Anticipatory Guidance

Prenatal Pediatric Visit

Pregnant woman.jpg
https://en.wikipedia.org/wiki/Pregnancy

The AAP's Policy Statement on The Prenatal Visit - Click here

Introduction

The prenatal visit is an excellent opportunity for pediatricians to meet prospective families and pediatricians should emphasize this concept to their obstetrician colleagues. By meeting with a pediatrician, parents have the opportunity to meet the individual who will be caring for their family for the next 20 years. During the interview they may get to know and understand your philosophy of caring for children and young adults and how much you value the relationship. A good impression during this interview could lead to the parents selecting you as their pediatrician and recommending you to other parents. This is an excellent way to build a practice and maintain a good flow of newborns into your office. Encourage both parents to attend the meeting.

In addition to meeting perspective parents individually, the pediatrician should make themselves available to talk to groups like Lamaze and other prenatal classes. Contacting hospitals is an excellent way to let these groups know that you are available to talk to parents about newborn care, parenting skills, and medical issues. 

Topics to discuss at the prenatal visit

  1. Feeding plans of the mother: Breast vs. formula. Advantages and disadvantages of each method of infant feeding are discussed. 
  2. Schedule of visits during the first year
  3. Newborn screening tests done at the hospital
  4. Immunizations and their importance
  5. Getting family and prenatal history
  6. Circumcision options
  7. Safety and anticipatory guidance including carseats, smoking, suggesting supine sleeping position to prevent SIDS, and appropriate crib accessories 
  8. How the parents can get in touch with you during the day, is there a special time to call? How do the parents reach the doctor after hours and how does coverage work when you are off or on vacation
  9. When should the parents call? Usually the parent should be instructed that when they feel there is a problem that they can't answer, they should call. Try to encourage them to work out some things by themselves but always make them feel that it is okay to call.
  10. Fee schedule and types of insurance and managed care accepted
  11. Establish parent-physician relationship
  12. Parenting skills
  13. Mother's prenatal care history, GBS, hepatitis, GC, Chlamydia, ultrasound and prenatal testing results, pregnancy complications.
  14. Mother's obstetrical history

 The importance of prenatal visit with a pediatrician cannot be overemphasized. A randomized control trial among low-income, urban mothers showed that pediatric prenatal visits have a beneficial effect on breastfeeding decisions, decrease the number of emergency department visits, and positively impact the doctor-patient relationship.

The visit represents an opportunity to make the parents feel comfortable with the physician that will be seeing their children on a regular basis for many years.

It must be emphasized that the prenatal visit is very important to the pediatrician trying to build a practice. The impression you make during these visits may lead to many other new patients. Make the parents feel comfortable and have a good feeling about the physician that will be seeing their children on a very regular basis for many years.

I recommend not charging the families for this visit.

Reference

  1. Committee on Psychosocial Aspects of Child and Family Health Pediatrics Vol.97 No.1 January 1996 141-142
  2. American Academy of Pediatrics The Prenatal Visit.  Pediatrics Vol 107 No. 6 June 2001
  3. Serwint Janet The Prenatal Pediatric Visit. Pediatrics inReview Janualry 2003
  4. American Academy of Pediatrics. Hospital Stay for Healthy Term Infants. Pediatrics May 2004
  5. American Academy of Pediatrics.  Clinical Report-The Prenatal Visit.  Pediatrics. October 2009
  6. Serwint J. A Randomized Controlled Trial of Prenatal Pediatric Visits for Urban, Low-income Families.  Pediatrics December 1996
  7. American Academy of Family Physician.  General Prenatala CAre and Counseling Issues.  AMerican Family Physician.  2005