I have received positive feedback from trainees and colleagues on my in-hospital newborn counselling, so decided to share it on Twitter with others. /start of thread

When I first started as staff at @NYGH_News, I was eager to empower families with information about their newborn, but instead found that I overwhelmed them more often than not. That deer caught in the headlights stare became too familiar /2

Vitamin D, car seat safety, SIDS prevention, breastfeeding, stool and urine patterns, nasal congestion, umbilical cord care, etc etc etc. Much of this information was already being reviewed by our amazing nurses and in pamphlets that we provide to all of our families /3

So I instead decided to focus my counselling on when parents should seek medical attention for their baby. This was based on some of the more common and serious reasons I have seen newborn babies in the @NYGH_News ER, and as a resident during my training at @SickKidsNews /4

So here it goes. I ask parents to have their baby assessed for:

1. Yellow skin or yellow eyes (jaundice)

2. Dark green/bilious vomit. Like the colour of spinach or broccoli. They need to GO TO THE EMERGENCY ROOM. Also remind them that green stool is totally normal /5

3. Orange/red spots in their diaper (urate crystals). This may be normal for the first diaper or two, but more than this likely means that the urine is too dry/concentrated. The baby needs to see a doctor for a weight check and assessment of feeding and dehydration /6

4. Fever ≥38.0C. This should measured rectally. Dont use temporal/tympanic thermometers. I dont recommend axillary anymore since the accuracy of the measurement is so user dependent. Rectal much more reliable (once parents get over the hump of actually doing it). GO TO THE ER /7

As a way of reviewing the information, and helping parents (and trainees!) remember everything in their sleep deprived and exhausted state, I will use the traffic light analogy below. I have found this memory aid really beneficial /8

I always encourage trainees to take the best of what they learn from observing others counsel. My traffic light approach came from watching my mentors (and now colleagues) like Drs. Silver, Kanani, Soon, Hutchinson counsel numerous families during my training at @NYGH_News /9

Hope others find this approach to newborn counselling, handy and practical. Always looking for feedback on how to improve. @uoftmedicine @UofTPGME

(None of the images used in my traffic light poster are my own and were all borrowed from Google Images)

/end thread