Oregon Health & Science University Pediatric Residency Training Program New Parent & Child Elective

Oregon Health & Science University Pediatric Residency Training Program

New Parent & Child Elective

Elective director:

Name: Megan Aylor, MD

Email: aylorm@ohsu.edu Pager: 13539

Phone: 503‐418‐5170

Office location: CDRC 3107

Elective goal:

The purpose of this elective is to help residents gain a better understanding of issues that arise for both

parents and child within the first few months of life. For residents with children, the time will allow for intensive time with a neonate, to betterunderstand day‐to‐day issues that arise in the neonatal period, as well as to study in further depth common outpatient medical issues duringthe neonatal period. For residents without children, this elective will provide insight into the life of a new parent and better prepare them toprovide anticipatory guidance to their patients and families.

Elective instructions:

To sign up for the elective:

· If this elective is to be used as part of maternity/paternity leave, let Chief Residents know as early in pregnancy as possible toschedule changes.

· This can be a call free elective.

· Continuity clinics are optional, but are mandatory for residents without children at home.

· Arrange with Mike Grubbs if you will be giving a noon conference.

At the end of the elective:

· Return any borrowed supplies – especially books and videos

· Turn in book review form, one‐page essay, multiple choice forms, and sheets from any other optional activity

· Turn in checklist

· Turn in powerpoint slides after giving a noon conference talk or copy of handout/smartphrase etc

· Fill out evaluation sheet and return materials to Megan Aylor

Elective objectives:

Medical Knowledge:

· Research will be done on the resident’s choice of a subject related to neonatology or normal newborn medicine. This research will beused to either provide a presentaion given as part of the Noon Conference Series or may be an informational handout, smarphrase etc foreither parents or providers.

· Early infant and breast feeding assessment skills will be obtained by firsthand experience as well as self‐directed reading and/or videos

· Resident will read articles on neonatal topics including: post‐partum depression, hyper‐ bilirubinemia, neonatal rashes, circumcisions andcircumcision complications, medication use during lactation, vaccination and colic

· Resident will learn various popular techniques for calming infants and addressing other common parenting concerns by completing abook review on popular parenting book of choice

Patient Care:

· Intensive time with neonate at home will replace patient care responsibilities.

· Continuity clinic is optional. If this elective is taken by a resident without a child at home, continuity clinic should be continued.

Practice‐Based Learning and Improvement:

· Residents will demonstrate self‐directed learning through the use of distributed materials and reading list

· Residents will contribute to a residency file of reviews of parenting books and videos with their book and/or video reviews

Communication Skills:

· Residents will communicate as a parent to healthcare providers for the infant. This role‐reversal will help improve resident‐parentcommunication by helping the resident to understand the role of the parent

· Residents may give a noon conference talk of 25 min duration at the end of the rotation, improving presentation skills

· Resident will study the nature of maternal infant bonding and communication patterns between a mother and/or father and theirnewborn

Professionalism:

· Resident will consider alternative empathic approaches to parents and their newborn to enhance their professionalism

· Residents will learn more about the balance of parenting in residency and with a career in medicine both through personal experience,and through articles on parenting during residency.

Systems‐Based Practice:

· Residents will develop a greater appreciation and understanding for obtaining health care for a new infant while also adjusting to being a new parent.

· Residents will become more aware of community resources available for parents, such as parenting groups, breastfeeding support, andhelp with car seat installation

· Residents may attend a parenting group, a breastfeeding group, or local classes for new parents.

Goals and Objectives

Rotations: New Parent and Child Elective

Revised: June 2016

Contact Information

Megan Aylor, MD

Location

OHSU Doernbecher Children’s Hospital

Ph 503-418-5170

FX 503-418-5337

Pediatric Residency Program Director aylorm@ohsu.edu

Goal: The purpose of this elective is to help residents gain a better understanding of issues that arise within the first few months of life. For residents with children, the time will allow for intensive time with a neonate, to better understand day-to-day issues that arise in the neonatal period, as well as to study in further depth common outpatient medical issues during the neonatal period. For residents without children, this elective will provide insight into the life of a newborn and parent and an opportunity to learn information that will be helpful when providing anticipatory guidance to the parents of newborns and infants. This elective is geared for both new mothers and fathers, but is not restricted to residents with children.

