The First Month of Life: A Precious Time
With the grand opening celebration of the Salmonberry Community Birth Center in a few days, families in Kitsap County will have more birthing options than ever before.
They can deliver infants at a hospital, birth center, or at home. While not endorsing one specific method, I will say choice is a wonderful thing and should be embraced by our entire health care community.
What about care provided after birth? The World Health Organization recommends postnatal care from a provider within 72 hours of birth, between days 7-14, and then 6 weeks after birth. Nursing difficulties peak around 3-7 days after birth and women are often discharged home by this time. The postnatal time period can be dangerous because infants face difficulties such as inadequate feeding, rapid breathing, lethargy, fever, or jaundice.
When available, home visits have been shown around the world to decrease infant mortality, a number the United States is working hard to decrease. A home-visit nurse, lactation consultant, or midwife skilled in navigating breastfeeding challenges can make strides toward helping mothers nurse successfully. In our community, mothers followed by midwives receive outstanding post-natal care already. Those who deliver in hospitals do not necessarily have access to these same services.
In the US, about 76% of women initiate breastfeeding after birth while in the hospital, but the nursing rate drops to 38% by 6 months of age. An evidence-based nurse home visitation program was recently evaluated in Florida and found women had a breastfeeding rate of 80% initially, and 56% at six months! All participants reported the program helped them continue to breastfeed and felt satisfied with additional hands-on support.
There is no doubt physicians with personal breastfeeding experience benefit their communities by increasing this number even more. The last 6 months in my clinic we have breastfeeding rates at or above 85% initially and more than 65% at 6 months. Dozens of mothers in my practice are nursing infants well into their second years of life. I was one of them less than a year ago still nursing my son into his second year.
We have always seen new infants in our practice within 3 days because it is critical to establish adequate milk supply early and ensure infants have a proper latch to nurse successfully. Home visitation is an integral part of a pro-breastfeeding healthcare model and I have long hoped to see these services delivered locally.
With that goal in mind, I am halfway toward making this a reality for patients of Silverdale Pediatrics. Starting January 1st, EVERY newborn infant on state Medicaid insurance will be provided one home nurse visit post-partum and if necessary, a visit from a lactation consultant. I am looking to hire additional support so that I can provide EVERY newborn infant in my practice a home nurse visit if they would like one.
This is going to be such an exciting year as we continue to try new things that provide children in Kitsap County better care. Thank you for your continued support and referrals. I am so excited to make home-visitation a reality for our patients!