Tracy Hart's son, Everett, was born five weeks early.
But when Hart took him to the doctor for his 2-week checkup, the pediatrician quickly saw that she was the one who needed attention. Hart had been crying uncontrollably since his birth and was even thinking of suicide.
The pediatrician "picked up on it with lightning speed," says Hart, 38, whose son turns 1 today . "The pediatrician said: 'The way you're talking, and the way you look, you need to take care of this. You need help.' "
Hart followed the doctor's advice and got help for postpartum depression.
Although pediatricians are trained to treat children, there are times when they also need to take care of parents, says Everett's pediatrician, Kerith Rudnicki of Atlanta. "As a pediatrician, I can't treat the child in isolation," says Rudnicki, who notes that new mothers make far more visits to the pediatrician than to their own doctors, especially in the first weeks after delivery. And fathers may not see a doctor at all. "The pediatrician is the one who needs to be on the lookout for personal problems."
Protecting newborns
A growing number of pediatricians are now calling on their colleagues to address parental medical needs -- such as depression, smoking cessation and vaccinations -- that directly affect a baby's health.
"It's also our job to make sure that the parent is OK," says pediatrician Jennifer Shu, Rudnicki's associate. "Parents need to take care of themselves before they take care of a baby."
Pediatricians also can help o protect children from tobacco smoke -- which increases the risks of asthma, ear infections and sudden infant death syndrome -- by helping parents quit, says Jonathan Winickoff, a pediatrician at the MassGeneral Hospital for Children and an associate professor at Harvard Medical School.
In an article in this month's Pediatrics, Winickoff says hospitals should counsel new parents about smoking before they take their babies home. Winickoff offers to fax parents' information to a state-sponsored quit-line, whose staff then calls parents directly. He also prescribes nicotine-replacement therapy.
Winickoff also has become certified as a lactation consultant to help his patients' moms with nursing. Pediatricians don't normally get this training, even though breast-feeding offers babies innumerable health benefits. Helping moms succeed at nursing, he says, is "one of the most rewarding parts of being a pediatrician."
Shu helps parents protect their newborns by vaccinating them against flu and whooping cough.
Newborns are vulnerable to these infections, because it takes months for them to be fully vaccinated, says Joseph Bocchini, a pediatrician and infectious-disease expert. At his hospital, Louisiana State University Health Sciences Center in Shreveport, nurses offer vaccines to new moms in the maternity ward.
The majority of babies with whooping cough -- which can be fatal in newborns -- catch the infection from their families, Bocchini says. Fewer than 2% of parents have had whooping cough boosters, according to 2008 Pediatrics study by Shetal Shah of Stonybrook University Medical Center in New York. Only about 30% of parents of newborns are vaccinated against the flu, Shah found.
But most parents of babies in the neonatal intensive care unit, or NICU, were willing to get a free vaccine during their children's stays, Shah says. His hospital now vaccinates at least 90% of NICU parents. And based on his research, New York passed a "landmark public health law," which requires hospitals with newborn nurseries to offer flu shots to parents, Shah says.
But doctors acknowledge there are limits to what pediatricians can do for parents. A pediatrician may not know enough about a parent's medical history to safely prescribe medications such as antidepressants, and may not see the parent enough to monitor progress, says Katherine Heim, president of the American Academy of Family Physicians.
"What we'd prefer is for the pediatrician to pick up the phone and call the mother's physician and say 'I'm concerned about this,' " Heim says.
Heading off trouble
And while doctors can legally prescribe to anyone, regardless of age, malpractice insurers may not allow doctors to treat patients in areas in which they aren't board-certified, Shu says.
But Winickoff says pediatricians sometimes feel compelled to step in, such as with a severely depressed mother who doesn't have health insurance or who faces a months-long wait to see a therapist.
"I'll start them on the medicine and say, 'While we're looking for a therapist, let's make sure that we stay in touch,' " Winickoff says.
"But I can't just leave the person who is directly responsible for my patients, because if she is a wreck, that affects the health of my patient. I can't take that chance."
To see more of USAToday.com, or to subscribe, go to http://www.usatoday.com
Copyright 2009 USA TODAY, a division of Gannett Co. Inc.