HOME VISITS HELP NEW MOTHERS LEARN INS, OUTS OF PARENTING

There was a time when new mothers got a luxurious weeklong stay in the hospital after giving birth.

Those days are long gone; most insurance companies now require women to be discharged 24 hours after the baby is born. So health-care workers are heading into the home to make sure mother and baby are fine after delivery.

"With those shortened stays, education is difficult," said LaDonna Wills, a registered nurse and Southeast Missouri Hospital's nursery manager. "It's hard to teach them everything about baby care and how to take care of themselves within 24 hours. Often, after they've been home for a few days, there are questions that they may not have had a chance to think about before."

Through Southeast's mother-baby home visit program, nurses make a one-time visit to families in their homes, usually two to three days after mom and baby are discharged from the hospital. Nurses check both the mother and baby for any health problems that may not have been apparent at the hospital and answer questions about infant care, safety, breast feeding and other issues.

"There's such a euphoria after delivery it's hard to think beyond, I've got this beautiful little baby," Wills said. "Then you get home and it's like, now what?"

"The biggest event of all is when we weigh the baby," said nurse Barb Dirnberger. "We always warn them ahead of time that the baby may not have gained weight since they left the hospital. Oftentimes they don't."

When Kevin and Jean Sutton's youngest son Aaron was born in March, they got a visit.

"He was our third, so we really didn't have many questions," Jean Sutton said. "But I can see where it would be good for a first-time mother."

The Suttons live near Fruitland, and their oldest son, Jeff, is now 19.

"I know I spent a lot more time in the hospital with Jeff than I did with the other two," Sutton said.

The nurses have seldom spotted any serious problems during their visits.

"There are feeding problems or maybe a cord needs some special attention," Dirnberger said. "Maybe the baby's a little bit jaundiced and that needs to be attended to. Those are the big things with babies."

In some cases, though, nurses may spot heart problems or other potential health threats that aren't apparent in newborns. And the visits are a good chance to check mothers' blood pressure and health signs to make sure they are recovering from childbirth.

Nurse Jeanne Wooldridge said visiting families at home makes for a more relaxed atmosphere.

"I like to actually sit down with mom and talk to her about how things are going," Wooldridge said. "I've always loved babies, so getting to go out and see these babies in their homes where they have their families around them is very enjoyable."

After leaving the hospital most babies won't see a doctor again until they're 2 weeks old, she said. That can be a long time if there's a problem.

"We feel like we're meeting a big need where the babies get assessed somewhere between two and four days after they leave the hospital," she said.

If Southeast's nurses spot problems that might require follow-up care, they refer families to the Cape Girardeau County Public Health Center. Nurses there make home visits for screenings, well-baby checks, monitoring and some tests and immunizations, as well as nutrition and diet education, said Jane Wernsman, nursing supervisor.

"We do a lot of education on infant care, feeding, formula preparation and advice and support if mom is breast feeding," Wernsman said. "Probably one of the biggest things we try to emphasize with the infants is to start planning for that first set of immunizations at two months. We also assess for bonding, to see if the mother and infant are bonding properly, and we see how the mother is doing. Does she have stress or any depression?"

If regular specimens are needed for follow-up testing, health department nurses can collect those, and they also provide monitoring services for sleep apnea or other problems, she said.

The home visits are also a good time to educate parents about WIC, a federally-funded nutrition program for pregnant women and young children.

The health department also provides for blood lead screening and works with the Educare program in helping get youngsters ready for school, Wernsman said.