The hospital does not perform routine DNA testing after birth for purposes of identification or paternity. The primary focus of hospital staff immediately following delivery is to provide medical care for the mother and newborn, which includes conducting mandatory public health screenings. Any testing that involves the baby’s genetic material in the first days of life is strictly focused on identifying serious, treatable health conditions, not on establishing biological relationships.
Standard Newborn Screening
The most common procedure involving a newborn’s biological material is the mandated public health screening, often referred to as the “heel stick” test. This procedure is performed when the infant is between 24 and 48 hours old, collecting a few drops of blood onto a specialized filter paper card. The blood spots are dried and sent to a state public health laboratory for analysis, looking for dozens of rare disorders.
This screening is not a full DNA test, but rather a biochemical analysis that detects markers for metabolic, endocrine, and hemoglobin disorders. The goal is to identify conditions like Phenylketonuria (PKU), sickle cell disease, and congenital hypothyroidism before symptoms appear. Early identification is crucial because timely intervention, such as dietary changes or medication, can prevent severe intellectual disability, developmental delays, or death.
The conditions included in each state’s panel are guided by the federal Recommended Uniform Screening Panel (RUSP), which lists core and secondary conditions. A condition is added to the RUSP only if a specific, sensitive test is available and an effective treatment exists. Although the RUSP offers national guidance, the final list of screened conditions can vary slightly because each state’s public health program ultimately determines its own specific panel.
Diagnostic Genetic Testing
Specific, targeted DNA testing may occur in the hospital, but only if a baby is clinically unwell or shows clear signs of a suspected genetic condition. This is a diagnostic procedure separate from the routine state-mandated screening, and it requires explicit parental consent. This type of testing is typically ordered by a neonatologist or a genetic specialist for critically ill infants.
If a newborn presents with unexplained seizures, congenital anomalies, or severe developmental delays, physicians may order a chromosomal microarray analysis (CMA) or rapid whole-genome sequencing (rWGS). CMA detects very small missing or extra pieces of chromosomes, known as deletions or duplications, which are often associated with genetic syndromes. Rapid genome sequencing analyzes the entire genetic code and provides a diagnosis in days, which informs time-sensitive medical management decisions.
Paternity and Legal DNA Testing
Hospitals do not offer paternity testing as a standard service and focus on the patient’s medical well-being, not on resolving legal or personal matters. Parents seeking to establish biological fatherhood must arrange for testing through an accredited outside laboratory. Even if a test is conducted while the mother and baby are still in the hospital, it is a non-routine event coordinated directly with the external testing facility, not the hospital administration.
For a DNA test to be legally admissible in court—for matters such as child support, custody, or inheritance—it must be performed under a strict procedure called chain-of-custody. This process ensures the identity of the person being tested and the integrity of the sample, involving an authorized third-party collector, photo identification, and notarized paperwork. The most common method for post-birth paternity testing is a painless cheek swab, or buccal swab, collected from the child and the alleged father.
A non-legal or “peace-of-mind” test can be performed at home using a kit, but these results are not valid for legal purposes because the collection process is not monitored. The hospital’s role is limited to providing a referral or information about qualified testing providers.
Retention and Privacy of Genetic Samples
The Dried Blood Spot (DBS) cards collected during the mandatory newborn screening are retained by the state’s public health laboratory for a period of time after the initial screening tests are complete. This retention allows the residual blood spots to be used for quality assurance, which helps improve the accuracy of future screening tests. The length of time these samples are stored varies significantly by state, ranging from a few months to many years.
The use of these stored genetic samples for public health research has been a subject of public concern regarding privacy and consent. Some states require parents to receive a form detailing the storage and potential research use of the residual blood spot, allowing them to opt-out of long-term storage or research. Parental rights regarding the sample’s destruction or use are not uniform across the country, highlighting the importance of understanding the specific policies of the state where the child was born.