Care Transition for Newborns: Home Visitation for Newborn Health

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Primary Author:</td>
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Carlo G. Parker, PhD</td>
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Co-Principal Investigators/Collaborators:</td>
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<p>Genee Warmuskerken, RN, Lorna Sinclair, RN-OB, BA</p>
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Organization:</td>
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University of Northern Colorado School of Nursing</td>
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Abstract</h2>
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Purpose</h3>
<p>To increase the rate of breastfeeding at six months, increase the proportion of new mothers seeing a healthcare worker, and identify any health issues promptly. </p>
<h3>
Background</h3>
<p align="left">Breastfeeding offers the best source of nutrition for newborns and has numerous health benefits. The American Academy of Pediatrics recommends breastfeeding for the first six months of life. Once the new mother and baby are discharged home the rate of breastfeeding in the U.S. drops from 76.5% to 37.7% at six months post-discharge. Adequate nutritional intake, preferable with breast milk, is required to prevent the most common threats to newborn health in the first weeks and months of life; newborn jaundice and newborn weight loss/dehydration. Healthy People 2020 contains goals related to newborn and maternal health that include; 70 % of new mothers will initiate breastfeeding, 60.6% of new mothers will still be breastfeeding at six months and all new mothers will have a postpartum visit with a healthcare worker. To address these HealthyPeople 2020 goals and evidence-based project was developed and implemented.</p>
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Materials & Methods</h3>
<p>The home visit is set up prior to hospital discharge and takes place between 1-4 days after discharge. Visits lasted 1 hour and included physical assessment of mother and baby, assistance and education with breastfeeding, and infant care. At the conclusion of the first visit a second visit can be set up if needed. </p>
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Results</h3>
<p>The regional average rate for breastfeeding at 6 months is 40.9%. Participants in the home visitation program had a 6 month rate of breastfeeding of 55.5%. Newborns identified with jaundice that were readmitted had a shorter length of stay compared to a regional benchmark (1.36 vs. 1.56 days). Any additional maternal-child health issues were addressed or referred to the appropriate healthcare provider promptly.</p>
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Conclusion</h3>
<p>Organizations should consider developing home visitation programs to increase breastfeeding rates and promote maternal-newborn well-being. </p>
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Bibliography</h3>
<ul>
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American Academy of Pediatrics. (2012). American Academy of Pediatrics policy statement: Breastfeeding and the use of human milk. Pediatrics, 129, e827. DOI: 10.1542/peds.2011-3552.</li>
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Brand, E., Kothari, C., & Stark, M. A. (2011). Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum. The Journal of Perinatal Education, 20(1), 36-44, doi: 10,1891/1058-1243,20,1,36.</li>
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Center for Disease Control and Prevention. (2013). Breastfeeding report card United States 2013. Retrieved from http://www.cdc.gov/breastfeeding /pdf/2013Breastfeeding ReportCard.pdf.</li>
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U.S. Preventive Services Task Force (2008). Guidelines for Breastfeeding. Retrieved from</li>
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http://www.uspreventiveservicestaskforce.org/uspstf08/breastfeeding/brfe...
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U.S. Department of Health and Human Services. Healthy People 2020: Conference Edition—Volumes I and II. Washington DC: US Department of Health and Human Services. Office of the Assistant Secretary for Health: 2010. 47-48. http://healthy people.gov/data/midcourse/html/foreword.htm.</li>
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VHA (2013). Regional Breastfeeding Database. Retrieved from https://www.vha.com/Pages/default.aspx</li>
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Wagner, E. A., Chantry, C. J., Dewey, K. G. & Nommsen-Rivers, L. A. (2013). Breastfeeding concerns at 3 and 7 days postpartum and feeding status at 2 months. Pediatrics, 132(4), p. e865 -e875 (doi: 10.1542/peds.2013-0724).</li>
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<p>© Improvement Science Research Network, 2012</p>
<p>The ISRN published this as received and with permission from the author(s).</p>