Newborn wellness check

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Joined: 12/01/10
Posts: 997
Newborn wellness check

I'm planning on giving birth at a free-standing birth center. One of my midwives told me at my appointment today that she doesn't think I should have to bring my newborn in for a pediatrician wellness check until after two weeks because the midwives will be doing baby/mother wellness checks at our home before then including jaundice and PKU screening. One point she really stressed is that she felt baby and I should stay in the comforts of our own home and not go into a clinic where he could be exposed to viruses and such. When I had my prenatal consult with our planned pediatrician a couple of weeks ago, the pediatrician made it very clear that she wanted me to bring the baby in on day 3 so that she could do her own wellness check and give him a Hep B vaccine (our midwife had stated that it would be fine to push the Hep B vaccine back to the 2 month mark especially if we were not going out much). So I'm confused because I feel like I'm getting conflicting info but can see reasons for both sides. If the midwives are doing the early wellness checks the only reason I can see for bringing the baby in to the pediatrician around that time is to start the Hep B vaccine series as per their suggested schedule. Any suggestions?

Marite13's picture
Joined: 08/07/09
Posts: 3368

We delayed the Hep B until the 2 mos check up. Really no reason not to.

I think a lot of pedis have this policy about wanting to see the baby early on, because they want to do their own evaluation. I was really unprepared in this dept when my DD was born, and we ended up taking her in on day 3. I plan on delivering with a midwife this time, and like you, will be looking for a pedi who will accept that I will have midwife care post-natally, as will my baby. I know my best friend ran into this, that her pedi wanted to see her second early on too, but she was just really firm that her midwife would be making a house call to do it, and unless he was prepared to do the same, he wouldn't see them until 2 weeks. He accepted that. I guess it's a risk maybe that a pedi might decline to take you on unless you follow their rules (I suppose they have that right).

Spacers's picture
Joined: 12/29/03
Posts: 4100

"Marite13" wrote:

...she was just really firm that her midwife would be making a house call to do it, and unless he was prepared to do the same, he wouldn't see them until 2 weeks.

I actually never discussed this issue with my chosen pediatrician either time, but the above is pretty much what I'd have said if I had. We didn't do the HepB vaccine for either baby, I don't think, because they weren't in daycare and there were no other risk factors for them. How is the ped going to know you had the baby if you just don't call before two weeks for an appointment? "Oh, I'm so sorry I forgot to call. I just had a baby so I've been a bit forgetful & time is just slipping away & suddenly it's been two weeks! Sorry." What can they do at that point? I'm with an HMO so my ped can't refuse me service if I don't follow her instructions, but honestly any ped that wanted to fire me over a parental decision I wouldn't want anyway. If my child needs to see a ped, I'll take him in; otherwise, we'll just hang out in bed away from the sick kids. Blum 3

TyrantOfTheWeek's picture
Joined: 12/26/05
Posts: 1147

I take mine at 48 hours because my midwives don't do the whole PKU thing. My last 2 home births, I took the babies in and the pedi ordered the bloodwork. We then had to take the baby to the hospital lab.

kaype's picture
Joined: 02/08/07
Posts: 219

with our first, our mw did a 2-day visit and a two-week visit. our ped wanted to see DS around 2 days as well, and our mw set us up with that expectation. she was checking on the baby, but really she was checking on me.

with DD, we did the same thing and i'm really glad. because i wasn't a FTM, our mw only did a phone call, not home visit. DD was losing weight because she was tongue-tied and couldn't nurse. we did need to supplement until we figured that out later -- and wouldn't have known she wasn't gaining unless we'd been to the ped.

so, i think it's up to you -- DH took both our kids to the ped at 2 days. and, the ped had well-visit-only hours so i felt a lot more comfortable that they weren't around sick kids. if you're having trouble finding a ped who's okay with you waiting, you might ask your mw for a recommendation.

Spacers's picture
Joined: 12/29/03
Posts: 4100

"kaype" wrote:

with our first, our mw did a 2-day visit and a two-week visit.

Around here, the usual schedule of midwife postpartum home visits is the day after birth, three days, five days, 10 days, and then two weeks. And most also do a six-week checkup for mom, although that might be in their office if they have one, not in your home. If my midwife wasn't checking on both of us that frequently, I'd have probably made a ped appointment for around one week at least for a weight check.

jolly11sd's picture
Joined: 02/02/05
Posts: 3327

We had planned on seeing our ped. during the first week only because our MW wasn't able to do a PKU test. If she had been able to then we would have waited until our LO was older to go in as the MW did checks the day after birth, 3 days out, 2 weeks, and 6 weeks.

