Baby Complete Blood Count

COMPLETE BLOOD COUNT (CBC)

A complete blood count is a test that looks at the basic components of blood: red blood cells that carry oxygen (denoted by bematocrit, or HCT), white blood cells that fight infection (WBC), and the platelets that help blood to clot (PLT). The CBC is an excellent screening test to look for a variety of medical issues, including anemia, infection, bleeding problems, and blood cancers.

The CBC must be drawn from an artery or vein; it cannot be done using a heel prick. The puncture site is cleaned with alcohol or another antiseptic, and a tourniquet is placed just above the area where the blood is to be drawn. This pressure restricts blood flow through the vein, causing the vein to fill with blood. Once the needle is inserted into the vein, blood is collected in a syringe or vial. Then the tourniquet and needle are removed, and the puncture site is covered with a piece of gauze or a bandage.

The blood must be sent to the laboratory shortly after it is drawn or it may clot, making the test unreliable. A clotted CBC must be redrawn. In a baby, because such small amounts of blood are drawn, a clotted CBC is not uncommon.

The HCT measures the proportion of whole blood that is made of red blood cells. In other words, it estimates how many red blood cells are circulating in the blood. Another measure for red blood cells is the hemoglobin (HGB). The HCT is simply a multiple of HGB - both measure circulating blood levels.

Anemia is the medical term for a low HCT. The normal range for HCT depends on age, and in general full-term newborns have very high levels. By the eighth week of life, however, the number of red blood cells falls sharply and the HCT is quite low. By 4 to 6 months of life, a baby's HCT is similar to an adult's.

WBCs are part of the body's immune system. When there is infection or inflammation in the body, the WBC will usually be elevated. This can also happen in times of stress, such as right after delivery. There are also cases during which the WBC number is actually lower than normal. Viral infections may lower the WBC, as may certain medicines, problems with the bone marrow, cancers, or diseases of the immune system. The normal range of WBC is 5,000 to 11.000 cells/ml.

Different types of WBCs serve different purposes. The different forms of WBCs include the following:

Neutrophils (also known as polymorphonuclear leukocytes, or "polys") tend to be elevated when there is a bacterial infection, though they can be elevated for a number of different reasons.
Bands are the most immature form of WBC. When they are significantly elevated, there is almost always a bacterial infection.
Lymphocytes are the type of WBC that fights viral infections. Therefore, they tend to be present in higher numbers during viral infections.
Monocytes are elevated in the presence of a variety of infections.
Eosinophils are often numerous when there is inflammation or allergy.
Basophils may appear in the CBC with some specific diseases.

PLTs help the blood to clot. The normal range of PLT is 150,000 to 450,000 per ml of blood. When the number is low, the skin may become bruised or there may be bleeding from the nose, in the stool, or internally. When the number is high, blood clot can form easily.

In addition to the HCT. WBC, and PLT count, many other characteristics of the blood are measured in the CBC.

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