1. Potera, Carol


And breastfeeding, parents' confidence in newborn care improve.


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New mothers and their infants are generally discharged from the hospital two to three days after delivery. Follow-up office appointments are scheduled to check the health of both babies and mothers, but many mothers don't make the appointments. According to a new study, however, home nursing visits within two days of discharge prove as safe and effective as office-based care for well-baby and postpartum check-ups and may be a practical way to ensure maternal and infant health after discharge.

Figure. Barbara Stew... - Click to enlarge in new windowFigure. Barbara Stewart, a nurse with the Nurses for Newborns program, examines baby Keshawn Vaughn during a home visit. Photo by Dana Johnson / Vanderbilt University Medical Center.

Researchers assigned 1,154 new mothers who intended to breastfeed their babies either to receive a home nursing visit within 48 hours of discharge or to make a timely office visit. They then surveyed participants by telephone at two weeks, two months, and six months after release from the hospital. Overall, both groups had similar rates of hospital readmission and ED visits. Mothers who were visited by nurses at home were more likely to breastfeed, and they felt more confident about their parenting skills than those seen at physicians' offices.


Home visits took about an hour on average and were performed by nurses with an average of 21 years' experience in maternal-child health. Infants were checked for newborn jaundice with a transcutaneous bilirubin meter, and the nurses drew blood if necessary. Nurses helped mothers with breastfeeding concerns and advised them about safe infant sleeping and feeding habits, as well as the nutritional and exercise needs of new mothers. They conducted psychosocial assessments and, according to study leader Ian Paul (responding in an e-mail to AJN), made referrals to community-based programs when indicated.


Home newborn visits are an alternative that can bridge the gap between nursery care and primary care, especially in areas where access to timely postdischarge care is limited. "Many health care providers are not aware that this service is available," said Paul. "Our paper supports home visits as a good model of care."-Carol Potera




Paul IM, et al. Arch Pediatr Adolesc Med. 2011 Nov 7, [Epub ahead of print].