All About the Newborn Visit: Information and Tips for Early Head Start Staff

The first few weeks of a newborn's life are an exciting and demanding time for both the baby and family. Required by the Head Start Program Performance Standards, the newborn visit focuses on the mother's and newborn's well-being. Use this tip sheet to understand the purpose, timing, and goals of the newborn visit. Early Head Start staff will also find strategies for making the most of the visit.

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The first few weeks of a baby's life are an exciting and demanding time for both the baby and the newly expanded family. The newborn visit, required by the Head Start Program Performance Standards (HSPPS), focuses on the well-being of both mother and baby and is to be scheduled within two weeks after a baby's birth.

45 CFR §1302.80(d)
A program must provide a newborn visit with each mother and baby to offer support and identify family needs. A program must schedule the newborn visit within two weeks after the infant's birth.

What Is the Newborn Visit?

This visit does not take the place of well-baby checks or replace medical care for the mother. At the newborn visit, staff:

Address families' questions
Assess the health of mother and baby
Offer resources and provide referrals as necessary
Offer support outside of medical appointments

Timing and Length of the Visit

To the extent possible, staff should plan the newborn visit with a family when the woman is pregnant. Staff should describe the goals of the visit and document plans in the Family Partnership Agreement. Plans must be flexible, however, as family preferences for the visit may change after the baby's birth.

The HSPPS do not specify a required length of time for the newborn visit or the qualifications of staff who conduct the visit. If programs are able to, they often designate staff with expertise in maternal and child health to conduct the visit. During the visit, staff should take cues from each family. For example, life with a newborn can be exhausting; therefore, staff should plan for a short visit unless a family asks for more time. Staff should avoid overwhelming families with information and instead offer them an opportunity to share how things have been going since the birth and ask any questions.

Key Goals of the Visit

Evaluate Safety and Address Concerns

Many safety issues (for example, issues related to sleeping and feeding practices or exposure to secondhand smoke) can be discussed before the baby is born. During the newborn visit, staff should address only issues of immediate concern. Any discussions about safety should be approached in a respectful and sensitive manner.

Ensure the Baby Has a Medical Home

One important goal of the visit is to ensure the baby has a medical home. Often, this is done when the mother is pregnant, as parents have to identify and make an appointment with a provider before being discharged from the hospital. The baby may have already had a 2-day-old visit with the health care provider before the newborn visit. Staff should reinforce the importance of routine well-baby visits and make sure the family has a medical home. Staff should also provide information about what to expect at well-baby visits. They can also encourage parents to share any concerns with their child's health care provider.

Assess Postpartum Recovery and Answer Questions

An important goal of the newborn visit is to make sure families have the information and resources they need to care for their new baby. Staff can encourage new mothers to consider how they can take care of their own recovery needs and gain support from their partner, family, or friends. Staff can also address families' needs for support for emotional well-being, nurturing and responsive caregiving, and father or partner engagement. And staff can ask families if they have questions about recovering from the birth.

Support Infant Feeding

Staff can provide information on the benefits of breastfeeding and support mothers in their decision to breastfeed. If necessary, staff can provide referrals to lactation consultants and counselors.

Coordinate Any Additional Care

Staff can encourage mothers to attend postpartum appointments, work with families to solve any challenges to accessing health care, and assist families with care coordination.

Identify Red Flags for Depression

Mothers and fathers in Early Head Start are at high risk for depression. Depression rates are highest during pregnancy and postpartum. Parental depression can severely impact child development. During the newborn visit, staff can work with families to identify any red flags for depression. Staff may want to use a validated tool to screen for depression, many of which are only a few questions long. Staff should also be prepared, with support from a program's mental health professional, to refer families for further support and intervention if necessary.

Tips for the Visit

Recognize the Family's Expertise

Families are the decision-makers for their children's health. They may have important and powerful culturally rooted beliefs about the health and care of a newborn. These beliefs lay the foundation for health and care decisions related to their baby.

Ask Questions and Encourage the Family to Do the Same

Ask open-ended questions (for example, "How are you and the baby sleeping/eating/feeling?"). Encourage the family to ask questions as well.

Point Out the Positives

Use the visit to support the family in focusing on the baby's behaviors. Invite the family to share their observations, reflections, ideas, and guesses about the baby's needs. Notice and affirm the positive ways family members engage with the baby. This will support their positive relationship with their baby and reinforce their confidence at a time when they might feel unsure.

Be Prepared

Although you cannot predict every question that families might have at the newborn visit, you should be prepared to provide information and answer questions on the following topics:

Physical Health

Mother's recovery
Breastfeeding concerns (for example, mastitis, pain in the breasts, chapped nipples)
Postpartum care (including any health concerns for the baby or mother)
Newborn's growth
Newborn's movement (including reflexes)
Newborn's temperature
Newborn's cord care
Newborn's sleeping
Jaundice
Newborn's hearing and vision
When to call the doctor

Nutrition

Nutrition for breastfeeding mother
Family access to nutritious food
Breastfeeding questions
Family access to lactation support or breast pumps
Making and storing formula and/or breast milk
Newborn's eating
Newborn's weight gain
Newborn's elimination patterns
Newborn's burping or spitting

Mental Health

Maternal and paternal depression
Parental responsiveness to the baby
Adjustment of all family members (including siblings) to the newborn
Family sense of competence
Social support for the family
Stress related to upcoming return to work or school and plans for the baby's care
Newborn crying and self-care strategies when the baby cannot be soothed
Substance use

Referrals

Staff may not have the expertise to respond to all family concerns. Staff should bring information on community resources that can support families to the visit. In addition, if families are not already connected to primary care and Women, Infants, and Children (WIC), this visit is a great opportunity to make those important referrals. Families with newborns might also request or benefit from information on: