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Clinical Tip: Try a change of venue for the newborn discharge exam

Over the years, I've developed the habit of performing the newborn discharge examination in the mother's hospital room-after briefly checking the infant in the nursery for jaundice and a dirty diaper. I continue to do the admission examination in the nursery, where the lighting is better and instruments are close by.

Examining the infant in the mother's room, with parents present, offers several advantages: I can answer questions and give routine advice as I proceed through the exam-for example, I discuss normal skin conditions such as erythema toxicum, normal vaginal bleeding, and care of the umbilicus and circumcision site. I can also reassure worried parents about minor physical variations that are of no consequence. Occasionally, a parent may even notice and bring to my attention something that turns out to be significant. I often carry the baby to the mother's room, which both I and the mother enjoy-and sometimes leads to a photograph.

Feedback from parents and nurses tells me that parents, especially mothers, find the in-room exam to be a positive experience. Although it may take a little longer than examining the baby in the nursery, I find that the time is well spent because it results in fewer postdischarge telephone calls and happier, more confident parents.
Patrick Meyer, MDJanesville, Wis.