Manitoba

More newborns showing up for emergency care during pandemic, Winnipeg pediatrician says

A Winnipeg pediatrician says she’s seeing a jump in newborns in need of emergency care during the pandemic — and she’s worried that trend will worsen in the coming weeks.

Early signs of jaundice, dehydration, poor feeding being missed without in-person visits: Dr. Lynne Warda

A baby is pictured holding an adult's hand. Emergency department pediatrician Dr. Lynne Warda said she's seeing an increase in newborns showing up needing emergency care. (Mongkolchon Akesin/Shutterstock)

A Winnipeg pediatrician says she's seeing a jump in newborns in need of emergency care during the pandemic — and she's worried that trend will worsen in the coming weeks.

Dr. Lynne Warda said that's because many of the issues babies are showing up with — from jaundice to dehydration to poor feeding and weight loss — are things that typically would have been flagged during an in-person visit in the first two weeks of their lives.

But with fewer face-to-face visits happening, those common conditions are often going unnoticed until they require hospitalization, she said.

"We're particularly concerned right now with the rising cases and also heading into the holidays, where we know many offices are closing [or switching to] holiday hours," Warda told CBC Manitoba's Information Radio host Marcy Markusa.

"It's going to be even harder to get face-to-face visits for these newborns."

Warda, who works in the children's emergency department at Health Sciences Centre, said that early on in the pandemic, the children's emergency department became eerily quiet.

In fact, she said the drop in babies showing up for care in the first two weeks of life was somewhere around 30 per cent.

Dr. Lynne Warda, seen in this file photo, works in the children's emergency department at Health Sciences Centre in Winnipeg. She says she's seeing a jump in newborns needing emergency care during the pandemic. (Holly Caruk/CBC)

"Part of the reason was we thought that probably the families were just scared to come in, not wanting to get sick from COVID," she said.

But then staff in the department started to see babies showing up with signs of jaundice, weight loss and dehydration much later in life than normal.

While those conditions are all fairly common for newborns, they weren't getting spotted early enough for typical treatments, like home phototherapy for jaundice cases, Warda said. 

"And then the baby needs to be admitted to hospital, which is obviously not what you want with your newborn," she said.

'Still facing these issues'

While emergency department visits for that age group are now back up to about normal, they're still seeing higher rates of admissions for certain conditions among newborns, Warda said.

Jaundice cases are up by almost 40 per cent this year, while visits for feeding difficulties and dehydration have climbed by over 20 per cent.

"So we're still facing these issues, and we believe it's [because of] a lack of face-to-face care and the ability of families to get their baby weighed at Day 3 to 5 to catch those more significant weight loss [cases]," she said.

Warda said she wants to encourage primary care providers like pediatricians and family doctors to make sure newborns are getting seen in those first days of life, even if it's a hybrid visit done partly by phone or virtually.

"They really need to have a weight done, in particular the babies that we believe are at highest risk for difficulties with breastfeeding, weight loss and dehydration," she said.

"So, for example, a first-time mom breastfeeding … is one who definitely needs a face-to-face assessment."

Warda said she knows it can be overwhelming for new parents to take in all the information they're bombarded with in hospitals.

But it's particularly important for parents to look out for what she calls red flags when they take their babies home — and to push to make sure they're getting face-to-face visits if they need them.

"You do need to advocate for your visits. It's going to be really challenging to get in over these next few weeks. Keep in touch with your primary care provider and your public health nurse," she said.

"Get all the support you can by phone and we will hopefully be coming up with further updates about other options that might be able to address this in the coming weeks."

With files from Wendy Jane Parker

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