Objectives:

Medical Knowledge:

1) Research will be done on the resident’s choice of a subject related to the newborn period.

This research will be used to give a 25 min talk given as part of the Noon Conference

Series or to create new handouts for parents or residents.

2) Early infant and breast feeding assessment skills will be obtained by first hand experience as well as self-directed reading and/or videos

choice

Patient Care:

1) Intensive time with neonate at home will replace patient care responsibilities.

2) This can be a call free month

Practice-Based Learning and Improvement:

1) Residents will demonstrate self-directed learning through the use of distributed materials and reading list

2) Residents will contribute to a residency file of reviews of parenting books and videos with their book and/or video reviews

Communication Skills:

1) Residents will communicate as a parent to healthcare providers for the infant. This role- reversal will help improve resident-parent communication by helping the resident to understand the role of the parent

2) Residents who give a noon conference talk of 25 min duration at the end of the rotation,

improving presentation skills

3) Resident will study the nature of maternal infant bonding and communication patterns between a mother and her newborn

Professionalism:

1) Resident will consider alternative empathic approaches to the parents and their newborn to enhance their professionalism

residency.

Systems-Based Practice:

2) Residents will learn more about the balance of parenting in residency and with a career in medicine both through personal experience, and through articles on parenting during

3) Resident will learn various popular techniques for calming infants, and addressing common parenting concerns by completing a book review on popular parenting book of

3) Continuity clinic is optional. If this elective is taken by a resident without a child at home, continuity clinic should be continued.

1) Residents will develop a greater appreciation and understanding for obtaining health care for a new infant while also adjusting to being a new parent.

2) Residents will become more aware of community resources available for parents, such as parenting groups, breastfeeding support, and help with car seat installation

Instructions for Elective

To sign up for the elective

1. If this elective is to be used as part of maternity/paternity leave, let Megan and Chief

Residents know as early in pregnancy as possible to schedule changes.

2. This can be a call free elective.

3. Continuity clinics are optional, but are mandatory for residents without children at home.

At the end of the month:

1. Return all borrowed supplies – especially books and videos

2. Turn in book review form, one-page reflection, and sheets from any other optional activity

3. Turn in checklist from notebook

4. Turn in powerpoint slides after giving your noon conference talk

5. Fill out evaluation sheet

Supplemental Materials List:

Articles:

Parenting in Residency

2. Residency Training and Pregnancy. van Dis J. MD. JAMA. 2004;291:636.

3. Maternity Leave During Training – AMWA Position Statement

5. Female Physicians: Balancing Career and Family. G. Verlander. Academic

Psychiatry: 28:4. 2004.

6. Fathers and the Well-Child Visit. C.F. Garfield, A. Isacco. Pediatrics 2006;117;e637- e645

Suggested Books for Review

A) Books Recommended by AAP

-- available as ebook from Multnomah County Library, www.multcolib.org

2. Caring for Your Baby and Young Child Steven P. Shelov, MD, MS, Tanya

Remer Altmann, MD. American Academy Of Pediatrics. 2010.

3. Your Baby’s First Year . Steven P. Shelov, MD, MS. American Academy Of

Pediatrics. 2010.

4. Mommy Calls: Dr. Tanya Answers Parents’ Top 101 Questions About Babies and

Toddlers. Tanya Remer Altmann, MD

-- available as ebook from Multnomah County Library, www.multcolib.org

B) Popular Books

General:

1. What to Expect the First Year. Heidi Murkoff

2. The Baby Book: Everything You Need to Know About Your Baby from Birth to Age

Two. William Sears, MD, Martha Sears, RN.

3. Be Prepared: A Practical Handbook for New Dads. Gary Greenberg Jeannie

Hayden

4. The New Father: A Dad's Guide to the First Year. Armin A. Brott

Sleep and Calming:

5. The No Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the

Night. Elizabeth Pantley

7. The Happiest Baby on the Block: The New Way to Calm Crying and Help Your

Newborn Baby Sleep Longer. Harvey Karp, MD

-- available as ebook from Multnomah County Library, www.multcolib.org

8. Helping Your Child Sleep Through the Night Joanne Cuthbertson, Susanna

Schevill, Susie Schevill

9. The Baby Sleep Book: The Complete Guide to a Good Night's Rest for the Whole

Family William Sears, MD, Martha Sears, RN. (Sears Parenting Library).

