Care coordination

Welia Health’s approach to your whole health care utilizes a team of care coordinators. This team includes your primary care provider (physician, nurse practitioner or physician assistant), pharmacists, rehabilitation therapists, spouse and family members.

The team approach

The approach to care has many benefits, including:

• Improving your overall health plan and quality of life through shared decision-making processes
• Getting you the right care at the right time and at the right place
• Helping you establish connections with specialists, appointments, community services and resources

Learn how Welia Health improves patient care through innovation.

As part of our discharge process, our care coordinators also follow up with you within 48 business hours after your hospital stay to check in to see how you are recovering, review and help you understand any new medications and make sure you are able to care for yourself.

Child immunizations

Your Welia Health provider will discuss the typical well-child schedule and related immunizations at each appointment. The following vaccines are recommended for children ages 2 months to 16 years. Please talk to your Welia Health family medicine provider with questions or concerns.

1. If the first dose is given 12-23 mos, booster needed in 8 wks. If the first dose is given at 24-59 mos, series is complete in one dose.

2. If the first dose is given 12-14 mos, booster needed in 8 wks. If the first dose is given at 15-59 mos, series is complete in one dose.

3. Kinrix® can ONLY be used for fifth dose of DTaP. Must be Infanrix® if the child is 4-6yo and this will be their fourth dose and then no more; series is complete.

4. Newborns must be 6 weeks old for first set of shots (except HepB) at birth. Don’t start Rotarix® if baby is older then 14-1/2 weeks old or give Rotarix® after 8 mos.

5. 2, 4 and 6 month shots can be given early as long as they are at least 28 days between injections.

6. If given at ages 9-14, 2 shots separated by 6 month. If given after 15yo is a 3-shot series, second shot is 1-2 months after the first shot, and third shot is given 4 mos after the second shot.

7. If given at ages 11-12, booster needed at age 16. If given at ages 13-15, booster needed in 3 yrs. Only one shot needed if 16 yo or older.

8. Tdap Boostrix® given in third trimester of EVERY pregnancy no matter when the last one was given.

9. ProQuad® can only be used at 4-12 years and given subcutaneously.

10. Recommended annually for everyone 6mo and older.

11. Recommended annually for everyone 6mo and older. 2-shot series 3 weeks apart.

• Consider for high-risk patients: Hep B, Hep A, TIV or LAIV, PPSV23, MCV4.
• High-risk and immigrant populations, for more information, visit the Centers for Disease Control and Prevention or Minnesota Department of Health. 

Questions? 

Call Welia Health at 1.800.245.5671 or 320.679.1313.

Opioids 

Pain management

Both non-drug and drug treatments can successfully control pain, helping you feel more comfortable and get well faster. You and your doctors and nurses will decide which is right for you, including combining two or more methods.

If your provider considers a controlled substance to manage pain, it can include a prescription for an opioid, these include medications such as hydrocodone, oxycodone, fentanyl or morphine. It is critical to understand the risks and benefits associated with these prescriptions. Opioids are considered controlled substances with significant risks, including addiction, dependence, and other side effects. Opioid addiction is characterized by a powerful, compulsive urge to use an opioid drug, even when they are no longer required medically. Individuals who become addicted often prioritize getting and using these drugs over other activities, damaging their professional and personal relationships. When left untreated or not treated adequately, addiction can cause disability or premature death.

We want to ensure the best health outcomes for you, our patient. For this reason, if you are prescribed a controlled substance for chronic or daily use, your provider will closely monitor your medication use for your safety and the safety of our communities.

Risks of overdose

According to the National Institute on Drug Abuse (NIDA), opioid-involved overdose deaths more than doubled from 2010-2017, increasing from approximately 21,089 to 47,600. Opioid deaths saw a significant jump in 2020 to 68,630, and again in 2021 with 80,411 deaths.

• Recognize and respond to an opioid overdose
• Resources for safe drug disposal

Opioid addiction

Do you think you or someone you love may be dependent on opioids?  Addiction to opioids, also called Opioid Use Disorder (OUD) or Substance Use Disorder (SUD), is:

• A primary, chronic disease of the brain’s reward, memory, and related circuitry.
• More than a behavioral disorder.

