New mothers, newborns happy with home visits

HERSHEY, Pa. -- Home nursing visits are as safe and effective as office-based care for initial post-delivery well-baby check-ups, according to medical researchers.

"Generally, moms and babies are discharged from the hospital less than 48 hours after delivery," said Ian Paul, M.D., professor of pediatrics and public health sciences, Penn State College of Medicine. "A follow-up appointment is scheduled, and they don’t always show up. This is unsettling because it is such an at-risk time of life for both baby and mom."

Home nursing visits solve the problem of whether or not mom and baby show up for the appointment -- and also have other modest benefits. Nurses can make visits any day of the week, while many doctors’ offices are not open or have abbreviated hours on the weekend. Home visits can be more comfortable for the mother. Also, parents do not need to worry about sick children in the waiting room.

In a previous study, Paul and colleagues showed that home nursing visits are cost-effective when compared to office-based care. Now they have shown that home-based visits are just as effective as office visits, and the mothers who received home visits were more likely to continue to breastfeed their babies. Home-visit mothers also had greater confidence in their parenting skills than those who received an office visit.

The current study, Nurses for Infants Through Teaching and Assessment after the NurserY -- NITTANY -- looked at 1,154 mothers and their newborns. Each set was randomly assigned office-based care or home nursing visits for their post-delivery well-baby check-ups.

The researchers conducted surveys by telephone at two weeks, two months and six months after release from the hospital. They report the results of the study in the Archives of Pediatrics and Adolescent Medicine. Home visits were scheduled within two days of discharge from the hospital, while the physician determined the timing of office appointments.

Overall, the researchers found care was equivalent whether carried out in an office or by a home nurse in terms of healthcare use after discharge, and there were similar rates of hospital readmission and emergency department visits among both groups.

"(Particularly) for hospitals and communities where access to timely post-discharge is problematic, home nursing visits should be considered as an option especially given the potential benefits for breastfeeding and parenting sense of competence," said Paul.

Working with Paul were Jessica S. Beiler, research project coordinator; Christopher S. Hollenbeak, associate professor of surgery; Sarah A. Sturgis, former manager of the pediatric clinical research office; Eric W. Schaefer, biostatistician; Fabian T. Camacho, senior instructor of public health; Carol S. Weisman, Distinguished Professor of public health sciences and obstetrics and gynecology; all at Penn State College of Medicine; Nancy Alleman, former director of Maternal-Child Health Services at the Visiting Nurse Association of Central Pennsylvania; and Stella M. Yu, chief, Research and Demonstration Branch, division of Research Training and Education, Maternal and Child Health Bureau, Health Resources and Services Administration.

The Health Resources and Services Administration - Maternal and Child Health Bureau, Department of Health and Human Services, supported this research. Home visits were provided by the Visiting Nurse Association of Central Pennsylvania, Harrisburg, Pa.