Mütterberaterin

In this post I mentioned the Mütterberaterin in passing and promised a full post, so here it is.

First of all, let me say that Small Boy is our only child and was born here in Switzerland, so I have no first-hand experience with pre- or post-natal care in the States. I hear things from friends who have had their children in the States, and while living there I sort of culturally absorbed stuff the way people do, but I have no direct experience. It's possible that somthing similar to the Mütterberaterin exists in the States, though I rather expect that it doesn't.

After we took Small Boy home from the hospital - where I stayed for five nights, which is fairly standard for a normal non-complicated vaginal delivery - we got a phone call from the Mütterberaterin (I'm going to start calling her the MB so I don't have to keep typing that! and, technically, she is the Mütter- und Väterberaterin). The hospital had notified her that somebody in her region of responsibility had given birth. She called us to set up an initial appointment, and visited us the first time at our home. She asked about my labor and delivery, checked on Small Boy, and answered any basic questions we might have had - though we didn't have so many questions because the midwives in the hospital showed/taught us most everything about Small Boy care, plus I had a midwife visiting me at home after we were discharged. (Swiss law requires insurance companies to fully fund 10 days of midwife care - in my case I had six days of care in the hospital - a day of guided labor and five days of rest - so I was entitled to have a midwife visit me at home four times. These visits can occur at any time - they do not have to be consecutive nor do they have to follow discharge immediately.) The MB opened a file on Small Boy - date of birth; birth weight, length, and head circumferance; weight, length and head circumferance at discharge; name of our pediatrician; whether we were breast- or formula-feeding; whether we had any concerns (I recall at the time wondering if the spots in his mouth were signs of thrush, or just "pearls" - they were "pearls").

Now comes the cool part. Five mornings a week the MB takes telephone consultations - I can call her with questions about something Small Boy is doing (say, spitting up a lot) or not doing (say, falling behind some developmental milestone like grasping objects) and twice a month she has open hours in the community church were we can take Small Boy and she'll weigh him, measure him, generally check him over, and answer any questions we might have. And this is free. All free. Technically, since the MB is a government sponsored position, we pay for it through our local taxes, but we can visit twice a month 12 months a year for years and never pull a franc out of our pockets. Regular use is in fact encouraged. When we were discharged from the hospital we received a little health notebook for Small Boy. There is basic care and developmental information inside, pages to keep track of developmental milestones acheived, pages for the pediatrician to record regular visits (there is space for 11 standard checks from 4 weeks to 14 years), an immunization schedule, and two pages for the MB to record weight, length, and comments. They clearly expect you to visit the MB. The MB also has her own files on which she records everything, so when I call her she can pull Small Boy's chart and see where he stood last time we talked/saw eachother.

The MB is neither a licensed doctor or registered nurse; it is a specific position here in Switzerland that requires its own Ausbildung (education and training). A MB will be responsible for a specific geographic area - say, several towns in the country side or a particular neighborhood in the city. So when we move to the new apartment, Small Boy will get a new MB. I assume our curent MB will forward his files, or give them to us to deliver to the new MB. Since they are paid from local taxes, once we leave here I'm pretty sure we can't keep coming back here for check-ups. That's too bad, because I like our MB. She is a no-nonsense, don't worry unnecessarily type and has many years of experience behind her.

It's a great set-up. You can keep track of weight and development without constanly running to the pediatrician, and nip any looming issues in the bud. Of course, for things outside the MB's area of expertise she will recommend seeing the peditrician, but a lot of what parents worry about fall within her training. Somebody with experience and a knowlege of child development - and first hand familiarity with the wide range of development that is still considered normal even if it doesn't follow the charts exactly - sees your child regularly and can pick up on anything that doesn't "seem right" and, possibly more importantly, reassure parents that something we think doesn't "seem right" is nothing to worry about. She can give advice on how to help baby sleep, what kinds of solids to introduce, what foods eaten by a nursing mother might upset a baby's stomach, what types of toys and games help develop particular skills and muscle groups, and so on. She's like a baby book that gets to see and touch your child. And I love it.

We are, in fact, going to the MB today after Small Boy wakes up from his nap.

Update: We're back. Looks like we're going to have to start calling Small Boy "Long Boy" - at 68 cm he jumped to the 90th percentile for length. Up until now he'd been tracking the 75th.