Care of the Normal Newborn
James W. Kendig MD1
1 Associate Professor of Pediatrics, University of Rochester School of Medicine and Dentistry, and Rochester General Hospital. Address reprint requests to the author: Department of Pediatrics, Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621; 716-338-4191
A variety of changes have occurred recently in perinatal care that influence the role of the pediatrician. These include new prenatal assessment techniques (ultrasonography and fetal electronic monitoring), an increased attention to the ambiance of delivery with family participation, and more rapid hospital discharge. This review will focus on the role of the general pediatrician in the care of the normal newborn in this new setting.
Prenatal Pediatric Visit
The pediatrician's role in the care of the normal newborn should begin with the prenatal pediatric visit during the third trimester of the pregnancy. This visit usually occurs in the pediatric office; some practitioners can schedule time for a home visit. This first meeting between parents and pediatrician frequently serves as the foundation for two decades of mutual trust, confidence, and communication. The topics that should be discussed and recorded at this visit are listed in Table 1. Serious potential problems identified during this visit may require discussion with obstetrical and neonatal colleagues.
The prenatal visit should include discussions about maternal nutrition; the hazards of alcohol, cigarette smoking, and other drugs to the unborn baby; and the dangers of passive smoking once the infant is home. The pediatrician should inquire about maternal illnesses and medications.
