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Repeat Newborn Screen Result
Normal repeat newborn screening result.
If the first screen showed a markedly elevated level of C14; C14:1
a normal second screen result is reassuring BUT this does not
rule out VLCADD. Therefore the metabolic physician may want to
continue treating the baby as though he/she has VLCADD 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 VLCADD, 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 VLCADD 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 C14; C14:1 on the second sample is very suspicious
of VLCADD and further evaluation by the metabolic doctor is definitely
required. The baby must be treated as though he/she has VLCADD
while definitive testing is carried out.
See C14, C14:1 markedly elevated, probable
VLCADD discussions in first newborn screening result
section. 
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