10. On Becoming Baby Wise: Giving Your Infant the Gift of Nighttime Sleep. Gary

Ezzo, Robert Bucknam

Breastfeeding:

11. The Breastfeeding Book: Everything You Need to Know About Nursing Your Child from Birth Through Weaning William Sears MD, Martha Sears, RN.

12. Better Breastfeeding: A Mother's Guide to Feeding and Nutrition. Daina Kalnins

RD, Joyce Touw RN, Debbie Stone RN

13. Ina May’s Guide to Breastfeeding. Ina May Gaskin, MA, CPM

14. The Nursing Mother’s Companion. Kathleen Huggins, RN, MS

Caring for Premature Infants and Children with Disabilities:

15. The Premature Baby Book: Everything You Need to Know About Your Premature

Baby From Birth to Age One. William Sears, MD, Robert Sears MD, James Sears

MD, Martha Sears RN.

16. Preemies: The Essential Guide for Parents of Premature Babies. Dana Wechsler

Linden, Emma Trenti Paroli, Mia Wechsler Doron MD

17. The Preemie Primer: A Complete Guide for Parents of Premature Babies – From

Birth through the Toddler Years and Beyond. Jennifer Gunter MD

18. Babies with Down Syndrome: A New Parent’s Guide. Susan J. Skallerup

19. Cerebral Palsy: A Complete Guide for Caregiving. Freeman Miller MD, Steven J Bachrach MD

Videos

Search for parenting videos on YouTube. Some topics include:

Happiest Baby on the Block (http://www.youtube.com/user/thehappiestbaby?feature=CAQQwRs%3D) Baby Sign Language (http://www.youtube.com/watch?v=EaSaGhWKb24) Breastfeeding techniques (http://www.youtube.com/watch?v=Zln0LTkejIs) BabyWearing (http://www.youtube.com/watch?v=Tabl1-dQfjM)

Cloth Diapering (http://www.youtube.com/watch?v=gVo6SMebcX8)

Breastfeeding and returning to work (http://www.youtube.com/watch?v=FjLoEkwn7hw) Elimination communication (http://www.youtube.com/user/ECSimplified?feature=CAgQwRs%3D)

Other free online videos:

http://thegotomom.com --child development & parenting issues http://www.parenting.com/article/parenting-com-videos --child development, product reviews

http://video.kaboose.com/parenting.html -- parenting and product reviews http://tlc.discovery.com/guides/family/tlc-baby-block/parenting-101/video/video.html -- parenting

http://babyparenting.about.com/od/homeandfamily/a/videos.htm -- parenting, safety

Check out the DVD section of your local library too!

Local Exercise or Wellness Activities

Stroller Walking

Stroller Strides

http://www.strollerstrides.com/programs-locations/overview

Locations: Oregon Zoo, Jamison Square-Pearl District, Mt. Scott Community Center, Willamette

Park, Lake Oswego, Tigard

Strollersize at the Southwest Community Center http://southwestcommunitycenter.wordpress.com

Baby Boot Camp

Beaverton: http://www.babybootcamp.com/or-beaverton1.aspx 503-780-9235

Hillsboro: http://www.babybootcamp.com/OR-Hillsboro.aspx 503-539-1603

Tigard: http://www.babybootcamp.com/or-portland-south.aspx 503-593-9692

East Portland: http://www.babybootcamp.com/or-portland-east.aspx 503-830-1009

Infant and mommy yoga

503-922-3100

Library and Language Activities

Book Babies

http://multcolib.org/events/storytime.html

For babies 0-12 months and caregivers

Babies Need Early Literacy, Too: A Play and Learn Workshop

http://www.beavertonlibrary.org

503-350-3600

For babies 0-12 months and caregivers

Libraryland for New Parents

http://www.beavertonlibrary.org

503-350-3600

For babies 0-12 months and caregivers

Literacy Launch Pad at Milagros

http://milagrosboutique.com/events

Building literacy skills in preschool-age children with Down syndrome

Spanish Baby Time PDX http://www.meetup.com/Spanish-BabyTime-PDX Intended to expose babies to a second language

