for six specific

conditions that can be that can be

reversed in terms of complications dr.

Chong is this a new how do you call a

test that's being offered in the

hospitals how long has it been being

offered you know we started in 1996 so

that's how many years old really not

seventeen seventeen years

so it's not really new but in the

Philippines only 17 years but worldwide

more than 50 years 50 years 61 was 60 61

was the beginning of newborn screening

in the u.s. that's where it started

why is it relatively new here in the

country well it's very difficult to you

know to start start the program we

completed a lot of priorities but even

in the u.s. they had problems starting

this at that time but I think we were

able to start your 24 hospitals we have

24 hospitals that actually started based

in the Philippines way back in 1996 and

we're happy to say that we have more

than 4,000 hospitals right now offering

newborn screening in the country so

where is it available and who conducts

NBS actually it's found it's offered in

every hospital because it's part of

licensing as part of the universe

screening law or the Republic of 9:00 to

8:00 8:00 every hospital has to offer

newborn screening as part of a licensing

requirement okay

so whether you're you give birth at a

private or a public hospital this kind

of test is offered to the parents yes

so as dr. podila mentioned it's

available in all hospitals and even

lying in clinics have a health facility

so for those children being born in the

barrios etc in far-flung areas there is

a nearby and think health facility that

offers newborn screening in the area

what is the significance of this

procedure why is it important

well this babies look normal at birth

and there are no symptoms as a matter of

fact they go home without any problems

the problems come in only on anywhere

from day five six or sometimes even at

two weeks so if you're not able to catch

them in time there will be a problem so

with within 24 hours are you're able to

catch or able to detect any disease that

the child might have though

we wanted the test shortly after 24

hours the result will come out about day

five or day six okay and that's enough

time to catch the baby and and give that

right treatment at that time if you do

the test at two weeks then you're going

to miss some of these conditions and the

baby may be very sick at that time

okay so doctors will go back to this

discussion we have on the line Angela hi

Angela

good thank you please go ahead with your

question for our doctors yeah I would

like to know we didn't know a newborn

screening will be done only once or

should I get a second opinion

okay Thank You Angela doctors dr.

