Background: Newborn screening is a public health tool for the early diagnoses and treatment of asymptomatic infants with inborn errors of metabolism. Biomarkers and enzyme activities are measured in dried blood spots (DBS) on Guthrie carts to diagnose diseases, which may later appear such as mental retardation and or other disorders could be presented. To evaluate the percentage and the educational status of mothers who do not respond to the requested for a second DBS of a suspected for a disease newborn. Methods: We created a questioner about the educational status as well as the etiology of maternal lack of response for a second blood sample. Results: Most of mothers who denied to respond were of low educational status and or immigrants, not knowing our native or English language. The rest were indifferent and or misunderstood the information letter they reserved. Conclusions: Amelioration of the educational status of mothers and or better cooperation with social workers and or midwives, nurses etc. Translation of the information booklet about National Neonatal Screening Program in to more foreign languages should be necessary. © 2019

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