The American Academy of Pediatrics recommends a pediatric prenatal visit before delivery to help children reach their healthiest potential, starting from Day 1
The American Academy of Pediatrics (AAP) recommends all parents-to-be visit a pediatrician during the third trimester of pregnancy as an important first step in establishing a trusted relationship and supportive medical home for their child. The recommendation comes in an updated clinical report, "The Prenatal Visit," published in the July 2018 Pediatrics.
Besides answering any urgent questions parents have about bringing home a new baby, a prenatal visit can help anticipate under-recognized challenges such as postpartum depression. At the same time, it can introduce positive parenting strategies to help buffer the health effects of stress in a child's life and the supportive role pediatricians can play.
"It's a chance to talk about how to keep a baby safe and thriving physically, but also ways build strong parent-child bonds that promote resilience and help a child stay emotionally healthy," said Michael Yogman, MD, FAAP, lead author of the report and chair of the AAP Committee on Psychosocial Aspects of Child and Family Health.
While more than three-quarters of pediatricians offer a prenatal visit, surveys show only 5 percent to 39 percent of first-time parents attend one. Dr. Yogman said it's concerning that less than 5 percent of urban poor pregnant women see a pediatrician during the prenatal period, even though they are at higher risk of problems during pregnancy that can affect the health of their child. Data suggests pregnant women in rural areas may have even more difficulty accessing a prenatal visit.
According to the AAP, a prenatal visit with the pediatrician is especially helpful for first-time parents and those who are facing a high high-risk pregnancy, experiencing complications, expecting more than one child, or in the process of adopting a child.
At a prenatal visit, a pediatrician can cover safety topics like car seats, what kind of bedding parents need for a crib or bassinet, and what immunizations family members need to protect the newborn. It's an opportunity to talk about breastfeeding and donating cord blood. The clinical report – which updates a previous version published in 2009 – also includes recommendations on recognizing depression and other challenges that can harm child health.
The pediatric prenatal visit is a good time to talk about normal feelings of stress from a baby crying or other demands of caring for an infant, as well as setting clear plans to help cope with the stress before feeling overwhelmed, said Arthur Lavin, MD, FAAP, co-author of the report, and incoming chair of the AAP Committee on Psychosocial Aspects of Child and Family Health. Parents are encouraged to bring other family members who are going to play important role in the baby's life to the visit.
"This is the only routine child wellness visit recommended by the American Academy of Pediatrics that doesn't actually require a child in the room," Dr. Lavin said. "It gives parents an opportunity to really focus on any questions and concerns they may have. They can talk with a pediatrician before the fatigue of new parenthood sets in and there's an adorably distracting little human in their arms who may be crying, spitting up, or in immediate need of feeding or a diaper change."
"At its heart and soul," Dr. Lavin said, "this visit is about laying a foundation for a trusting, supportive relationship between the family and their pediatrician, who will work together to keep the child healthy for the next 18 or 20 years."
Additional Information from HealthyChildren.org: