Table 2 Potential concerns to be assessed at 1–2 weeks postpartum by a project nurse in the home

Infant

Feeding:

• Infant weight (< birth weight)

• < 3 wet diapers in 24 hrs

• < 1 stool in 24 hrs

• Infant given other food/fluids other than breast milk or formula

• Infant not receiving vitamin D supplements

Safety:

• Sleeping prone (↑ risk of Sudden Infant Death Syndrome)

• Infant rides in car without car seat

Infection:

• Purulent discharge from eyes or conjunctivitis

Hyperbilirubinaemia:

• Jaundice visible below the umbilicus

General health:

• Blood in stool

• Persistent vomiting and/or black/green/red in colour and/or copious amounts (> 250 mls) of vomit in the last 24 hours

Psychosocial:

• Insufficient clothing (as measured by < 1 change of indoor clothing, inappropriate outdoor wear, < 1 blanket)

Maternal

Pain:

• Uterine → visual analogue scale (VAS) pain score > 4 in past 24 hrs (based on WHO Pain Ladder)

• Perineum → VAS pain score > 4 in past 24 hrs

• Breast (general) → VAS pain score > 4 in past 24 hrs

• Breasts (engorgement) → VAS pain score > 4 in past 24 hrs

• Nipples → VAS pain score > 4 in past 24 hrs

• Back pain → VAS pain score > 4 in past 24 hrs

Bleeding:

• Soaking > 3 pads per 24 hrs

• Clotting

Breast care:

• Pain while breastfeeding → VAS pain score > 4 in past 24 hrs

• Pain prohibiting breastfeeding

Infection:

• Perineal discharge

General:

• Blood pressure (diastolic >90 systolic < 90 mm Hg)

Psychosocial:

• Signs of depression (score ≥ 10 on the Edinburgh Post-natal Depression Scale [91])

• Absence of social support (as measured by the Personal Resources Questionnaire – Q 11 [71]

• No knowledge of tel. #911 in case of severe health problem or if in danger (self or infant)

• Inadequate food (i.e., Woman has missed or reduced meals because of lack of resources to buy food)