Thursday, April 03, 2008
Early discharge should not be expected

By Dr. Anthony Policastro

There was a time when mothers and newborns all stayed in the hospital for 72 hours. This was gradually moved to 48 hours. Now we send some babies home at 24 hours of age. The rules for 24-hour discharges are simple. Everything needs to be perfect with the baby. The pediatrician should know the mother well enough to know that she is reliable. What is surprising to me is that there are now many mothers who have come to expect to be discharged at 24 hours of age. They do not realize that early discharge is really the exception rather than the rule. There are many things that can keep the baby longer than 24 hours of age. The first of these is related to how many children a mother has already had. If she is an experienced mother, an early discharge is more likely. However, if she is a first time mother, there is no way for the pediatrician to know her expected reliability. For that reasons first time mothers can expect to stay longer than 24 hours. A second reason for staying has to do with all the changes that occur in a newborn's heart. Before birth the lungs are collapsed. There are blood vessels present that bring blood with oxygen to the baby. When the baby's lungs expand, these blood vessels close down. However, until they close, we can hear the blood flowing through them. That blood flow creates a heart murmur. These murmurs usually go away by the second day. However, it is sometimes difficult to tell them apart from a significant murmur. For that reason, if a baby has a heart murmur in the first 24 hours, we need to check it the following day. Babies are natural eaters. However, some of them have trouble figuring out how to feed. That might take 24 hours to happen. If a baby does not feed well initially, he/she should be observed to make sure that the feedings are going well before discharge. Babies can get infected with a bacteria called Group B Strep (GBS). Women who have a history of Group B Strep can have an infant who is infected with it. It is true that 85% of the infected infants will show signs of it in the first 24 hours. However, the other 15% will show it in the second 24 hours. Therefore, these infants are observed for 48 hours. The good news is that only 1% of women who have Group B strep ever have an infected infant. That means we keep a lot of infants who are never going to be infected. Jaundice is common in newborns. A normal adult level of jaundice is 1-2. In newborns the normal level is 8. It goes up for the first 72 hours of life. Thus if we have a newborn with a level above 6 at 24 hours of age, it may get too high by 72 hours of age. Therefore, these infants are not sent home by 24 hours of age. There are many other reasons why an infant should stay beyond 24 hours. Parents need to remember that 48-hour stays are the rule. Discharges at 24 hours of age are the exception to that rule. Parents should not have the expectation that their child will be ready to go home at 24 hours of age.

Mammograms at Greenwood library The Women's Mobile Health Screening Van is coming to Greenwood Public Library on Wednesday, April 23. Free or low-cost mammograms will be given to women who have scheduled an appointment. Women interested in receiving a mammogram must call 888-672-9647 before April 23 to schedule an appointment. No one will receive services without an appointment. A doctor's prescription is also required. Don't delay in calling if you are interested in receiving this service at no or low cost. Mammograms can save lives by finding breast cancer as early as possible. The van is administered by the Delaware Breast Cancer Coalition, Inc. and offers high quality services delivered by professional medical staff. The Greenwood Public Library is located east of the railroad tracks, on the corner of Market Street (DE Rt. 16) and Mill Street. You may call 888-672-9647 or 302-349-5309 for information.

Caregivers Diabetes Program Nanticoke Memorial Hospital, Seaford will provide a Caregivers Diabetes Education Program on Saturday, April 12 from 10 a.m.-1 p.m. Call JDRF (Juvenile Diabetes Research Foundation) 302-888-1117 to register or fax 302-741-8602.

Del Tech offers first aid Parents, teachers, coaches, and day care providers can increase their caregiving and safety skills with courses in pediatric first aid, basic first aid and cardiopulmonary resuscitation (CPR) at Delaware Tech, Owens Campus. The course is approved by the Office of Child Care Licensing. Participants must attend both sessions to receive a three-year course completion certificate. For those whose jobs require certification of CPR and basic first aid skills, the college offers courses that teach adult (one-rescuer) CPR and relief of foreign body airway obstruction as well as hands-on skills for quick response in medical emergencies and first aid situations. Those who pass the written exam earn a two-year course completion card. The Pediatric First Aid courses will be held from 6 to 9 p.m. on April 7 and 9. CPR & Basic First Aid is a one-session class and will be held from 8:30 a.m. to 4:30 p.m. on April 23. For more information, contact Delaware Tech's Corporate and Community Programs at 854-6966.

