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Ontario's Screening System

Ensuring that every infant born in Ontario is offered screening and that every affected infant receives appropriate treatment and follow-up requires the coordinated efforts of parents/guardians and three main groups of health care providers:

Parents/guardians

Parents/guardians are responsible the following when it comes to newborn screening:

  • Reviewing educational materials about newborn screening.
  • Discussing any questions with a health care professional.
  • Screening their infant for biliary atresia using the Infant Stool Colour Card provided to them by the birth hospital, birthing centre or midwifery practice.

Hospitals, birthing centres, midwifery practices, and primary care providers are responsible for:

  • Parent education about newborn screening, including dried blood spot (DBS) screening, critical congenital heart disease (CCHD) screening, and parent-led screening for biliary atresia.
  • DBS collection
  • CCHD screening using pulse oximetry
  • Providing accurate and complete information to NSO for every infant screened
  • Promptly following up on CCHD screen positives
  • Promptly following up in the event a baby requires a repeat newborn screen, or a screen is missed.

NSO's responsibilities include, but are not limited to, the following activities:

  • Providing education about newborn screening to parents/guardians, health care providers and the public. 
  • Performing newborn screening tests and ensuring quality assurance standards are maintained.
  • Reporting DBS screening results to submitters, including communication regarding the need for repeat screening (e.g. unsatisfactory samples, missed screens, transfusions).
  • Referring DBS and BA screen positive infants to a Regional Treatment Centre (RTC) or specialized health care provider for assessment and obtaining follow-up diagnostic outcome information.

The responsibilities of Regional Treatment Centres (RTCs) and specialist physicians include the following:

  • Timely confirmatory testing of DBS or biliary atresia screen positive infants referred to them by NSO, including the management and care of affected infants.
  • Returning diagnostic outcome information to NSO in response to the medical referral, ensuring quality screening and care. 
  • Educating health care providers in their region about newborn screening.  

In addition, the NSO Advisory Council is an independent advisory body of health and other professionals with expertise in newborn and childhood screening with a mandate to advise the MOHLTC and NSO on its policies and programs related to newborn and childhood screening.

Contact NSO

Subscribe to the Submitter Bulletins to stay up to date on the latest newborn screening updates, or submit a question about newborn screening.

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