Home Visiting and the Health of Preterm Infants

Abstract

The results of home visiting programs which target medically fragile low-birth-weight preterm infants (LBWPT) have been inconsistent. We provided nurse/social worker home visits to families of LBWPT infants on a regular schedule. Teams were trained in approaches to improve the health and development of the infants. The completion of immunization series was sigmificantly higher and the infant mortality rates of the home visits childen were significanly lower compared to national and state rates. We used state Medicaid data and examined frequency of hospitalization, emergency department visits, routine and nonscheduled visits to primary care physician, and pharmacy use of the home-visited subjects compared with a propensity-matched group. The home-visited group had more routine and nonscheduled visits but no more hospitalizations or E.D. visits. Home visiting teams improved important markers of child health, including completed immunizations and mortality rate, perhaps by the careful monitoring of health status and assuring health care when needed.

Follow-up care for premature children: the repercussions of the COVID-19 pandemic

“…The support provided by health workers to families with premature children is essential to promote health and prevent diseases ( 28 - 29 ) , as well as to reinforce measures to control the spread of COVID-19 ( 5 , 7 ) . A study conducted in the same context addressed here reports that there are important vulnerabilities in the continuity of care provided to premature children, showing a deep disconnection between PHC, hospital-based and specialized services ( 28 ) .…”

Care opportunities for premature infants: home visits and telephone support

“…The HV, considered an ancient care technology, brings favorable results and is important for the family, especially in vulnerable situations such as prematurity and those that recently come out of NICU (22) . The HV establishes a closer relation with the family environment, routines, culture and attitudes towards health care (17,22) .…”

“…Premature children may have complex needs at home, with more difficulties for caregivers and possible errors in relation to food, medication and use of health equipment or services (22)(23) . The active presence of health professionals at the homes can anticipate the identification of errors and difficulties of caregivers, helping them to apply effective practices to enhance care for their children (23) .…”

A visita domiciliar ao recém-nascido

“…It is also an opportunity to promote breastfeeding, encouraging and supporting early breastfeeding, with the maintenance of the exclusive offer; [3][4][5]17,27 promoting family planning 17 and increased immunization coverage; 3,5,17,28 favoring health education with a focus on baby care, 6,26,32 like caring for the umbilical stump and bathing the newborn at home, 14,21 including observation of danger signs 13,17,22 so that family members and guardians seek, with the support of the health service, adequate and timely care and the consequent impact on reducing neonatal and infant morbidity and mortality. 3,20,[28][29][30] Through the approximation of health professionals to the newborn and his family, mediated by the HV, the strengthening of the bond with the health teams is promoted, improving the use of health services for monitoring and prevention, thus reducing hospitalizations for complications, as well as emergency consultations. It was considered, in a study projecting the results of performing HV to families in the pre and postnatal period, that the strategy can reduce smoking, complications in pregnancy and injuries in childhood, improving child care for the development of language, increasing the proportion of breastfeeding and compliance with immunization schedules.…”