Bedelia the same that is being done all

over the country so there are you're

actually four Lots right now we just

opened the fifth lab so it doesn't

matter which lab you you go to because

they're doing the same tests if there is

a need for a second test it's called the

confirmatory test it's not a newborn

screening test so there's a protocol for

each one so all they have to do is if

there's a problem their pediatrician or

Midwife or nurse practitioner will be

telling them what to do how's the

information on NBS in the country except

talked about with your OB is it talked

about with your pediatrician how is the

information given well ideally you know

the obstetrician should already inform

the parents who are about to give birth

no other mommies no pregnant mommies no

during the prenatal care they should

already inform this parents about

newborn screening and the benefits of

newborn screening you know its

importance and then probably the

pediatrician again no can reiterate know

the significance of newborn screening

once the baby is delivered and I think

during labor or probably upon delivery

these parents are being given

know which contain information about new

world screaming and it is encouraged

that every parent was a new morn baby

have their child tested for MBA yes

because you don't want to have a baby

who's you don't want a baby who

dies of a condition that can be saved so

I think it's the right of every

individual every newborn to have a

normal life and that opportunity starts

with that you burn screaming what

medical conditions have been detected

because of NBS at the moment we have six

disorders that are included in the panel

no can I describe them talk about one

one one first okay so what's the most

common the most common among the five is

actually glucose 6-phosphate

dehydrogenase deficiency or we called

g6pd deficiency you know there is an

enzyme in your red blood cell that is

deficient and when you are exposed to

certain food or drugs the RBC gets

destroyed and patients will present with

join this or yellowing of the skin and

it can also lead to brain damage

that's the commonest I think one in 55

is that right man one in 55 Filipinos

and this is inherited from the parent or

is does this develop as the mother is

pregnant

it's it's inherited it's it's a gene

actually that's you should it's found in

actually in the mother but it can

actually be present in the father so I

think it's just important to know that

you know once you have this condition

you have to avoid certain food items and

drugs when you go to the doctor they

bring the list and the topic but maybe

you know the most maybe next year we can

talk about another condition later

that's probably more fatal and in

another in a later segment yes

how about those let's say you know

there's information given already

and your doctor has talked to you about

it that you know NBS screening is very

important it can save your baby's life

but what about other mothers who choose

not to have NBS and me later on decide

to have it when they've taken their baby

home and it has been a couple of weeks

already well you know if for instance

for some conditions the the critical

period is only two weeks so if you do

your and after that condition is

congenital hypothyroidism and after two

weeks the baby starts losing IQ points

if the mother decides to have a test at

at one month or two months old that baby

lost already several IQ points I cannot

recall the baby cannot recover that so

it's a you can stop the the damage but

but it's there so the important thing is

that you do it at birth and if it's

positive then you start treating the

baby right the way doctors we have

another caller on the line Louisa

hi Louisa good evening good evening

please go ahead with your question for

our doctors hi good evening my question

is that is it possible to detect

something from my baby even if we don't

have a history of decision the family

Thank You Louisa it is passed don't some

of these conditions have parents who are

carriers actually that's what you call a

recessive condition so you're not going

to pick up any history from the family

but it's because the gene is passed on

to the baby and the baby may have

problems so our recommendation is that

any baby regardless if there's a family

history or no family history you were

speeding must be done but emphasizing

the benefits of getting and Bs we can't

emphasize it enough and since this is

newborn screening Awareness Week we'd

like to inform them more about the

benefits of NBS dr. Bedelia actually a 1

it's not just the mothers I think the

mothers and grandmothers can push can

ask for newborn screening the mothers

the father is the t-test the low loss in

the lowest but we'd like to reach out

also to the professionals who are

listening that it is their

responsibility to offer it to the

mr. taking care of so it's part of the

Republic of 98 it we're in the the

professional who's handing the baby is

responsible for offering it to the baby

dr. Chong um well I would just like to

say that early diagnosis will plus early

treatment of course because if you

diagnose them early you will be able to

treat them early okay given if you do it

early and give treatment early these

patients will live normal lives

so the effect that children can have

normal lives now because of newborn

screening dr. Chong dr. Padilla we will

talk more about newborn screening when

Meg talk returns

did you know that for infants can be

saved every hour from mental retardation

or death as a result of newborn

screening according to the Department of

Health all of the do age as of December

2010 more than 2 million Filipino babies

have undergone and v/s saving them from

imminent sickness and death

we're back here on Mad Dog still talking

about newborn training so doctors what

are the other disorders that can be

detected because of NBS

okay so one is congenital hypothyroidism

where is the missing hormone congenital

and it's you don't see any symptoms

until much later in life several months

okay

the CAH or congenital adrenal

hyperplasia for the classical type they

can be dead within 10 days

phenylketonuria and maple syrup urine

disease will need a special of milk

formula to be able to be difficult

normal and the other condition was g6pd

deficiency but i do want to mention

congenital hypothyroidism because in the

world if there is one condition we want

to be tested in every baby it's going to

be congenital hypothyroidism studies

have shown that you have to start

treating by two weeks after to achieve

lose IQ points and i think you know this

picture is you know tells us oh it's

this portrait actually found in every

hospital and this poster shows a baby

not a baby anywhere actually the girl is

the girl was about okay okay

the girl was about seven at the time

this was taken the boy was 14 okay okay

okay and as you can see the boy is the

boy is in the girl is normal

the difference here is that the girl was

had Nupur screening done and was treated

the boy was picked up at the age of 14

and was severely but the boy is

is alive you know i just i just saw his

pictures the other week he's 20 plus

minor and of course severely so

that is the impact of newborn screening

you can change the future of the baby

like look at the future of the girl the

girl is normal and proud

in college right now and the same

condition in the boy and the boy is

severely retired and there's nothing I

can do about the retardation at this

point but but just because of NBS just

because of newborn screening you're able

to see the life of the girl and

hopefully a lot more parents would be

aware that this is the result yeah

after NBS I feel right now I think the

program is save more than sixty thousand

babies already but just because of

because we've had newborn screening for

the past so many years and we can save

more dr. Chung oh I think there's one

more decease mom galactosemia there are

