About 4 million babies are born each year in the United States, and those first fragile days after birth are important for both the mother and the baby's health. At the same time, expensive care and limited beds have pushed hospitals to reduce the time new mothers and their babies spend at the hospital. One potential solution is to send nurses to the new babies' homes a couple of days after they are discharged. Researchers from Pennsylvania State University looked into whether nurse home visits made for healthier newborns.
What the researchers wanted to know: Do babies return to the hospital less often for jaundice or dehydration if a nurse visits the family at home shortly after birth?
What they did: The researchers looked at records from all births at the Hershey Medical Center in Hershey, Pa., from 2000 to 2002. They compared the number of hospital readmissions and emergency department visits 10 days after birth for 2,600 babies who did not have a nurse visit their new home and 330 babies who did have a nurse visit. They simplified their research by looking only at care for jaundice and dehydration, two common problems for newborns. In addition, they analyzed the cost of nurses' home visits compared with the cost of care for infants who did not receive a visit.
What they found: None of the newborns who were visited by a nurse at home went to the emergency room within 10 days of birth, while 92 (3.5 percent) of the babies not visited by a nurse did go. In addition, only two babies visited by a nurse were readmitted into the hospital, while 72 babies not visited went back in. Because far fewer infants who were visited at home needed more care, it costs less, the authors concluded, to send nurses to every baby's new home than to pay for the additional time in the hospital.
What it means to you: Some hospitals have programs in which mothers can choose to have a nurse visit, and some insurance programs will cover the visit. When nurses come to your home, they weigh the infant, look for signs of jaundice, and make sure the baby is feeding. They also ask the mother about her health and check out the home to make sure it is safe for the baby. These visits can greatly help new parents and avoid further hospital visits with their tiny new family member.
Caveats: This study only examined the effect on a baby's first 10 days of life and only on two conditions: jaundice and dehydration. But, other more serious conditions are likely to increase hospital costs and tip the balance even further in favor of nurse home visits. In addition, the researchers did not assign the babies randomly to each groupthey looked back at visits that had already happened. So, the babies that had nurse home visits could have been a healthier group overall than the others.
Find out more: The University of Michigan has a good guide for caring for babies during their first days home from the hospital.
In addition, check with the hospital where your baby will be or was born and ask about their newborn home-visit programs. Many states and local hospitals have programs for new mothers.
Read the article: Paul, I.M. et al. "Cost-Effectiveness of Postnatal Home Nursing Visits for Prevention of Hospital Care for Jaundice and Dehydration." Pediatrics. October 2004, Vol. 114, No. 4, pp.10151022.
Abstract online: pediatrics.aappublications.org