Bright Future – Prenatal Visit

Dec 6, 2019 admin NHI KHOA 0

Bright Future – Prenatal Visit

Health Supervision

Observation of Family dynamic

Do verbal and nonverbal behaviors and communication among family members indicate support and understanding, or differences and conflicts?

Screening

Discuss purpose and importance of routine newborn screening tests performed before the baby is discharged. Inquire about any maternal prenatal testing, any abnormal findings seen on ultrasound, and/or any maternal conditions that may affect the developing fetus or newborn.

Immunizations

Discuss importance of initiating routine immunizations.

Anticipatory Guidance

The first priority is to attend to the concerns of the parents. In addition, the Bright Futures Infancy Expert Panel has given priority to the following topics for discussion in this visit:

Social determinants of health: Risks (living situation and food security, environmental risks, pregnancy adjustment, intimate partner violence, maternal drug and alcohol use, maternal tobacco use), strengths and protective factors (becoming well informed, family constellation and cultural traditions)

  • Community agencies can help you with concerns about your living situation.
    Tell me about your living situation. What are your resources for caring for the baby?
  • Check home for mold, lead.
  • Programs like WIC and SNAP are available to help you if you have concerns about your food situation.
    Within the past 12 months, were you ever worried whether your food would run out before you got money to buy more? Within the past 12 months, did the food you bought not last and you did not have money to get more?
  • Eating nonfood substances can harm you and your baby.
  • Take advantage of support from family and friends and community groups.
    How have you been feeling physically and emotionally? How does your partner feel about your pregnancy?
  • Ask for help if you are concerned about or have experienced violence from your partner or another significant person in your life
    Do you always feel safe in your home? Has your partner ever hit, kicked, shoved, or physically hurt you? Would you like information on where to go or who to contact if you ever need help?
  • You can also call the National Domestic Violence Hotline toll-free at 800-799-SAFE (7233).
  • Don’t use alcohol/drugs/tobacco/e-cigarettes. Call 800-Quit-NoW (800-784-8669) for help to quit smoking

Parent and family health and well-being: Mental health (perinatal or chronic depression), diet and physical activity, prenatal care, complementary and alternative medicine

  • Become well-informed, using trusted sources.
  • Support your other children to help them get used to baby.
  • Maintain your health (medical appointments, sleep, physical activity, healthy diet with appropriate weight gain).
  • It is common for women during and after pregnancy to feel down, It is important to address these feelings to ensure your health and your baby’s. I can help with treatment options.
    Over the past 2 weeks, have you ever felt down, depressed, or hopeless? Over the past 2 weeks, have you felt little interest or pleasure in doing things?

Newborn care: Introduction to the practice as a medical home, circumcision, newborn health risks (handwashing, outings)

  • Let me tell you about our practice.
  • Circumcision has potential benefits and Let’s discuss what’s best for baby.
  • Wash hands frequently (diaper changes, feeding).
  • Limit baby’s exposure to others

Nutrition and feeding: Breastfeeding guidance, prescription or nonprescription medications or drugs, family support of breastfeeding, formula-feeding guidance, financial resources for infant feeding

  • Choose breastfeeding if possible; use iron-fortified formula if formula feeding.
    What are your plans for feeding your baby?
  • Contact WIC/community resources if needed. Are you concerned about having enough money to buy food or infant formula? Would you be interested in resources that can help you care for you and your baby?
  • Tell me about supplement/over-the-counter medication use.

Safety: Car safety seats, heatstroke prevention, safe sleep, pets, firearm safety, safe home environment

  • Use seat belt.
  • Correctly install rear-facing car safety seat in backseat.
  • Prevent heatstroke; never leave your baby alone in a car.
  • Put baby to sleep on back; choose crib with slats less than 2⅜” apart; have baby sleep in your room in own crib.
  • Learn about pet risks.
    Do you have pets at home? If you have cats, have you been tested for toxoplasmosis antibodies?
  • Remove firearms from home; if firearm necessary, store unloaded and locked, with ammunition separate; if firearms in other homes where child plays, ensure same safety precautions are used before letting child play there.
    Do you keep firearms at home? Are there firearms in homes you visit (grandparents, relatives, friends)?
  • Set home water temperature less than 120°F; install smoke detectors, carbon monoxide detector/alarm.

 

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