A JDRF Downstate Diabetes Forum A JDRF Downstate Diabetes Resource Forum will be held Saturday, April 5 from 9:30 a.m.-12:30 p.m. at Community Christian Church, 6400 Culver Road, Salisbury. Guest speakers will be Dr. Gerard Kuhn, M.D. and Vic Pelletier. Dr. Kuhn is a parent of a Type 1 daughter. A pediatrician, Dr. Kuhn will speak about JDRF's research. Pelletier lived for 30 years with Type 1 Diabetes and was the recipient of a new pancreas three years ago. He will speak about living with diabetes. The event is hosted by Sondra Messick of Seaford and Robyn Wilson of Ocean City. RSVP to Messick at 302-629-8210.

Stroke support group Nanticoke Memorial Hospital will offer free monthly Stroke Support Group meetings designed for individuals who have survived a stroke and their families and caregivers. Meetings are held the third Thursday of each month at Nanticoke Cancer Care Center, from 1:30 - 3:30 p.m. The meetings will consist of guest speakers and breakaway sessions, in which caregivers and survivors will meet in two groups to discuss concerns, provide support and networking. Refreshments will be provided. Sheila Brant and Joan Burditt, occupational therapists at Nanticoke Memorial Hospital, will facilitate the support group meetings. Pre-registration is not required. For more information, call 629-6611, ext. 5121.

Depression support group in Laurel The Mental health Association in Delaware will be sponsoring a Depression Support Group in Laurel on the second and fourth Thursdays of each month. The meetings begin at 7 p.m. The MHA encourages anyone dealing with a depressive disorder to attend. Register in advance by calling 1-800-287-6423. Peer support groups sponsored by Mental Health Association of Delaware are not intended to replace professional mental health treatment. MHA does not publish support group locations; locations are provided with registration.

Free Colorectal Cancer Screening This year, more than 148,000 Americans will be diagnosed with colorectal cancer and nearly 50,000 people are expected to die from the disease. The risk for colorectal cancer increases with age and anyone over 50 should be screened. If detected early, colorectal cancer can be cured and with proper screening it can even be prevented. To help fight this disease, Bayhealth Medical Center will offer a free colorectal screenings for Colorectal Cancer Awareness Month on Saturday, April 5 at GI Associates, 742 S. Governors Ave., Suite 3, Dover at 9 a.m. to noon. Pre-registration is required. For more information or to register, please contact Paula Hess, MSN, RN, at (302) 430-5064.

Paramedic is promoted Paramedic Robert Schoonover was recently promoted to technical services division manager following the retirement of Paramedic John Kinsley. Schoonover became a paramedic in 1988 in Maryland. Before joining Sussex County EMS in 2004, Paramedic Schoonover served as director of Caroline County EMS in Maryland. He has an associate's degree in allied health from Chesapeake College. Schoonover currently resides in Greensboro with his wife and two children and are planning to move to Greenwood.

Dr. Stetzer acquires practice Dr. Kraig Stetzer D.M.D has recently acquired the practice of Dr. Paul Kuk located at 1412 S. Salisbury Blvd. in Salisbury. Dr. Stetzer graduated from the University of Pittsburgh before moving to Cambridge, Md., where he practiced dentistry for the last seven years. Dr. Stetzer's office hours are 8 a.m. to 5 p.m. Monday through Thursday and 8 a.m. to noon on Friday. He offers services ranging from general cleanings to crowns and dentures as well as Invisalign. Dr. Stetzer is welcoming new patients of all ages. For an appointment, call the office at 410-546-5797.

