No, routine newborn HCV screening isn’t done; infants exposed in pregnancy are tested later with an RNA test at 2–6 months.
New parents ask about hepatitis C testing right after delivery because they want clear next steps. Hospitals do not run a blanket screen for hepatitis C in newborns. Testing is timed to give results that actually answer the question of infection, and that timing is not day one. Below you’ll find what happens, when testing is done, why the timing matters, and what each result means for your child’s care.
Newborn Hepatitis C Testing: What Hospitals Actually Do
Maternity units screen pregnant patients for hepatitis C during prenatal care. That prenatal result sets the plan for the baby. If the pregnant patient has current hepatitis C infection (detectable HCV RNA), the infant is considered perinatally exposed. Exposed infants are scheduled for an HCV RNA test between 2 and 6 months of age. If the pregnant patient tested negative, the baby does not need hepatitis C testing.
Why Testing Isn’t Done On Day One
Two facts drive the schedule. First, a baby carries the pregnant parent’s hepatitis C antibodies for many months, so an antibody test in early infancy does not prove infection. Second, a nucleic acid test (commonly called an RNA test) is accurate a little later once early false negatives settle out. Running a screen in the delivery room creates noise, not clarity.
When Testing Happens And Which Test Is Used
Clinicians order a single HCV RNA test for exposed infants during the 2–6 month window. If the result is “not detected,” no further hepatitis C follow-up is needed unless a clinician has another reason. If the result shows detectable virus, the child is linked to a pediatric liver specialist to watch labs and plan treatment when age-appropriate medicines are indicated. Antibody testing returns at or after 18 months only for children who were never checked earlier.
Timing And Rationale At A Glance
| Age | Test | Why This Timing Works |
|---|---|---|
| Birth–1 month | No routine test | Cord or day-one checks don’t settle infection; maternal antibody and early RNA fluctuation get in the way. |
| 2–6 months | HCV RNA (NAT) | Detects the virus directly; a negative result here ends hepatitis C follow-up for most exposed infants. |
| 18 months or older | Anti-HCV with reflex RNA (if not tested earlier) | Maternal antibodies have waned; antibody test regains meaning and reflex RNA confirms active infection. |
Risk Of Passing Hepatitis C During Birth
Most babies born to a parent with hepatitis C do not acquire the infection. Transmission risk clusters around deliveries from parents who have current viremia. Coinfections can raise risk. Planned cesarean does not prevent hepatitis C transmission and is not used for that purpose. There is no vaccine yet, and there is no shot at birth that clears hepatitis C. The plan rests on timed testing and follow-up.
What Parents Can Expect Before Leaving The Hospital
Your discharge packet should list the exposure status and the due date for the infant RNA test. Pediatric clinics often book that lab draw at a routine well-visit. If your paperwork does not include a date, call the clinic and add it. A simple calendar reminder helps families avoid lost follow-up.
Breastfeeding, Daily Care, And Daycare
Breastfeeding is permitted with hepatitis C. HCV is not spread by breast milk. If nipples are cracked or bleeding, pause nursing on the affected side until healed and feed expressed milk from the other side or use formula for that interval. Shared household items like spoons and cups are fine; this virus spreads through blood, not casual contact.
How The RNA Result Guides Next Steps
Two clear paths follow the early RNA check. A “not detected” result allows you to drop hepatitis C from the problem list. A “detected” result brings a specialist into the care team. That specialist will repeat labs, watch growth, and plan for treatment when the child reaches the approved age for direct-acting antivirals. These medicines are well-tolerated in older children and have high cure rates.
Result Paths Parents Ask About
Families ask the same three questions after the first RNA result. What if it’s negative now—could it flip later? What if it’s positive—does that mean liver damage today? And what happens at 18 months?
- Negative at 2–6 months: The child is considered uninfected and needs no extra hepatitis C checks unless a doctor sees another red flag.
- Positive at 2–6 months: The child is referred to pediatric hepatitis care. The team tracks labs and plans therapy at the age window set by current approvals.
- No early test done: The backup plan is an antibody test at or after 18 months, with reflex RNA if that antibody is reactive.
