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How many well-baby visits are necessary in the first 2 years of life?
Insights
Reducing scheduled well-baby visits for healthy newborns from 10 to 5 did not increase illness or undetected abnormalities. This study suggests fewer visits are safe and effective for low-risk infants, with adjustments for first-time mothers.
Area of Science:
- Pediatrics
- Preventive Medicine
- Health Services Research
Background:
- The standard recommendation for well-baby visits in Ontario is 10 visits within the first two years.
- A scientific basis for this number of visits for healthy, low-risk newborns was not readily apparent.
Purpose of the Study:
- To determine the efficacy and safety of reducing scheduled well-baby visits for healthy, low-risk newborns from 10 to 5.
- To compare health outcomes, development, and parental satisfaction between reduced and standard visit schedules.
Main Methods:
- A randomized trial involving 570 healthy, low-risk newborns.
- Comparison of outcomes between a group with 5 scheduled visits and a group with 10 scheduled visits.
Main Results:
- Babies in the 5-visit group had significantly fewer scheduled visits (4.77 vs. 7.63) but a similar incidence of illness and undetected abnormalities compared to the 10-visit group.
- Physical and mental development, maternal-child relations, maternal anxiety, and parental satisfaction were comparable between the two groups.
- The 5-visit group experienced more unscheduled visits (1.42 vs. 0.26).
Conclusions:
- The number of recommended well-baby visits for healthy, low-risk newborns can be safely reduced.
- A schedule of 5 visits for children of multiparas and 6 visits for children of primiparas is suggested.
- Additional visits should be individualized based on parental needs and experience.
Abstract:
Since we could find no scientific basis for the 10 well-baby visits recommended in the first 2 years of life in Ontario, we carried out a randomized trial in 570 healthy, low-risk newborns to determine the efficacy and safety of decreasing the number of scheduled well-baby visits from 10 to 5. Among the 466 babies still in the trial at the end of the study period those in the 10-visit group had had a mean of 7.63 scheduled and 0.26 unscheduled well-baby visits and those in the 5-visit group a mean of 4.77 scheduled and 1.42 unscheduled well-baby visits. Reducing the recommended number of visits did not result in an increased incidence of illness or an increased prevalence of undetected abnormality, and the physical development of the babies in the two groups was almost identical. The mean scores of the two groups in assessments of mental development, maternal-child relations, maternal anxiety and parental satisfaction with health care were close. The results suggest that the recommended number of well-baby visits for healthy, low-risk newborns can be reduced to five for children of multiparas and six for children of primiparas. Any additional well-baby visits should be scheduled according to the needs and experience of the parents.