Peninsula Home Care ranks high Peninsula Home Care announces that it has been named to the 2007 HomeCare Elite, a compilation of the most successful Medicare-certified home health care providers in the United States. This annual review identifies the top 25% of agencies, ranked by an analysis of performance measures in quality outcomes, quality improvement and financial performance. The 2007 HomeCare Elite also indicates those providers who are included in the Top 100 and Top 500 of providers nationwide. Peninsula Home Care's Branch Director, Robyn Coughenour BSN, HCS-D, credits the agency's commitment of ensuring the highest quality standards of care and its dedication to the Sussex County community. The 2007 HomeCare Elite is the only performance recognition of its kind in the home health industry. The 2007 HomeCare Elite is brought to the industry by OCS, Inc. the leading provider of healthcare informatics and DecisionHealth, publisher of home care's most respected independent newsletter Home Health Line. The entire list of 2007 agencies can be viewed online at

Alzheimer's offers courses The Alzheimer's Association Delaware Valley Chapter is offering professional training programs at the Georgetown office. These programs include CEU credit for social workers, nurses and nursing home administrators. Certificates of completion are also available. Courses include "About Dementia" on Tuesday, May 6 from 9 a.m. to noon (three credits); "Making Connections" on Tuesday, May 13 from 10 a.m. to noon (two credits); and "Understanding Wandering" on Friday, May 23 from 10 a.m. to noon (two credits). The cost of each session including CEU credit is $49 or a certificate of completion is $29 per registrant. Pre-registration is required by e-mailing Jamie Magee at or by calling 302-854-9788.

F.A.M.E. Racing joins arthritis walk The Arthritis Foundation, Delaware Branch announces that F.A.M.E. Racing has joined the "Speed the Way to a Cure" Arthritis Walk on Saturday, April 26, at Dover International Speedway. Fast Action Motorsports Entertainment (F.A.M.E) will provide their best package to walkers - a 16' x 24' high-banked oval race track with six full-size steering consoles and six custom designed 1/10 scale radio-controlled stock cars; tire change challenge; and a race car simulator. The Arthritis Walk is a one, two, or three mile walk that helps promote awareness, provide education and raise funds to support research and activities within Delaware. Walkers who raise $500 will earn a four lap trip as a passenger in a Monster Racing race car. Those who raise $1,500 earn the opportunity to drive a Monster Racing race car 10 laps. Walkers must be at least 14-years-old to ride and 18 with a valid driver's license to drive. Walkers can sign up online for the "Speed the Way to a Cure" Walk at or they can contact the Arthritis Foundation of Delaware at 888-730-9008.

Community walk In an effort to make Delaware's Children the healthiest in the Nation, the Sussex Child Health Promotion Coalition in conjunction with Nemours Health and Prevention Services (NHPS) has planned their second annual Community Walks. The walks take place on Saturday, April 5, in Laurel, Seaford, Bridgeville and Georgetown simultaneously, beginning at 9 a.m. The walks are not fundraisers, but rather community awareness events. Each community is showing support for the event and the following activities have been planned: Laurel- Highlights of the walk in Laurel include an appearance by the Bulldog mascot, a cup stacking exhibit, a performance by the local cheerleaders, free fruit and water, free giveaways, and free T-shirts for the first 100 walkers. Seaford- Highlights of the walk in Seaford include appearances by Allen's Fitness Chicken, Bobby Banana and friends, free blood pressure screenings from Nanticoke Health Services and other health-related representatives including the American Diabetes Association, a posh pet parade hosted by the Seaford High School Student Government, face painting hosted by the Seaford High School Ladies of Distinction, a live remote broadcast from the Bee Radio station, free T-shirts to the first 100 walkers and Subway Achievement Awards for all children under 12 who have 100% participation in the children's physical activity stations. Bridgeville - Highlights of the walk in Bridgeville include "opening day" of the youth soccer league and barn tours of the Ag facilities. Georgetown - The Community Walk will be held at Delaware Tech at the gazebo near the Student Services Center at 9 a.m. The rain date for the walk is April 6, at 2 p.m. Highlights of the walk include an appearance by the Delmarva Shorebirds mascot, Sherman the Shorebird, face painting and various youth organizations. Organizers encourage everyone to plan to come out and show their support of area children and help to promote the importance of living a healthy lifestyle. While at the walks, there will be an opportunity to sign a pledge to commit to taking steps toward a healthier lifestyle.