Discharge Planning
Your baby had a whole team caring for him in the Baby Unit, and now you and your partner will have to do many of the things they did for him. This can be a scary thought, but there are steps you can take to help make the transition easier.
As your baby's discharge date approaches, you should spend as much time as possible with your baby at the hospital so that you will be comfortable caring for him at home. While he is still in the hospital, you should:
- feed your baby at least three or four times daily and observe how he feeds and burps
- practice giving his medicines (vitamins)
- watch how he breathes and has bowel movements
- notice his skin colour
- practice changing nappies, bathing and dressing your baby
When the day to bring your baby home finally arrives, be assured that your baby will be ready for the event:
- his short-term health problems will be resolved
- possible longer-term problems will have been identified.
- he is considered to be healthy and stable enough to leave the hospital with you
Arrange for Follow-up
The NICU team can help you make the move from hospital to home. If you do not already have a general practitioner, ask the doctor or nurse to suggest one prior to discharge. Your follow up will include return visits to the baby clinic and developmental clinic to follow your baby's progress. These appointments will be made prior to discharge.
What else can you do to get ready for baby's homecoming?
Ask the NICU nurse to help you make a list of the skills you will need when your baby comes home. Check off the items you already know and ask for help in learning the skills that are new to you. Read your notes and ask the doctor or nurse about follow-up appointments and who to call if you have any problems with the baby's medicines. Ask if you can call the NICU nurse with questions about caring for your baby. You should also ask about vaccinations and other baby shots before you leave the hospital.
Understanding Medicines and Special Instructions
Make sure your doctor explains to you how to spot signs of any sicknesses or other problems your baby could encounter after leaving the hospital. Ask about the most recommended sleeping position for your baby, and about vitamins and baby formula.
If your baby needs medicines, write down the names with a note about what each medicine is used for. Get instructions on how to give medicines and make a note of any possible side effects, as well as any special instructions. In the case of twins or triplets, if one of your babies goes home before the other(s), ask if you are allowed to bring him/her back to the NICU when visiting your other babies.
Special Equipment
In the rare case that your baby is going home with an apnoea monitor, oxygen or other special support, learn how to use this equipment.
CPR Cardiopulmonary Resuscitation
It is recommended both parents take training in infant cardiopulmonary resuscitation (CPR). This is provided by the medical team prior to discharge.
Supplies
Be sure to get in any special supplies you might need, such as premature baby clothing, changing mat, nappies, baby wipes, baby oil, a bath, sponge, baby bath lotion, creams, bottles, sterilizer, cot, pram, blankets, sheets, hanging - mobile, cotton-wool, babybuds, formula milk if using, soothers, etc.(Also see the separate section on baby supplies.)
Reducing the Risk of Infection
To reduce the risk of giving your baby an infection, make sure everyone in your home knows that it is important for family members and visitors to wash their hands properly before touching the baby.
For the same reason, holding the baby should be encouraged but kissing the baby should be avoided.
Ask your doctor if visitors are allowed into your home and also when no one should visit. Find out how soon you can take your baby out in public.
Remind family members and visitors not to smoke in your home and ask others not to smoke near your baby when you are out in public.
Also ask how much stimulation is best for your baby, and what signs to look for when the baby is over stimulated, tired or hungry.
Choosing a Car Seat
Ask for information about choosing a car seat for your new baby. Find out if the NICU staff tests for apnoea or bradycardia while the baby is in the car seat. Place the car seat in the back seat of your car and be sure to carefully follow the instructions about securing the seat. If you have access to the Internet, you can also visit the web site www.aap.org/family/carseatguide.htm for more information.
Reprinted with permission from "NICU Notebook: A Parent's Journal," by Maureen A. Doolan Boyle, copyrighted 1999.
