Detectable at birth, newborns are screened for hemoglobin diseases which are a group of autosomal recessive disorders characterized by synthesis of abnormal hemoglobin molecules or decreased synthesis of a beta globin chain. Substitution, addition or deletion of amino acids occurs to globin chains. Affected newborns with sickle cell disease may have early overwhelmng sepsis and require prompt evaluation at a comprehensive care facility. Early care and prophylactic penicillin can reduce morbidity and mortality. Prevalence (1:4000 of African descent and 1:1300 in general population.