Addiction can cause disability or premature death, especially when left untreated or not treated adequately. Like other health conditions, recovery from addiction is best achieved through a combination of self-management, mutual support and professional care.

Medication-assisted treatment at Welia Health

At Welia Health, we have a team of healthcare providers trained to prescribe medication to help individuals overcome opioid addiction. This is commonly known as Medication-Assisted Treatment (MAT). MAT is the use of medication, in combination with counseling and behavioral therapies, to provide a “whole patient approach” to the treatment of substance use disorders.

What will these medications do?

These medications relieve the withdrawal symptoms and psychological effects of chemical imbalances in the body. They provide a safe and controlled level of medication to overcome the use of an abused opioid.

What can I expect from my first visit?

Members of Welia Health’s care team and a physician will meet with you to assess your suitability for MAT. If you are a suitable candidate, a plan of care will be developed with you and members of the team.

If you or someone you know has concerns with opioid or other prescription pain medication addiction, contact Welia Health’s controlled substance care team at 1.800.245.5671 or 320.679.1313.

Common orthopedic procedures

At Welia Health, we know that when your daily activities like walking, running or going up the stairs, are disrupted due to injuries or conditions of the musculoskeletal system, you need Welia Health’s orthopedic physicians. Along with our team of physical therapists, they will tailor a plan to personally coach you through your office visits, surgery, follow-up appointments, and recovery.

Common orthopedic procedures performed at Welia Health include:

• Arthroscopy – A procedure using special cameras and equipment to visualize, diagnose and treat problems inside a joint.
• Fusion – A “welding” process by which bones are fused together with bone grafts and internal devices (such as metal rods) to heal into a single solid bone.
• Internal fixation – A method to hold the broken pieces of bone in proper position with metal plates, pins or screws while the bone is healing.
• Joint replacement – A procedure in which an arthritic or damaged joint is removed and replaced with an artificial joint called a prosthesis. Procedures include partial, total and revisions.
• Osteotomy – The correction of bone deformity by cutting and re-positioning the bone.
• Soft tissue repair – The mending of soft tissue, such as torn tendons or ligaments.

Descriptions from the American Academy of Orthopaedic Surgeons.

Orthopedic services are available in Mora, Hinckley and Pine City. Call Welia Health at 320.679.1313 or schedule an appointment using MyChart.

A referral may be required from your primary care provider, please check with your insurance carrier.

At home with your baby

There are things you will want to pay attention to when you and your baby are at home together.

Diaper rash

Common causes

• Infrequent changing of soiled diapers
• Introduction to solid foods
• Mother’s diet (milk products)

Prevention and treatment

• Wash your hands before changing
• Check diaper frequently
• Choose mild wipes
• Pat the area dry instead of rubbing
• Be sure the area is completely clean and dry prior to putting on a new diaper
• Use a cream or ointment with zinc oxide
• Try different diaper brands
• Mother’s diet (may need to eliminate an irritant)

Urine output

• After seven days of life, your baby should have at least 6-8 wet diapers in a 24-hour period
• If your baby is receiving enough milk, the infant will have adequate wet diapers
• Your baby should nurse at least 8-12 times per day

Poopy diapers

• After seven days of life, babies should have at least four poopy diapers a day
• His or her stool will change from sticky, black, tarry stools to brown, then to mustard yellow color (if breastfeeding)

Cord care

• Cleanse with soap and water once daily
• The cord will fall off on its own
• Watch for diaper irritation at the cord site
• Do not give your baby a bath until the umbilical cord site is completely healed

Crib safety

• Make sure you put your baby to sleep on their back
• Have a firm mattress with a fitted sheet and no toys, pillows, blankets, or bumper pads in the crib
• Keep your baby in a room near you
• Do not allow smoking around your baby or allow pets to be in the crib

Dressing your baby

• Babies have a harder time regulating their body temperature
• Dress your baby in one more layer than you are wearing and have extra clothing, blankets and bibs available

Birth control

With so many birth control options on the market today, having accurate, up-to-date information is the first step in deciding which is the best choice for you and your circumstances. A brief description of popular birth control options is listed below. Additional information about the number of pregnancies per 100 women, use, and risks and side effects can be found on the FDA website (PDF).