Practical Prep For The 2–6 Month Visit
Bring the prenatal hepatitis C lab report or patient portal screenshot if you have it; this speeds ordering. Confirm your lab location takes pediatric draws. Ask the clinic to message you the result in writing. If you move or change providers, those records make life easier.
What Not To Worry About
Casual hugs, shared toys, and bath time do not spread hepatitis C. Standard vaccines are on schedule as usual. Childcare settings do not need special restrictions beyond standard hygiene. If a cut happens, clean with soap and water and cover with a bandage. These simple steps keep households and classrooms safe for many conditions, not just hepatitis C.
Common Myths, Straightened Out
“They Should Test The Baby Before Discharge”
Early checks sound appealing, yet they do not settle the question. An RNA test in the first days can miss infection. An antibody test reads the pregnant parent’s antibody, not the infant’s immune status. Waiting a short time yields a result you can trust.
“Breast Milk Spreads Hepatitis C”
It does not. The virus travels in blood. Nursing is allowed. The only caveat is cracked or bleeding nipples; pause on the affected side until healed.
“A Cesarean Will Prevent Transmission”
Mode of delivery is not used to prevent hepatitis C. The best prevention steps happen before pregnancy through testing and treatment for adults who qualify, and during pregnancy through routine hepatitis C screening.
Talking With Your Pediatrician
Here are quick lines you can bring to the visit:
- “The prenatal lab showed detectable HCV RNA. Please order the infant RNA test at [X] months.”
- “If the RNA is not detected, can you send a message that says no more hepatitis C follow-up is needed?”
- “If the RNA is detected, please refer us to a pediatric liver clinic.”
Linking Care Between Obstetrics And Pediatrics
Good handoffs matter. Obstetric teams document the exposure status and the plan. Pediatric teams act on that plan. Parents close the loop by booking the lab at the right age. This three-step chain is simple and keeps babies from falling through the cracks.
What The Numbers Mean For Families
Among exposed infants, the share who acquire hepatitis C is a minority. Most exposed babies test negative at the early RNA check. For the smaller group with confirmed infection, treatment in childhood or later brings cure in the vast majority once eligible medicines are started. Early identification sets the stage for that cure.
Care Pathway Cheat Sheet
| Scenario | Next Step | Who Leads |
|---|---|---|
| Pregnant patient HCV screen negative | No infant hepatitis C testing | Pediatrician handles routine care |
| Pregnant patient HCV RNA detected | Infant HCV RNA at 2–6 months | Pediatrician orders; family schedules lab |
| Infant RNA not detected | No further hepatitis C follow-up | Pediatrician documents clearance |
| Infant RNA detected | Refer to pediatric hepatitis care | Pediatric liver specialist |
| No early test was done | Anti-HCV at ≥18 months with reflex RNA | Pediatrician orders at well-visit |
Treatment Outlook For Children Who Do Have Hepatitis C
Today’s direct-acting antivirals cure hepatitis C at high rates in older children and teens. Plans vary by age, weight, genotype, and national approvals. The pediatric liver clinic explains when a child becomes eligible and which regimen fits best. In the meantime, most children with hepatitis C do well, attend school, play sports, and grow on track with routine checkups.
How Parents Can Reduce Missed Testing
Missed infant testing remains common nationwide. A few steps cut that risk. Add the RNA test date to your phone calendar before discharge. Ask the pediatrician to place the order during the first newborn visit, even if the blood draw will happen later. Confirm your lab’s hours and infant draw skills. Keep copies of results in a folder or secure app.
Where To Read The Official Guidance
Current clinical recommendations lay out the exact timing and result-handling steps for perinatal exposure. See the CDC’s infant testing recommendations and the obstetric society’s call for universal screening in pregnancy. Bringing these pages to visits helps align everyone on the same plan.
Bottom Line Parents Use
Hospitals do not run a day-one check for hepatitis C. Exposed infants get a single RNA test at 2–6 months. A negative result ends the matter. A positive result starts a specialist partnership and a clear path toward cure when age allows. Mark the date, get the test, and keep the result where you can find it.