Blood Spot Card Collection

Ordering Blood Spot Cards

• Please contact the C&W Newborn Screening Laboratory to obtain blood spot cards (phone: 604 875-2148 e-mail: nbs_office@cw.bc.ca).
• Plan ahead and allow enough time for the cards to reach you by regular mail so that you do not run out of cards.

Blood Spot Card Collection

• Fill all four areas on the blood spot card completely with the blood sample. For babies in whom blood is difficult to draw (e.g. premature babies), a minimum of two spots is required.
• Collect blood spot cards for all babies, including babies who are breast/bottle fed or on Total Parenteral Nutrition (TPN) or intravenous fluids or fasting.
• Take blood from arterial lines, when available.
• Do not use cord blood. Maternal blood contamination may interfere with screening result interpretation (CLSI Guideline, 2007).
• Utilize appropriate measures to enhance the comfort of the baby during blood spot collection (e.g., breastfeeding, skin-to-skin contact).

Timing of Collection

1. Babies discharged after 24 hours of age: Collect the blood spot card prior to discharge and between 24 and 48 hours of age (pre-term and term babies). If collection is not completed during this timeframe, collection should be done no later than 7 days.
2. Babies discharged before 24 hours of age: Recommended practice: collect the blood spot card prior to discharge. The Newborn Screening Laboratory (NBS) at BC Children’s Hospital (BCCH) will request, through the baby’s physician/midwife, that a repeat sample be collected by 2 weeks (14 days) of age. If the parent(s)/guardian declines collection of the card prior to discharge from hospital, have them sign the Informed Deferral: Newborn Screening form. (Individual Health Authorities' forms have been created.)
3. Babies who receive a blood transfusion: If a blood transfusion is anticipated, whenever possible, collect a blood spot card prior to the transfusion regardless of the baby’s age. If not collected prior to the transfusion, collect between 24 and 48 hours of age. The NBS Laboratory will request, through the baby’s physician/midwife, repeat cards as required.
4. Very low birth weight babies (1,500 grams or less): Collect an initial blood spot card between 24 and 48 hours of age. The NBS Laboratory will request, through the baby’s physician/midwife, a repeat card at three weeks (21 days) of age or on discharge from hospital to home, whichever is sooner. Rationale: very low birth weight babies who have congenital hypothyroidism (CH) may have a delayed rise in thyroid stimulating hormone (TSH). The first screen (done between 24 and 48 hours of age) may miss the detection of CH.

Follow-up of Positive Screens

• The NBS Laboratory will contact the baby's physician/midwife by phone to discuss a positive screen and coordinate next steps.

Updated: March 11, 2011