SOUTHEAST PROGRAM: HOUSE CALL FOR MOM

Three-day-old Nicholas Patrick Essner's parents traded amazed glances as he slept soundly. The now-peaceful baby had been awake crying most of the night, Doug and Sandi Essner said. Honest.

The first night home from the hospital can be tough, Southeast Missouri Hospital nurse LaDonna Wills told the first-time parents during a 1990s version of a house call Friday.

Changes in insurance coverage over the past several years have shortened hospital stays. For uncomplicated deliveries, the hospital stay for mother and baby can be 24 hours or less. For uncomplicated Caesarean sections, the hospital stay ranges from 48 to 72 hours.

As a result, mothers and babies are going home before some post-delivery problems might develop.

In response, Southeast Missouri Hospital came up with Mother-Baby Home Visits. A registered nurse from the hospitals obstetrics department visits new parents at home a few days after they take their newborn home.

Wills coordinates the program. She also makes some of the visits.

At the Essner's home, she checked Sandi's blood pressure and temperature.

The nurses also check on incisions and other problems a new mother might have.

Wills weighed Nicholas, who had lost some weight from the time he was born. "That's normal," Wills told the parents.

She took blood for the state-required PKU test. In the past, parents have to pack their newborns back to the hospital for that test.

After a brief crying spell when the blood was drawn, Nicholas resumed sleeping. Sandi and Doug speculated that perhaps the house had been too quiet during the night and that the baby likes a little noise.

The Mother-Baby Home Visits began in January. Home visits are offered to new parents in seven Southeast Missouri counties: Cape Girardeau, Scott, Perry, Bollinger, Stoddard, Mississippi and New Madrid. Parents who live outside the area may come back to the hospital for a check-up.

About 1,600 babies are born annually at Southeast. Wills said nurses have made home visits on the majority of babies born since the program started.

The visits work, Wills said.

"We have found some complications," she said. "The most common thing is jaundice. We've seen some infections, and a couple heart murmurs in babies that were not heard at the hospital."

When something serious is noted, the nurses notify physicians.

Although it is important to discover problems early, one of the biggest benefits for parents is the reassurance that everything is going OK, Wills said.

Sandi Essner knew that babies cry, but she didn't know how hard it would be to listen to her son cry. "I bawled too," she said.

Wills told her that it might take a few days for Nicholas to settle in at home. Wills also told her that mild mood swings are common among new mothers.

They talked about breast feeding and how to make it work. "It can be tough in the beginning," Wills said.

Essner wondered what a normal temperature should be for the baby and when she should call the pediatrician. She also asked which pain medications would be OK for her to take while she is nursing.

Wills left a folder of information about child safety and development and emergency telephone numbers.

Nicholas briefly opened his eyes, sneezed, then went back to sleep.