Lots-o-Tots's picture
Joined: 01/29/06
Posts: 574

Yeah, I don't see any reason to rush to the ped's if your mw is doing home visits, except to adhere to a vax schedule. Vax schedules can be modified, though.

mommys's picture
Joined: 05/08/06
Posts: 6264

I had a choice either way. We ended up going to ped because of some spitup concerns, but they didn't even mention Hep B at that first appt (other than to verify if we got it at birth or not) and I would have declined it anyway.

kaype's picture
Joined: 02/08/07
Posts: 219

"Spacers" wrote:

Around here, the usual schedule of midwife postpartum home visits is the day after birth, three days, five days, 10 days, and then two weeks. And most also do a six-week checkup for mom, although that might be in their office if they have one, not in your home. If my midwife wasn't checking on both of us that frequently, I'd have probably made a ped appointment for around one week at least for a weight check.

wow! that's awesome Smile as a FTM, i think i would have LOVED being checked on that much...and again, when sophie wasn't gaining weight. maybe we would have caught her tongue-tie sooner than five weeks!

emansmom's picture
Joined: 03/24/09
Posts: 752

My midwives (also at free standing birth center) suggest the same thing. To not worry about taking them to the ped untik AT LEAST 2 weeks. My midwives come to the house for the pku and do many newborn assesments between birth and day 3. they also do a 2 week check as well. I didn't take my DD to the doc until she was 1 month. Even then it was pointless and I could have waited even longer. We don't vax (right now) so that was never a concern of mine. My docs happen to be the husband and daughter of one of midwives so they were very much on board with my plan Smile Midwives are more than well trained in newborn/infant assesments so honeslty if I were you I would take their advice and wait till at least 2 weeks.

boilermaker's picture
Joined: 08/21/02
Posts: 1984

My MW does the newborn screens-- she comes to the house at 1 day, 3 days, 1 week and 2 weeks to check on mom and baby. Honestly, she did a much better check-up up my LO's than our previous pediatricians.

With our last baby, we skipped the ped and went with a family doctor. I much prefer the care I receive from our family physician.

Oh-- and we delay Hep B until our kids are going to kindy. I don't expect them to be sexually active or using intravenous drugs before that time. Wink

Stay home. Let the MW's do their assessment. They are trained in newborn assessments, draw the same labs at your ped, and probably send the labs to the same place (at least mine do!) Enjoy your babymoon-- and don't let your ped pressure you.

Joined: 12/01/10
Posts: 997

Thank you for everyone's feedback. I did end up calling the ped clinic this morning to discuss the newborn checkup schedule and they seemed fine with me pushing back our first visit and the Hep B vaccine since my midwives were doing the same assessments/testing those first couple weeks. I don't know why I was worried that they would try to bully me into coming in earlier but like some of you said the worse that could happen is I would have to find a more supportive provider if that were the case. Whew...I think I was making a mountain out of a mole hill in my mind Blum 3

kridda_88's picture
Joined: 01/28/08
Posts: 1798

I will probably go in when this little boy is a few days old to get the circumcision done and I love my dr's PA-C, which is who i'm going to. She loves the whole natural thing i'm doing and fully supports everything I do. My actual Ped on the other hand hates basically everything i'm doing. But she is a great dr just not supportive of midwives. I vaccinate my kids though and keep them on schedule, so unless they have a reaction and I have a reason to do the delayed I follow the dr's vaccine schedule.

I think it mainly just depends on those two factors. Vaccinations and if you will be having your boy circumcised. Glad you didn't have to fight with them and they were cool with your decisions. Smile

Joined: 12/01/10
Posts: 997

We aren't planning to circumcise so we will probably take the little guy in for his first peds visit around 2 weeks and possibly get the first Hep B vac then. I really clicked with my pediatrician during our prenatal consult, she is around my age and has 2 young daughters, very pro breastfeeding and has a let's work together vibe without being paternalistic. However, I don't think she is very familiar with the free-standing birth center and midwifery system (even though we are one of the more progressive parts of the US for this type of care) so I hope she is willing to learn through working with me and maybe it will help when she has future patients from a similar setting.