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Repeat Newborn Screen Result
Normal repeat newborn screening result.
If the first screen showed a markedly elevated level of C8 a normal
second screen result is reassuring BUT this does not rule out
MCADD. Therefore the metabolic physician may want to continue
treating the baby as though he/she has MCADD while awaiting the
results of more definitive tests.
If the first screen was only mildly elevated however, the newborn
screening increase was probably transient (false positive). Once
the metabolic team has confirmed that the infant does not have
MCADD, it is essential to reassure the family that their baby
is well and that they should treat their baby as entirely normal.
Many people can be traumatized by a false positive result and
counseling may be appropriate. If the metabolic physician remains
concerned, however, then he/she will discuss this further with
you and may decide to continue with frequent feeds and early intervention
if the baby becomes sick. It is important to remember, however,
that this does not mean that the baby has MCADD but only that
the metabolic doctor is taking an extra cautious approach until
definitive results are available to keep the baby safe and well.
Abnormal repeat newborn screen result.
An elevated C8 on the second sample is very suspicious of MCADD
and further evaluation by the metabolic doctor is definitely required.
The baby must be treated as though he/she has MCADD while definitive
testing is carried out.
See C8 markedly elevated, probable MCADD
discussions in first newborn screening result section. 
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