Philadelphia Medicine Summer 2021 - 22

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NEWBORN CARES
IN A POST-PANDEMIC WORLD
By Dr. Joanna J. Parga-Belinkie
T
he COVID-19 pandemic has restructured childbirth and newborn care
in the United States in interesting and unexpected ways.
While the pandemic is seemingly going to simmer and burn out by summer,
endemic changes in infant care are here to stay. What do pediatricians need to
think about when counseling parents about family planning and delivery in the
immediate post-pandemic age?
Here is a rundown of a few changes, along with some evidence-based sources
for families to reference as the world reopens.
Early hospital discharges
The postpartum floors pre-COVID-19 were filled with newborn babies, doting
grandparents, and sibling meet ups. Once restrictions on visitation hit, parents found
themselves and one support person managing the 24/7 aspects of newborn care.
Masked and confined to a hospital room, many families opted for early hospital
discharges: 24 hours after a vaginal delivery or 48 hours after a C-section. For
pediatricians, this means following up on newborn issues that might have resolved
for infants prior to hospital discharge.
Outpatient offices have to be more facile in planning for hyperbilirubinemia,
weight loss and lactation support in the first week of life.
Virtual and drive-through visits
While in-person visits for newborns are preferred, virtual visits skyrocketed during
the pandemic and will remain a staple of care. Counseling on newborn care over
Face Time presents pediatricians with some advantages, and evolving challenges.
At an event coordinated by Dr. Parga-Belinkie,
two nurses at the hospital of the University of
Pennsylvania orchestrate outdoor blood draws
for infants during the pandemic. Patients were
discharged earlier from the hospital necessitating
closer follow up outpatient. The postpartum
team adapted to the changing needs of their
patient population in style.
22 Philadelphia Medicine : Summer 2021
The stress of packing up a baby to get to the doctor and being concerned about
exposing them to viruses (more than just COVID-19!) is lessened. However, monitoring
weight loss, measuring bilirubin levels and watching feedings can be trickier.
Offices might think about scales that can be rented and used in the home.
Utilizing home visits with certified nurses or lactation consults can be a key service
to help support families in a time of need. Additionally, helping to coordinate
outpatient drive up visits is now a must. That way an infant can be confined to
the car seat and parents can both decrease exposures to their infants, and make
efficient use of their time.
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