reply to this discussion
I have seen several babies for well child visits and/or weight checks this rotation. Most of them just are not putting on weight as they should, primarily between ages 1 week to 4 months, falling slightly below in their curves. Most of these visits consisted of education on the importance of weight gain, how mothers can maximize their baby’s feeding schedule, diet improvements to help with breastmilk production, etc… (Maaks et al, 2020). Most mothers are very receptive and ready to take into action the offered advice. Some, we referred to a lactation consultant to help with breastfeeding. Some required formula supplementations. One had had a tongue tie repair weeks prior, but was still struggling to nurse, so an occupational therapy referral was utilized at that time (Motil & Duryea, 2022). Careful follow up is established at each visit, along with anticipatory guidance for the next stage in the baby’s life (Hagan et al, 2017). In addition, we make sure that these babies are getting their vaccines, should parents accept, and emphasize the importance of continuing to attend scheduled well-visits. Most of these babies have been a “watch closely” kind of situation, and hopefully as interventions are made early on, we will see great improvement and a catch-up in weight (Motil & Duryea, 2022). Most weight checks follow ups are between 2 weeks and 1 month, depending on the baby’s age.
I enjoy these visits because it is nice to go through with these parents and talk and interview and find out what parts of their routine at home could be improved or addressed to make a difference in their baby’s weight. I am noticing that these types of visits take time to get the information and offer the education needed to make the most difference. Many of these visits with my preceptor are only scheduled for 15 minutes, and I find myself really struggling to manage time and making sure the patient and family get what they need. Learning ways to maximize time in office visits will come with time and education for families and identification of “problems” will come more efficient as we gain more experience with our patients.
Hagan, J. F., Shaw, J. S. & Duncan, P. M. (2017). Bright Futures: Guidelines pocket guide (4th ed.). American Academy of Pediatrics.
Maaks, D. L. G., Starr, N.B., Brady, M. A., Gaylord, N. M., Driessnack, M., Duderstadt, K. G. (2020). Burn’s Pediatric Primary Care (7th ed.). Elsevier.
Motil, K. J. & Duryea, T. K. (2022). Patient education: Poor weight gain in infants and children. UpToDate. https://www.uptodate.com/contents/poor-weight-gain…
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