AAP Updates Guidance for Care of Infants Born at Home
The AAP does not recommendplanned home birth, which is linked to increased risk for infant mortality
MONDAY, April 20, 2020 (HealthDay News) -- In an American Academy of Pediatrics (AAP) policy statement, published online April 20 in Pediatrics, recommendations are presented for the care of newborn infants immediately after birth and in the transition and subsequent period after home birth.
Kristi Watterberg, M.D., from the University of New Mexico in Albuquerque, and colleagues address provision of care for infants born at home, while summarizing appropriate care that is consistent with that provided for infants born in a medical care facility. They note that the AAP does not recommend planned home birth and that data have shown a twofold to threefold increase in infant mortality associated with home births in the United States.
The authors note that there should be two care providers present at every birth, one of whom has the primary responsibility to care for the newborn infant. Care for the newborn infant immediately after delivery should include provision of warmth, initiation of appropriate resuscitation measures, and assignment of Apgar scores. In the transitional period, the infant should be monitored closely. Infants who receive extensive resuscitation should be transferred to a medical facility. Infants should be screened for hypoglycemia if they are small or large for gestational age or required resuscitation. Newborn infants should receive prophylaxis against gonococcal ophthalmia neonatorum and receive a single parenteral dose of vitamin K1 oxide. In addition, infants should undergo hyperbilirubinemia screening, universal newborn screening, hearing screening, and pulse oximetry screening, ideally between postnatal age of 24 and 48 hours.
"We are providing information for physicians to share with expectant parents to help them understand the factors that increase the risks of home birth and recommend standards for newborn care," Watterberg said in a statement.