Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-08-07 Encounter: Spruce text message followed by in-person home visit (NP Catherine Watson visiting the home on 2026-08-08) CC: Newborn with 9% weight loss on day of life 2, concern for adequate feeding, and parent-observed jaundice on first night home. HPI: August (Gus) was born on 2026-08-05 at 8 lbs 14 oz. On day of life 2 (2026-08-07), the on-call pediatrician noted a 9% weight loss and recommended follow-up weighing by Saturday to assess need for supplementation. Mother was uncertain whether her milk had come in, reported heavier breasts, seedy green stools, and limited output with hand expression; lactation was not offered during the hospital stay. On the evening of discharge (2026-08-07 into 2026-08-08), mother noted Gus appeared jaundiced and expressed concern about a hemolyzed bilirubin lab result from the hospital. Gus was relatively sleepy but waking on his own to feed approximately every 2.5 hours with good diaper output. Assessment: Newborn with expected physiologic weight loss of 9%, requiring weight recheck to determine need for supplementation. Jaundice noted by parent; NP reassured that dirty diapers help clear bilirubin and that jaundice clears from bottom up (face and eyes last to normalize). Hemolyzed bilirubin lab result reviewed by NP via screenshot. Overall clinical picture reassuring given active feeding and good diaper output. Plan: NP Catherine Watson arranged a home visit on 2026-08-08 (approximately 4:20 PM) for weight check and clinical assessment. Mother instructed to continue breastfeeding every 2 hours. Parent sent screenshot of hospital bilirubin lab results for NP review. Home visit confirmed for weight monitoring and jaundice evaluation; supplementation decision deferred pending visit findings. No prescription sent. Key clinical quotes: "It's reassuring that he's making dirty diapers- that brings down the bilirubin" "The yellow faded from the bottom up so he face and eyes will be last to normalize" "just trying to maximize your number of visits" Source: Spruce conversation t_2NG6VL41Q8800