Blood is drawn from newborns differently than it is in adults, teens and kids and is often done through a heel stick (capillary sample) for small volumes or for larger volumes that are needed the blood is draw from a newborn through a gentle venipuncture.
When drawing blood from newborns, it requires specialized pediatric training, pre-warming the site, using a sterile lancet on the outer edges of the heel and applying some gentle pressure afterward.
Before drawing blood the doctor will wash their hands, put on gloves and gather the supplies which include the sterile lancet, antiseptic, gauze, collection tubes or card.
Then the doctor will warm the newborn's heel for 3 to 5 minutes with a warm, moist compress to dilate blood vessels and improve blood flow.
Next the doctor will administer pain reduction measures like using a small oral sucrose solution with a pacifier, or have you breastfeed the baby, 2 minutes before the puncture.
Then the doctor will position and securely stabilize the newborn's foot or limb to prevent sudden movement.
The doctor will then clean the lateral or medial plantar surface which is the outer sides of the heel with an antiseptic wipe and allow it to air dry completely.
The doctor will avoid the central back portion of the heel to prevent damaging the underlying bone and then puncture the skin firmly with a sterile, single use automated lancet, which keeps the depth of the puncture under 2.0mm.
Then the doctor will gently wipe away the very first drop of blood with a sterile dry gauze to remove surface alcohol or tissue fluid and apply intermittent, gentle pressure and release around the site to allow natural capillary refill, avoiding harsh or excessive squeezing, which causes hemolysis.
And finally the doctor will collect the blood into micro-collection tubes or onto a newborn screening card without pressing the baby's skin directly against the card.
After the blood is collected, the doctor will then apply clean, dry gauze with gentle pressure to the puncture site until the bleeding stops completely and then place a small adhesive bandage only if the newborn is old enough or per local clinical protocol and then discard any and all sharps.
The doctor will then label all the specimens at the bedside and comfort the infant.