Going to the doctor with a newborn or young baby can be stressful at baseline. Your 2-day-old poops the moment you get her in the car seat. You almost forget your diaper bag before heading out the door and can barely manage it and the stroller as you maneuver the elevator on the way into the clinic. Attempting a newborn or first-year visit to the pediatrician in a post-quarantine COVID-19 world can seem even more daunting.
As states reopen and as pediatricians' offices resume non-emergency visits, here's what you need to know as you head into the doctor's office with a baby for first-year or newborn checkups:
1. You may see your pediatrician on a screen for part or all of the visit.
In an effort to promote social distancing and limit the spread of COVID-19, many pediatric clinics are performing some or all parts of baby well visits via telehealth, though this is less common for early newborn visits.
If your office follows a split visit protocol, your doctor will meet with you on a virtual platform to perform the history portion of the visit. She'll ask about baby basics like feeding, sleep, elimination and behavior. In early visits postpartum, she will also discuss how you're handling your transition to motherhood and screen for postpartum depression and anxiety. There will be plenty of time for individual questions and concerns you have.
To complete the physical exam portion of the visit, including any measurements your child needs, you'll come briefly into the clinic. Sometimes, your child's pediatrician may have extra questions for you based on what they observe in the office and may, especially in the newborn period, need to do additional testing for issues like elevated bilirubin—a substance in the blood that can lead to jaundice in the early days—to make sure your baby is safe.
2. Your pediatrics office will still encourage you to come in for immunizations
While the medical community cares deeply about making sure you and your family don't contract COVID-19, we also know there are other serious conditions that could come to the forefront if not kept at bay during this time of crisis. It's important that we continue immunizing babies for dangerous diseases like polio and pertussis so we don't create new pandemics we can't control. Though it may seem like putting off these vaccines is no big deal, our immunization program is one of the most important ways we keep kids and their entire families well.
3. Your appointment might get moved...several times.
Post-quarantine, pediatric practices are finding creative ways to maintain the most protective environments for their sick and well patients with ever-changing community needs and limitations. As stay-at-home orders lift and neighborhoods reopen, practices are constantly re-assessing the ways they schedule patients and may, from time to time, move your appointment to assure you're treated in a safe environment that maximizes the time you spend with your provider.
4. Your child's pediatrician will be extra careful with you and your baby.
Pediatrician offices are following strict safety precautions to ensure their patients and their parents are safe. Many pediatric groups with multiple sites have implemented a well clinic and sick clinic model, where those coming for scheduled routine pediatrician appointments are seen in one location, and those who are worried about respiratory symptoms like cough and congestion are directed to another. Those with solo or small practices are also being especially careful with their patients to assure the safest clinic environments possible. This protects all patients but is especially important for our most vulnerable populations.
Even when there's not a worldwide pandemic, offices often reserve specific appointment times each day for newborns and babies to make sure they're isolated from other potentially ill patients.
5. You'll need to be prepared for extra screenings and specific protocols before you arrive and throughout your visit.
At my office, we call families before each visit to question them about any COVID-19 symptoms or exposure risk factors. Many offices check patient and parent temperatures prior to admittance, ask that all who attend the visit (over 2 years old) wear a mask and request that guests refrain from sitting in the lobby. We also only allow one parent to come to each visit per patient, except in the newborn period.
Physicians and staff members are required to wear masks throughout the clinic, practice social distancing amongst themselves, and to stay home if they have any potential COVID-19 symptoms. They're also frequently cleaning high-touch areas and limiting time with others in enclosed spaces. Call your child's pediatrician if you have questions about specific protocols they have in place.
While it's daunting to head out anywhere post-quarantine, and while the doctor's office may seem like an especially high-risk destination, pediatricians are taking extra precautions in the office, prioritizing virtual appointments when feasible, and making sure medical exams and immunizations are performed safely. Above all, they're making sure families feel confident and comfortable as they establish or reestablish medical care for their newborns and babies in the post-quarantine period.
Don't be nervous, new mamas. You've got this.