six garlic dose is a sugar that is

predominantly seen in your dairy

products No

so when that baby's diagnosed with the

lab it galactosemia we just change the

milk the treatment is as easy as that

okay now doctors will just go to our

Facebook question this newborn screening

hurt are there any other methods

aside from pricking my baby's heel of

course this is a concern of the moms no

no painful for the baby

yeah heel prick is the most convenient I

think and the ECS you know when we do

you know this test in that age group

know and it's similar to your

immunizations like at Birth they are

being given hepatitis B vaccine on the

thigh and vitamin K injections so it's

similar to those injections so the

baby's heel is pricked yeah and then

what what happens to the so I think we

just get like a few drops of blood and

then drop it on a special filter paper

and then we just dry it and send it to

the laboratory didn't have a screening

facility how long after do we get the

results if it's if it's positive they

would get a phone call maybe by what

they find and then if it's normal it to

join the ordinary mail but the

physicians there is a coordinator in

every hospital every lying in

every breathing center every hospital

has one coordinator who handles all of

the results so if there's a positive

case this coordinator will inform the

pediatrician that they have to recall

the patient and we have recalled

patients even up in the mountains and

they really come and really they only

come somebody will go get them yes it's

good to know yes another question from

Twitter my child has a health condition

will my next baby have it - I think it

depends on the condition four of those

conditions can recur in each pregnancy

25% of the time so it depends on which

condition but I think most of them are

inherited in a recessive minor as what

dr. podila mentioned and if it's an

autosomal recessive pattern of

inheritance we presume that both parents

are carriers of the gene and the

condition can happen again 25% of the

time each pregnancy all the more and

they should get nbsp only for each child

yes another question doctors from

Twitter how accurate is the standard

newborn screening the the methods that

were using is the same method that's

being used in more than half of the labs

in the world okay so we do follow

international standards
there's an international accreditation

by CDC Atlanta Georgia and and we have

to pass those tests just like any other

lab in the world and I'm proud of the

labs fear because they perform very well

and are comparable with the other labs

in the developed countries how about

those who give birth at home well right

now what's happening is they can go if

if the rule of Health Unit has it they

can have it down there otherwise they

have to go to a facility or any Hospital

that has that has that's offering you

one screening so upon getting the

results of newborn screening let's say

the baby has been tested positive for

for the disease for any of the six

diseases that

mentioned what is the next step for the

parents what should they do next well be

when the positive result comes out then

the pediatrician will arrange a referral

to a specialist because we have very few

specialists in the country and and if

let's say the patient is coming from a

distant place then we will link up that

physician with a specialist in in Metro

Manila Cebu Davao and arrange the

treatment of the patient what normally

happens after that other more that's

conducted or their medicine medications

already given or administered so after

the first newborn screening and it turns

out positive we proceed to the

confirmatory testing and then if the

confirmatory tests are McGann are still

positive then we start treatment for I

think for three of the dose diseases

which are Street with changing the milk

formula and these are also again being

given free by the program by the newborn

screening program so yeah we treat right

away once the confirmatory test turns

out positive does the child outgrow this

no questions inherit that yeah it's just

controlled well you reverse the

complications you don't have retardation

you don't have that there are many

issues like even if that the problem I

think is complete you have to be

compliant with the treatment so some

parents from my experience is when they

see that the patient their baby's normal

sometimes you stop the treatment in

their own that's very dangerous so that

there's a reason why they have to be

matched with the physician who knows

exactly how to handle the case is it

expensive to undergo and BS and to

continue on with with the other tests

it's covered by feel health right now

the cost is five hundred and fifty

pieces for the six diseases I did

mention that we're going to 28 diseases

by January but it's if they're a member

if they're members of field health then

there's no there's no payment because

it's just covered okay but if they're

not members of ill health then it's an

out-of-pocket

but I always compare it with you know

the desire of a parent to know the sex

of the child I know that they spend

actually to get an ultrasound and then

if they the sex was not shown they want

to repeat it again but here is another

opportunity for the baby to be normal

and that's to spend set aside 550 bases

for the new brush meaning dance so if

you're not a member of you hope they

have to save it they have to save for it

and it is not factored in with the

hospital bill though this is separate

it's it's a it no it's not it's it can

be part of the hospital bill but then if

you're a member feel health then it can

be cleaned from field health ok it's

actually part of the newborn package of

field health including your BCG

vaccination and your HEPA be part of

that package so doctors or any other

advice to the parents out there I know

that in the country NBS has only been

here for 17 years and how what how can

you what do you say or what can you say

about those already have the information

on NBS and we still want to know more

and to those who aren't aware of NBS yet

how can you encourage them to read up on

it and be more guided on how to go about

doing this well I think every every baby

has the right to a normal life and since

the babies look normal at birth it's

very difficult to ask for specific tests

and I look at newborn screening as an

opportunity to have a good start with

life because if one is positive then you

can change the future by you know being

treated properly and then

normal so my advice to parents is that

you know don't hesitate to have nuprin

screening done the pain is very minimal

I will not say it's not painful because

there is pain but the the rewards are

are great if the patient is positive I'd

like to talk to you know to the

grandmothers because I know that they

participate in the decision-making they

should ask for it they should make sure

that if it's not offered in their

hospital that they should ask for new

per screening for the baby because

that's for the future of the baby thank

you very much dr. Padilla dr. Joan I

think I'd like to ask all to the help of

our health professionals now and to

encourage newborn screaming to offer it

to their patients because I think they

know already the benefits so they should

emphasize it to their patients know the

obstetricians and the pediatricians I

think they should offer newborn

screening because the benefits are great

for the baby

okay thank you very much dr. Chong thank

you once again doctors for helping us

understand more about and Bs and its

importance really in having our children

that's good for NBS thank you thank you

thank you again it liked the scent of

Tora Carmencita Bedelia and dr. Mary Ann

shone for enlightening all of us about

our topic for tonight see you again next

Tuesday on men talk 10 p.m. on your

schedules on air consultations on the

solar news channel this is angel Hakam

good night