Remember, not all options provide protection against sexually transmitted diseases, and we advise you to speak with your healthcare provider about that.

Birth control options

Abstinence

In its simplest form, abstinence is the decision not to have sexual intercourse. However, it does mean different things to different people. Some people might view abstinence as refraining from all sexual activity. Others might engage in outercourse, avoiding penetration. Used as a form of birth control, when abstinence is followed 100% of the time, it is 100% effective

Natural family planning/cycle planning

Sometimes referred to as fertility awareness, natural family planning (NFP) is a contraception method where the woman carefully predicts and records her fertile and infertile days as cues about when to avoid sex.

Non-hormonal birth control/barrier options

• Condoms
• Female condoms
• Spermicide
  • Contraceptive substance placed vaginally or applied to the condom that immobilizes or kills sperm before they enter the uterus
• Diaphragm and cervical caps
  • Cup-like devices that fit over the cervix to block sperm from entering the uterus

Hormonal birth control

Short-acting reversible contraception

• The Pill (oral contraceptive)
• Nuva Ring (vaginal ring)
• Ortho Evra (the patch)

Long-acting reversible contraception (LARC)

• Mirena Intrauterine Device (IUD)
• Depo shot
• Kylcern IUD
• Nexplanon implant
• Paraguard (copper) IUD

Permanent, irreversible contraception

• Tubal ligation
  • An outpatient surgical procedure in which the fallopian tubes are either tied, banded, sealed off, or removed altogether, preventing an egg from traveling into the uterus.
• Vasectomy
  • An outpatient procedure performed on the male where the vas deferens, the tubes that carry sperm, are cut and the ends cauterized or blocked with surgical clips

Birth control and breastfeeding

There are several options that are safe to use if you choose to breastfeed your baby.

• Mini pill (progesterone)
• Depo shot
• Condoms, both male and female
• Spermicides
• Diaphragm and cervical caps
• All IUDs
•  Nexplanon
• Abstinence
• Ovulation monitoring/family planning

It is recommended that abstinence is practiced for at least six weeks after birth to give your uterus time to heal.

If you have questions about birth control, please talk with your Welia Health provider.

Postpartum recovery

You are not alone: Postpartum depression affects 1 in 5 new mothers. Postpartum recovery includes both your physical health and mental health. 

Your physical health

It’s no surprise that the dramatic physical changes that take place during and after pregnancy can result in discomfort and pain. Fortunately, physical therapy can provide some relief for pregnancy-related:

• Back or pelvic pain
• Urinary incontinence
• Swelling
• Difficulty with bowel movements
• Hemorrhoids
• Leaky breasts
• Transition back to work and breastfeeding
• Urinating with stitches

For more information, call Rehabilitation Services at 320.225.3356.

Your mental health

When caring for your baby is not what you expected, you are not alone. Although postpartum depression is common, it is serious—and treatable. If you think you might have it, tell your doctor or another health care provider. With help, you can feel like yourself again.

Could it be just the baby blues?

Having a baby brings big changes in a woman’s life. These changes can be overwhelming. While most moms get past the “baby blues” within the first two weeks, some moms struggle for longer.

Or is it postpartum depression?

If the baby blues last longer than two weeks, you may have postpartum depression. It is easy to confuse the symptoms of postpartum depression with normal hormone changes. How can you tell if it’s serious? Watch for these symptoms:

• Feeling sad, anxious or “empty”
• Lack of energy, feeling very tired
• Lack of interest in normal activities
• Changes in sleeping or eating patterns
• Feeling hopeless, helpless, guilty or worthless
• Feeling moody and irritable
• Problems concentrating or making simple decisions
• Thoughts about hurting your baby, even if you will not act on them
• Thoughts about death or suicide

What can I do?

Being a good mom means taking care of yourself. If you take care of yourself, you can take better care of your baby and your family.

• Get help. Talk with your care provider, call an emergency support line or ask a loved one to help you get the care you need.
• Ask your care provider about medicines that can be safely used for postpartum depression.
• Talk to a therapist, alone or in group therapy.
• Ask your faith or community leaders about other support resources.
• Learn as much as you can about postpartum depression.
• Get support from family and friends. Ask for help when you need it.
• Keep active by walking, stretching, swimming and so on.
• Get enough rest.
• Eat a healthy diet.
• Don’t give up! It may take more than one try to get the help you need.