Tiny Talkers Baby Signing Workshop

www.tinytalkersportland.com

503-754-8776

Local Parenting Classes

OHSU

Breastfeeding Basics, Newborn Care, Infant Safety and CPR, Baby Brain Food: Cooking Class, http://www.ohsu.edu/xd/health/services/women/services/pregnancy-and-childbirth/childbirth- classes/index.cfm

Milagros Boutique

503-493-4141

Mindful Parenting PDX

http://mindfulparentingpdx.blogspot.com/

207-409-9419

Local Support Groups

There are a lot!

http://www.metro-parent.com/pse_parent_support_groups

Some specific groups:

OHSU New Moms Group

http://www.ohsu.edu/xd/health/services/women/services/pregnancy-and-childbirth/for-new-moms- and-babies/new-moms-group.cfm

Free for moms who delivered at OHSU

Postpartum Depression

Group Support for Depression and Anxiety in Pregnancy and Postpartum (Baby Blues

Connection): 866-616-3752 http://www.babybluesconnection.org/bbc/finding-help/bbc-groups

At Zenana Spa & Wellness Center, Pod + Kin, Munchkin Playland, Sante Mama, Eastrose

Fellowship Unitarian Universalist Church

Older Moms

Motherhood Later…Wiser Mothers Over 35

Multiples

Full House MOMs and Dads – For families of twins, triplets and higher order multiples http://www.fullhousemoms.com

Adoption

Adoptive Family Support Groups in Oregon

http://www.adoptivefamilies.com/support-group-results.php?action=results&state=OR&country=D

Special Needs

Autism

Autism Oregon http://autismoregon.org/support_groups

NICU

Precious Beginnings: Parents Supporting Parents of Critically Ill Newborns http://www.precious-beginnings.org

(503) 244-3350

Bereavement

Compassionate Friends – For parents who have lost children http://www.tcfportland.org

Brief Encounters – For parents who have lost babies before, after or during birth http://www.briefencounters.org/bewp

(503) 699-8006

Breastfeeding sites for support, extra visits or supplies

OHSU Center for Women’s Health http://www.ohsu.edu/xd/health/services/women/services/pregnancy-and-childbirth/for-new-moms- and-babies/lactation.cfm

503 494-9397

Breastfeeding classes and consultations

Consultation and support groups

503-762-1632

503-681-1336

Free telephone advice and (bilingual) breastfeeding support group

503-282-3338

Free telephone advice, breastfeeding support and classes

503-215-6085

971-673-0040

WIC Clinic and State Programs, information for employers and employees about pumping in the workplace and laws regarding breastfeeding

Sante Mama (Vancouver, WA)

http://www.santemama.com/classroom/breastfeeding_support

360-253-BABY

Breastfeeding Support Group

Internet Information and Support Groups

MomMD

http://www.mommd.com

Blogs and conversation threads on different issues for physicians in medicine.

Pregnancy and newborn care with forums

Pregnancy and newborn care with forums

Preemie information and forums

Yoga Shala, Mom and Baby Yoga http://www.ombase.org/

Offered by the Multnomah County Libraries at Albina, Belmont, Central, Gregory Heights, Gresham, Holgate, Hollywood, Kenton, Midland, North Portland, Northwest, Sellwood-Moreland, St. Johns, and Woodstock

Babywearing, Cloth Diapering, Breastfeeding http://milagrosboutique.com/events/

Greater Portland Moms of Multiples Club http://www.gpmomc.org

Located at Legacy Emanuel and OHSU. Offers parents a “Parent Buddy” whose child was previously in the NICU; holds “Baja Night” with free food for parents

Nursing Mothers Counsel of Oregon http://www.nursingmotherscounsel.org

OHSU Employee Lactation Support http://ozone.ohsu.edu/hr/resources/breastfeeding.shtml Information about pumping after returning to work OHSU Lactation Room Coordinator: (503) 494-9434

La Leche League, Portland http://dev.lllusa.org/web/PortlandOR.html in NW/NE or SE Portland

Birthingway College of Midwifery’s Breastfeeding Center http://www.birthingwaybreastfeedingcenter.org/

Offers free telephone advice, free one-hour consultations with a certified lactation consultant, and breastfeeding support groups

Tuality Healthcare Lactation Services (CRADLES clinic) http://www.tuality.org/home/index.php/womens_health/birth_center/http://www.tuality.org/home/index.php/events/breastfeeding/

4. Arrange with residency coordinators when you will be giving your noon conference. This is half a noon conference, and can be shared with other residents doing the elective. It needs to be given within 3 months of the elective.

