What to tell parents before they leave the hospital

April 1, 2007

Discharging a newborn from the hospital is a golden opportunity for anticipatory guidance. Here's a 12-point approach, based on years of experience.

At a time when parents of a newborn just need proper counseling and reassurance for a simple problem, or some guidance, they are often forced to enter a crowded and germ-filled office. They never receive the necessary anticipatory guidance because the essential elements of pre-discharge counseling are not well taught to residents. In most hospitals, teaching parents about newborn care is left, for the most part, to nurse-educators in the hospital (who may make use of videotapes on such topics as bathing, diapering, and breastfeeding) and informational handouts developed by private pediatric practices, HMOs, academic institutions, and manufacturers of baby products and infant formula.

While these efforts are valuable, parents may not read all of the material they are given. Even if they do, reinforcement is usually needed. A face-to-face talk with the pediatrician summarizing what parents need to know before they take their baby home imparts valuable information and lays the groundwork for a long-term relationship centered on anticipatory guidance. You will also find that if you do your job well, you will have fewer calls about normal newborns and will seldom see one of them coming into your office for a non-problematic "problem" outside of scheduled checkups.

If you see HMO patients, you may not be compensated for the prenatal visit. But a prenatal visit will help establish your relationship with the parents as well as give you a chance to encourage breastfeeding and other important points. Nothing helps more with learning than repeated messages!

Always warn parents that many substances the mother takes in, including herbs and drugs, may find their way into the breast milk. Emphasize the need to check with a pediatrician before they take any prescription medications, to avoid transmitting potentially harmful substances to the baby.1,2