What should I know?

It is very common for new moms to have the “baby blues.” They often start a few days after a baby’s birth. Usually, feeling sad and irritable will not stop you from taking care of your baby or yourself.
If symptoms interfere with your life or last longer than 2–3 weeks, you may have postpartum depression. This affects up to 2 out of 10 moms. It can occur at any time in your baby’s first year.
Women who have a history of depression are more likely to become depressed during pregnancy or after birth. Depression can be caused by stress, hormone changes, trauma, lack of support and other factors. If you are depressed, you need to get help. It will not get better on its own.

What are the most effective treatments?

The most effective treatment for depression includes:

• Individual or group therapy
• Medicine that can be safely used if you are breastfeeding (prescribed by your doctor)
• Support from your family, friends and community

Who can I contact for help?

A variety of resources are available for pregnant or new moms, dads or partners, infants and children. Review the list below, and talk with your Welia Health provider.

Emergency Hotlines

• For immediate help, call 911.

• 988 Suicide and Crisis Lifeline
  Call 988 (formerly the National Suicide Prevention Lifeline)

• National Maternal Mental Health Hotline
  Call or text 1.833.TLC.MAMA (1.833.852.6262)

Non-emergency Helplines

• Mother-Baby HopeLine at Hennepin Healthcare
  612.873.HOPE (612.873.4673). The HopeLine is not a crisis phone line. A mental health professional will call you back within two business days.

• Pregnancy & Postpartum Support Minnesota
  Call or text 1.800.944.4773. Text en Español 971.203.7773. Support and information provided by peer volunteers 7 days a week.

Additional resources

• Mental Health Association of Minnesota
  www.mentalhealthmn.org
  Includes culturally-specific resources.

• Redleaf Center for Family Healing
  612.873.HOPE (4673)
  www.redleaffamilyhealing.org

• Postpartum Support International
  www.postpartum.net

Local resources

• Pregnancy Resource Center
  315 Main St S Ste 20
  Pine City MN 55063
  10am–4pm | Mon–Fri
  320.629.2792

• Nurse-Family Partnership
  Your provider may suggest meeting with a home nurse.

• Mora Crisis Pregnancy Center
  114 Maple Ave W Ste 2
  Mora MN 55051
  11am–4pm | Mon–Wed
  320.679.4493

• Pine County Health and Human Services
  320.216.4150

• Kanabec County Community Health
  320.679.6330

Questions? 

Talk to your Welia Health provider or call us at 800.245.5671 or 320.225.3625.

This information meets the requirements of Minnesota Statute 145.906. For more information, call the Minnesota Department of Health (MDH) at 651.215.8960 or visit the MDH website.

Car seat safety

Having the best passenger safety practices is an important step to keeping your baby safe while riding in a vehicle.

Kanabec and Pine Counties have certified technicians that can help you install your baby’s car seat and check if you’ve installed it yourself to ensure it is done correctly. Call to make an appointment.

• Kanabec County
  320.679.6329 or 320.679.6338

• Pine County
  320.591.1597 or 320.216.4143

Open 8am–4:30pm, Monday–Friday. Both counties observe federal and state holidays.

For more information about car seat safety, visit Safe Kids Worldwide.

Reading to your baby

Even before your baby says their first word, he or she is learning about language through sounds, the combination of sounds, vocabulary, tempo and the rhythm of words and phrases. By the time your child is six years old, about 95% of his or her brain is formed.

Children who are read to, told stories, interacted with, and who visit the library may be better prepared to learn when they start school.

How does Welia support early literacy?

Welia Health has partnered with Reach Out & Read^® Minnesota, an organization that builds on the unique relationship between parents and medical providers, to develop critical early reading skills in children by incorporating books into wellness visits and encouraging families to read aloud together. Reach Out & Read is endorsed by the American Academy of Pediatrics and the National Association of Pediatric Nurse Practitioners.

How can wellness exams support healthy brain development?