1. Juggling Work and Breastfeeding: Effects of Maternity Leave and Occupational Characteristics. Guendelman S. Lang Kosa J, Pearl M, Graham S, Goodman J, Kharrazi M. Pediatrics. 2009. 123 e38-46.

4. The Impact of Parental Leave on Extending Training and Entering the Board Certification Examination Process: A Specialty-Based Comparison. Rose SH, Burkle CM; Elliott BA, Koenig LF. Mayo Clin Proc. 2006;81(11):1449-1453

6. Sleeping Through the Night: How Infants, Toddlers and their Parents Can Get A Good Night’s Sleep. Jodi Mindell

1. Heading Home with Your Newborn: From Birth to Reality. Laura A. Jana MD, Jennifer Shu MD, American Academy Of Pediatrics. 2005.

End of Rotation Checklist:

Note: Must have done 10 activities, 6 core and 4 elective

Items with a * have an attached form

Required:

Attend 4 day check-up. Date

Attend 2 week check-up. Date

Read parenting book and complete book review*

Write a one-page reflection on: how being a parent affects your relationships with the parents of patients and your vision of yourself as a pediatrician (if you are a new parent) or how not being a parent affects your relationships with the parents of patients and how knowledge from this rotation may help that relationship

Visit a Child Care facility and complete the review.

Give noon conference on topic of choice and turn in copy of slides or create a handout/smartphrase etc for either parents or residents that provides helpful insight into parenting a newborn

Optional:

Visit to the Safety Center for car seat installation

Attend parenting group*

Videos: See Supplemental materials for a list of possible options*

Exercise or wellness activity with infant: See Supplemental materials for a list of local options

Library or language development activity with infant: See Supplemental materials for a list of local options

Read internet parenting sites. Include at least one anti-vaccination or anti-fluoridation site. See Supplemental materials for recommended sites.

Babies R’ Us Equipment inspection*

Visit parenting/breastfeeding specialty store

Meet with another resident and a faculty who already have children to discuss return to work and other experiences. Resident: Faculty:

Book Review

Title:

Did you find this book helpful? How?

Did you feel that the medical advice was sound, and grounded in evidence?

Did you disagree with any recommendations made?

Was the book easy to read while tired?

What tips did you feel were most helpful?

Would you recommend this book to new parents in your clinic?

Parenting Class Review

Class & Location:

Did you find this class helpful?

Did you feel that the medical advice was sound, and grounded in evidence?

Did you disagree with any recommendations made?

What tips did you feel were most helpful?

Would you recommend this class to new parents in your clinic?

Video Review

Title:

Did you find this video helpful?

Did you feel that the medical advice was sound, and grounded in evidence?

Did you disagree with any recommendations made?

Was the video easy to watch while tired?

What tips did you feel were most helpful?

Would you recommend this Video to new parents in your clinic?

Babies R’ US items to examine

Write down any concerns you have in looking at the product, and if you think it appears to be useful.

Boppy

Bumbo Chairs

Bouncy chairs/Walker

Household safety items: gates, door knob covers. Etc

Bath water temperature devices

Thermometers

Types of Bottles:

Baby Monitors:

Crib wedge cushions

Advanced breastfeeding: talk to a lactation specialist, attend a La Leche League meeting or join a breastfeeding class

Infant sleeper (for the bed, not clothing)

Child Care Facility Review

Name of facility:

Is the facility licensed? By whom?

Hours of care:

Cost for infant care:

Cost for toddler care:

Cost for late pickup or early drop off: Ratio of care providers for infants: Ratio of careproviders for toddlers:

Are all staff trained in infant/child CPR and First Aid?

Restrictions for attendance (e.g. fever, illness etc):

What kind of training/background do the care providers have?

Course Evaluation

Name_ (optional) Date (optional) What expectations did you have for thiselective?

Did the course meet these expectations? What are the strong points of this elective? What could be improved in this elective?

Did you find the multi-media offerings useful?

Further Comments: