Science and TechnologyAccurate DNA Paternity Testing

Infant mix-ups in hospitals could happen any day. Steve Kaufer from Inter/Action Associates, a Las Vegas security consulting firm, estimates that 1 out of every 1,000 infants is switched in hospitals. The firm interviewed more than 400 maternity ward employees across the U.S. for a study on baby switching and found that the opportunity exists in hospitals for mixing up babies, especially during the routine transfer of the baby immediately after birth: The baby is initially transferred to the mother, then to the bassinet, to the nursery, and then back to the mother1.

A new mother may worry about a mix-up occurring when she delivers. If a question arises about the baby’s identity, the most reliable way to be sure he or she hasn’t been switched in the hospital is for the mother and child to undergo a maternity DNA test.

Newborn Identification
Newborn identification varies from hospital to hospital, but one of the most prevalent methods is the use of corresponding ID bracelets between mothers and their babies. These tags typically list the patients’ names and a matching code between the two (for example, if the mother’s code is “1234,” her child’s code will be “1234”). Some of these bracelets even contain RFID tags so the hospital staff can electronically verify the mother-child relationship.

Despite advancements in ID tag technology, infant-mother mix-ups occur more than 23,000 times each year. Dalton, et al.2(PDF), identified human error as the leading cause of these mix-ups, often due to:

• Misreading infant or mother bracelet information
• Bracelets falling off the infants’ ankles or wrists, which is particularly common in newborns, whose arms and legs may shrink after birth due to water loss
• Bed mix-ups, in which a child is removed for bathing or treatment and then returned to the wrong bed
• Mix-ups of babies with similar or identical names
• Misreading of sequential names or ID numbers
• Inadequate physical security mechanisms
• Parents who are not fluent in the staff’s native language

Hospitals also employ footprinting and/or fingerprinting of the infant at birth for identification. This interpretive technology has also improved over the last 80 years, but inconsistencies–and thus opportunities for infant-mother mix-ups–remain. Footprinting and fingerprinting require consistent and careful procedures, and if a staff member is not highly experienced in these techniques, the chance of less complete and clear footprints and fingerprints is greater.

In light of some of the shortcomings these forms of identification may have, maternity DNA testing is becoming more popular when doubt arises. Maternity DNA tests compare the genetic information of the mother with the child to identify matches. Because the DNA of a child comes directly from his or her parents, half of the DNA should match the mother’s DNA. DNA samples are painlessly collected through buccal swabs–the process of rubbing the inside of one’s cheeks to pick up cheek (buccal) cells that contain DNA–and submitted to a laboratory for analysis. In as little as a day, the laboratory can determine if the child and mother are biologically related.

Hospital Security Measures to Prevent Baby Swaps
The maternal instinct may curb some of the baby-switching anxiety. U.S. researchers discovered that postpartum mothers have natural cues that can help them to recognize the crying sounds and smells of their babies. 65.9% of mothers tested recognized their babies from recorded crying, and 52.3% recognized their babies by smell, according to the British Journal of Nursing.

Hospital Hospital nurseries have implemented security measures such as video surveillance in the nursery and computerized chips in bracelets that cause an alarm to go off if they leave without authorization. When touring the maternity ward before their child’s birth, new parents are encouraged to ask if their hospital has these kinds of precautions in place, along with learning the identification protocol of newborns. During this tour, parents can ask questions such as:

• What are the security precautions in the maternity ward?
• What is the procedure for infant identification?
• Where will the baby be when he or she is not with me?

If parents are unable to choose the hospital where the birth will take place, their birthing coach can ask these questions during labor.

Some hospitals allow for the baby to stay in the room with the mother at all times. If the mother needs to leave the room for any reason, she is advised to find a nurse to watch over the baby. Other hospitals still keep the baby separated from the mother, but the mother is encouraged to choose a family member or friend to keep guard outside the nursery in these settings.

A Case of Infant-Mother Mix-Up
Despite these preventive measures, 64 mother-baby mix-ups occur every day.

Paula Johnson of Ruckersville, Virginia, found herself in one of these cases.

Johnson learned through a paternity suit that her daughter, Callie, was not the baby that she had given birth to. According to hospital records, Callie was born with the rare blood type O-negative and now has A-positive. Johnson found out later that another child, Rebecca, was born at the same hospital with a blood type of A-positive and now has O-negative blood. This was not conclusive enough for the hospital to prove there was a mix-up, so the hospital paid for a maternity DNA test to be carried out at a laboratory, and Johnson found out that Rebecca, not Callie, was her biological child. Despite this, Johnson does not want to switch the girls back to their biological parents.

“It’s the only thing they’ve ever known,” she told a CNN reporter. “I don’t see me changing my mind about taking her away from these people.”

If a mix-up is suspected, mothers can request a maternity DNA test to prove whether or not the child is hers. Like a paternity DNA test, a maternity test compares a child’s DNA pattern with that of the assumed mother to determine how likely it is that the child has inherited the DNA from the assumed mother. The father’s participation in the maternity test helps to exclude half of the child’s DNA, leaving the rest for comparison with the assumed mother, but his participation is not necessary.

A chain of custody maternity DNA test is the most reliable form of identification testing in these situations because it is legally defensible. The courts prefer this process because an impartial third party collects the samples at a clinic or a laboratory, participants must provide government-issued identification, and all parties must be photographed and fingerprinted at the collection site.

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