From the Guidelines
Yes, doctors should perform home visits for neonates within the first two weeks of life, as it allows for early detection and management of potential complications, such as hyperbilirubinemia.
Key Considerations
- The American Academy of Pediatrics recommends follow-up visits for newborns, with the first visit occurring between 24 and 72 hours after discharge, depending on the age at discharge 1.
- Clinical judgment should be used to determine the frequency of follow-up visits, with earlier or more frequent visits for newborns with risk factors for hyperbilirubinemia 1.
- A physician-directed source of continuing health care, or medical home, should be identified for the mother and infant, and instructions should be provided for emergency situations 1.
- Home visits can provide an opportunity for healthcare providers to assess the newborn's condition, provide guidance to the mother, and address any concerns or questions she may have.
Follow-up Schedule
- Newborns discharged before 24 hours should be seen by 72 hours, those discharged between 24 and 47.9 hours should be seen by 96 hours, and those discharged between 48 and 72 hours should be seen by 120 hours 1.
- For some newborns, two follow-up visits may be required, with the first visit between 24 and 72 hours and the second between 72 and 120 hours 1.
From the Research
Benefits of Home Visits for Neonates
- Home visits by physicians or neonatal nurses can enhance the physician-family relationship and improve mothers' perceptions of well-being 2, 3
- Home visits can provide an opportunity for healthcare professionals to assess the home environment and family interactions, which can inform care and support for the family 2
- Mothers who receive home visits may be more likely to initiate breastfeeding and have a lower rate of acute care service usage in the first 6 months of life 3
Ideal Time for Home Visits
- The ideal time for the first home visit to a newborn is within the first week of life, especially within the second day after birth 4
- Home visits within the first two weeks of life can be beneficial for families with newborns, in terms of minimizing acute care service usage and promoting breastfeeding 2, 3
Challenges and Alternative Approaches
- Geographical barriers, poor quality of care, and low numbers of notifications of mother-baby binomial hospital discharge can impede the realization of home visits 4
- Telemedicine can be a useful alternative approach to support neonatal home care, particularly for hospitals covering large regions 5
- Parents may prefer telemedicine devices that provide 24-hour access to nurses, video-conferencing, and timely written email communication with the neonatal unit 5
Parental Needs and Preferences
- Parents of premature infants value home visits as a support to the family and appreciate individualized home care and feeling cared for and supported in performing their baby's care 6
- Parents may prefer home visits that provide guidance and communication, rather than hands-on support for infant care 5