the disease. A pilot screening program for four lysosomal storage diseases (Gaucher disease, Pompe disease, Fabry disease and Niemann-Pick disease was undertaken using anonymised dried blood spots was completed in Austria in 2010. Their data showed an increased incidence from what was expected in the population, and also a number of late onset forms of disease, which are not typically the target for newborn screening programs. Hearing loss Undiagnosed hearing loss in a child can have serious effects on many developmental areas, including language, social interactions, emotions, cognitive ability, academic performance and vocational skills, any combination of which can have negative impacts on the quality of life. The serious impacts of a late diagnosis, combined with the high incidence (estimated at 1 - 3 per 1000 live births, and as high as 4% for neonatal intensive care unit patients) have been the driving forces behind screening programs designed to identify infants with hearing loss as early as possible. Early identification allows these patients and their families to access the necessary resources to help them maximize their developmental outcomes. Newborn hearing testing is done at the bedside using transiently evoked otoacoustic emissions, automated auditory brainstem responses, or a combination of both techniques. Hearing screening programs have found the initial testing to cost between $10.20 and $23.37 per baby, depending on the technology used. As these are screening tests only, false positive results will occur. False positive results could be due to user error, a fussy baby, environmental noise in the testing room, or fluid or congestion in the outer/middle ear of the baby. A review of hearing screening programs found varied initial referral rates (screen positive results) from 0.6% to 16.7%. The highest overall incidence of hearing loss detection was 0.517%. A significant proportion of screen positive infants were lost to follow-up before a diagnosis could be confirmed or ruled out in all screening programs. Congenital heart defects In some cases, critical congenital heart defects (CCHD) are not identified by prenatal ultrasound or postnatal physical examination. Pulse oximetry has been recently added as a bedside screening test for CCHD at 24 to 48 hours after birth. However, not all heart problems can be detected by this method, which relies only on blood oxygen levels. When a baby tests positive, urgent subsequent examination, such as echocardiography, is undergone to determine the cause of low oxygen levels. Babies diagnosed with CCHD are then