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 they feed and burp
- bring feeding bottle that you hope to use at home to the hospital and discuss this with the nurses to see if it is appropriate for your baby
- practice giving their medicines (vitamins)
- watch how they breathe and their bowel movements
- notice their skin colour and temperature
- 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:
- their short-term health problems will be resolved
- possible longer-term problems will have been identified
- They are 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 it is important that you locate one close to where you are living. 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. There may also be other appointments such as eye check ups and possibly hearing check. You will be informed of these prior to discharge. It is a good idea to have a small diary or planner to keep track of appointments.
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. 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 will be given information regarding the timing of your babys vaccination schedule and some babies may have commenced these in the hospital so it is important to keep up to date.
Understanding Medicines and Special Instructions
Make sure you understand how to spot signs of any sicknesses or other problems your baby could encounter after leaving the hospital. Understand the importance of safe sleeping for your baby from the recommended guidelines, you will receive a copy of these. Ask how long your baby will require vitamins and if your baby is on a special formula how long should that continue.
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, formula milk if applicable, soothers, etc. Discuss these with the nurses looking after your baby. (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 your baby.
For the same reason, holding the baby should be encouraged but kissing the baby should be avoided. Take care not to overhandle the baby.
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 that smoking is strictly prohibited in your house 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 test 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.