When our Family Medicine providers perform child wellness visits (well child checks), a book is just as important as a stethoscope or tongue depressor. Books can be used as tools to quickly give input to some developmental staging in children but also to encourage parents to read aloud, giving them a simple, practical way of spending time and engaging in conversation with their young children. These parent-child interactions during the early years support healthy brain development that forms the base for success later at school and in life.

Wellness exams and books

At Welia Health, during your child’s wellness exam, they will receive a brand new, age-appropriate book to bring home and keep. We know the importance of a well-developed vocabulary and that it is a building block for children to become successful readers. By the time your child reaches age five, he or she should have a library of 11 new books.

• Newborn well-baby visit
• 2-week well-child visit
• 2-month well-child visit
• 4-month well-child visit
• 6-month well-child visit
• 12-month well-child visit
• 15-month well-child visit
• 18-month well-child visit
• 2-year well-child visit
• 3-year well-child visit
• 4-year well-child visit
• 5-year well-child visit

In addition, each February during I Love to Read Month, Welia gives away books to kids aged ten and under to promote early literacy.

Why is reading so important?

Reading aloud to children has been called the single most important activity for building the knowledge needed for reading success. It helps your child learn new words, learn about the world, learn written language and learn the connection between spoken and written words.

Because you are your child’s first and most important teacher, the best time to begin reading to your child is when he or she is an infant. Babies learn about spoken language when they hear family members talking, laughing and singing. They also learn about the written language when they hear stories and see family members reading. Numerous studies demonstrate the importance of developing vocabulary in learning.

Where can I learn more?

• Milestones for Early Literacy Development
• Home Literacy Environment Checklist
• A Menu of Activities to Encourage Literacy
• Toddler Reading Time

Questions?

At Welia Health, we want to do our part to help to increase literacy rates within our communities. For more information, call Welia Health’s Reach Out & Read coordinator at 320.225.3586.

Breastfeeding

The most natural way to feed your baby is by breastfeeding. It provides all the nutrition your baby needs during the first six months of life.

If you choose to breastfeed your baby, our OB staff will help initiate breastfeeding within an hour of birthing your baby.  We will encourage breastfeeding on demand and practice rooming-in, allowing mothers and babies to remain together 24 hours a day. 

Welia Health has certified lactation consultants to help new moms achieve their breastfeeding goals. They’ll also answer any questions you may have along the way.  Here are some of the more common questions we hear from new moms.

What should I expect after my baby is born?

For the first hour after birth, expect plenty of skin-to-skin contact with your baby. Expect assistance with positioning, “latching on,” how to tell when your baby is swallowing milk, infant behavioral feeding cues, how often babies should be breastfeeding, and how to keep a breastfeeding log.

How often should I nurse my baby?

Newborns need to nurse frequently, at least every two hours, and not on any strict schedule. This will stimulate the mother’s breasts to produce plenty of milk. Later, the baby can settle into a more predictable routine. As breast milk is more easily digested than formula, breastfed babies often eat more frequently than bottle-fed babies. As you and your baby learn, breastfeeding will get easier. You will know your baby is getting enough if the baby eats as often as every 1–2 hours and needs several diaper changes daily. By the end of the first week, 6–8 or more diaper changes and 8–12 feedings every 24 hours will tell you the baby is getting enough.

Breastfeeding also helps both mom and baby avoid many health problems. Children who are not exclusively breastfed for six months have a greater chance of health problems, including ear infections, type 1 and type 2 diabetes, overweight or obesity, leukemia, respiratory diseases like pneumonia or asthma, and diarrhea. Breastfeeding also reduces the likelihood of your child having allergies, illnesses and tooth decay.

Benefits for the baby

• Breast milk provides special protection.
• Breast milk is easily digested.
• Breast milk is the perfect food for premature babies.
• Breastfed babies have higher IQs.

Benefits for the mother

• Breastfeeding is convenient.
• Breastfeeding helps shrink the uterus and stop bleeding after birth.
• Moms may return to their pre-pregnancy weight quicker.
• Breastfeeding helps mothers and new babies bond.
• Breastfeeding will reduce time lost from work or school because of sickness.
• Breastfeeding honors values, heritage and traditions.

