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Prenatal Pediatric Visit
The prenatal pediatric visit usually takes place during the third trimester of the pregnancy. 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 should be discussed. Maternal illnesses and medications should be reviewed.
Information about the benefits of breast feeding or information about infant formula is provided. The use of car seats, safety of cribs, and issues regarding circumcision of boys should be discussed.
| Prenatal Pediatric Visit Discussion Issues |
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Maternal History
General health and nutrition Past and present obstetric history Maternal smoking, alcohol, or drug use Maternal medications Infectious diseases: Hepatitis, herpes, syphilis, Chlamydia rubella Maternal blood type and Rh blood groups Family History Newborn Issues Assessment of basic parenting skills Feeding plan: Breast feeding vs formula Car seats Circumcision of male infant |
Delivery
Neonatal Resuscitation
A pediatrician should be present for high-risk deliveries, and all equipment must be set up and checked before delivery. The infant who fails to breath spontaneously at birth should be placed under a radiant warmer, dried, positioned to open the airway, mouth and nares suctioned.
The mouth should be suctioned first to prevent aspiration in case the infant takes a deep gasp when the nose is suctioned. Prolonged or overly vigorous suctioning may lead to bradycardia and should be avoided unless moderate-to-thick meconium is present.
The infant born with primary apnea is most likely to respond to the gentle stimulation of drying, rubbing of the back, and gentle tapping of the soles of the feet. The infant who fails to respond rapidly to these measures is experiencing secondary apnea and requires positive pressure bag ventilation.