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From:
PERETTE PERETTE <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 29 Oct 2006 22:56:37 -0800
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Hi,
   
  A member posted that because of the AAP's recommended guidelines about followup of newborns that babies are being seen earlier postpartum.
   
  I wish it was so.  In my community in the Central Valley- with the exception of a few providers babies were still being seen 2 weeks postpartum for the FIRST visit.  If the baby had Medi-Cal (the California state name for Medicaid for low income patients) that first visit could happen as late as 6 weeks post-partum.  Babies did not go out the door with followup appointments-- moms were expected to call to make appointments- in some practices that was a daunting task just to get through the phone system.  When I had my private practice-- I did my best to see babies 2-3 days post discharge from the nursery  ( I saw about 50% Medi-Cal in my private practice).  
   
  Up here in Sonoma County- docs see the babies anywhere from 1-2 weeks postpartum.  Most babies do however get a visit from the homecare nurse (many of whom are also IBCLC's as well).
   
  So perhaps in bigger US cities with higher income patients, babies are seen within the 2-3 day window by a doc.  If one is lucky, the hospital may have a home visiting nurse do a visit in the first week.
   
  These days, I am spending most of my time (75%) working in public health doing administrative work, my only clinical work is on the weekends in a pediatric urgent care.  I miss the patient care aspect of general pediatrics.  However in the United States (especially in California) it has become increasingly difficult to practice general pediatrics and actually make money (especially if one chooses to care for indigent patients).
   
  Perhaps in the future I will find some happy medium.  A way to still do breastfeeding support and be able to cover all my costs.
   
  Best,
   
  Pierrette Mimi Poinsett MD
  Petaluma CA



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