Benefits for the community

• Breastfeeding saves valuable natural resources and keeps our environment clean.
• Breastfeeding means fewer healthcare dollars will be spent on illness.
• Breastfeeding will reduce time lost from work or school because of sickness.
• Breastfeeding honors values, heritage and traditions.

Benefits for the future

• Breastfeeding may lead to less diabetes.
• Breastfeeding may lead to fewer weight problems for the next generation.
• Breastfeeding may lead to stronger and wiser leaders for the challenges of the future.

Is breastfeeding easy?

Breastfeeding is not always easy for everyone. Even once breastfeeding is established, it can present challenges for some. In all cases, however, try to remember:

• Breastfeeding makes you feel part of a miracle that you share with your baby. Every time you breastfeed, you give the gift of life.
• Breastfeeding is not painful, though your nipples may be sensitive at first.
• Trust your body to have enough milk. You will know your baby is getting enough if the baby eats every 1-2 hours and needs several diaper changes. By the end of the first week, 6-8 or more diaper changes and 8-12 feedings every 24 hours will tell you the baby is getting enough.
• You are giving your baby a gift that only you can give.
• Nurture yourself as you would nurture your baby. Be patient with yourself as you and your baby learn new things together.
• The longer a mom and baby breastfeed, the greater the benefits. Exclusive breastfeeding for 6 months before introducing solid foods benefits you and your baby the most. It is also recommended that you continue to breastfeed for 12 months and thereafter for as long as desired.

What if I need help breastfeeding?

At Welia Health, a certified lactation counselor (CLC) is available to support you with breastfeeding advice and education.

Lactation support can include:

• Correct positioning and latch
• Management of sore nipples
• Milk supply concerns
• Plugged duct and mastitis
• Pumping and storing breast milk
• Returning to work while breastfeeding
• Taking medications while breastfeeding
• Addressing individual questions and concerns

Call Welia Health’s Lactation Helpline at 320.225.3525.

How long can I store breast milk?

Breast milk may be stored for 4 hours at room temperature, 4 days in the fridge, and 6 months in the freezer.  Please visit the Center for Disease Control & Prevention for more information about the proper storage and preparation of breast milk.

• Store breast milk in 2-4 ounce portions to avoid waste.
• Clearly label breast milk with the date it was expressed or pumped.
• Use thawed milk right away or store in refrigerator for up to one day.
• Never heat breast milk in the microwave.

Ask Welia Health’s Lactation Consultants for this refrigerator magnet for a quick reference and reminder.

As a dad, how can I be involved with breastfeeding?

Many women who breastfed say they could not have done it without the support of their baby’s father. As a dad, you undoubtedly feel a great deal of pride, joy and delight at the birth of your baby. Although you can’t breastfeed your baby, you play a key role in the success of breastfeeding your baby!

• Change your baby’s diaper. It’s easy after the first few, and when a baby is breastfed, it doesn’t smell very bad.
• Give your baby a bath. This is one of the most fun things you can do with the baby.
• Bring your baby to your partner for feedings. Yes, even in the middle of the night.
• Bottlefeed your baby and give your partner some extra, needed rest. Moms can utilize a breast pump to collect milk which can allow others to help with feedings, creating additional bonds and potentially easing the transition to a bottle longer term.
• Spend time with your baby on your bare chest, touching, stroking, holding, and talking softly. Babies thrive on skin-to-skin contact.
• Cuddle and walk with a fussy baby – movement is calming for many babies.
• Talk, sing and read to your baby. Babies learn to speak from hearing lots of talking.
• Hold your baby while your partner takes a shower, naps or eats a warm meal.
• Give your baby a massage. Stroking and gentle massage can be soothing for both dad and baby.
• Play with your baby. Dads typically have different ways of playing with babies than mothers do. This is valuable for babies and fun for you too.

How else can dads help?

Give the new mom words of encouragement. She might need to hear them.

• “I am so proud of you and how healthy our baby is.”
• “You are doing a great job.”
• “Don’t give up. The first few days are the hardest – it will get easier.”
• “You’re giving our baby something no one else can.”

Questions?

Call Welia Health’s Lactation Helpline at 320.225.3625.