Parents aware of infant screening but fail to follow up causing delay in detecting and treating disabilities

To ensure the healthy growth of a child, the National Referral Hospital and hospitals in some districts and Thromdes have been screening newborns right after birth. The newborns are being screened for apparent defects during birth including heart, vision and hearing among others. According to health officials, although many parents are now aware of the importance of such screenings, some do not come for follow-up. As a result, doctors say, they are unable to thoroughly detect and correct the defects on time in some children.  

According to a doctor from the National Referral Hospital, the screening starts right at the birth of a newborn. The doctor or a nurse examines the newborn from head to toe for any apparent defects of the eyes, ears, oral cavity, neck, chest, abdomen, genitalia, anal opening, back and limbs.

The doctor added that after 24 hours of birth, a newborn is then screened for critical congenital heart disease. This is to check whether a newborn is suffering from heart disease and the ones suspected to have such diseases are forwarded for further examination.

Then within day three or seven, a newborn is screened for vision and hearing. If any issues are detected during the screening, the child is forwarded to respective experts for follow-up.

However, currently, only a few hospitals with paediatricians in the country have such screening. Besides Thimphu, it is currently available only in hospitals in Monggar, Gelephu, Wangdue Phodrang, Samtse, Phuentshogling, Bumthang, and Trashigang.

In addition, only the National Referral Hospital and the two regional hospitals have audiologists to conduct hearing defects.

The doctor said that the paediatrician department is currently formulating a newborn screening guideline to screen every newborn throughout the country to ensure that their diseases are detected and treated early.

Dr Dinesh Pradhan, a Neonatologist at the National Referral Hospital said, “In those hospitals which have a paediatrician, all these tests are done, but in those hospitals which do not have a paediatrician only the head-to-toe examination and maybe the screening for congenital heart disease is done. In Bhutan, currently, we don’t have the additional metabolic blood tests or newborn screening for metabolic hormonal and genetic tests. We have proposed a budget  for these tests in the 13th Five-Year Plan.”

Meanwhile, one of the three audiologists in the National Referral Hospital said that after the screening, they have referred the newborns with profound hearing loss or complete hearing loss for Cochlear implant surgery and auditory rehabilitation. The National Referral Hospital screened around 1000 newborns for hearing impairment in the last three years.

“Pre-term infants are at risk of developing hearing loss. Other things are like infections such as meningitis and then neonatal jaundice. Apart from that, those infants who require a Neonatal Intensive Care Unit are also at risk of developing hearing loss or at risk of having hearing loss. Another common factor that we have to look into is family history, infants born into a family with a history of hearing loss have to be screened,” said Karma Tenzin, an Audiologist with JDWNRH.

He added that though parents are more aware of the importance of such screening compared to the past, few parents do not come for the follow-up due to time constraints and distance issues.

Meanwhile, a few parents BBS talked to expressed their gratitude for such screening.

“My infant was screened right after birth. This kind of screening is beneficial in preventing disease as it can detect and prevent diseases even before it is too late,” said Kritiman Gurung.

 Pema Yangchen said, “Screening is very helpful because, in the past, we did not check if the baby had hearing problems. Now, there are lots of screenings and we can detect defects related to the five senses in an infant which make early intervention possible.”

Health experts say that such screening to identify birth defects developmental delays and disability in newborns is critical for timely interventions.

Singye Dema

Edited by Phub Gyem

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