What to Expect When Bringing Your Baby Home From NICU

Your baby has had a rough start and has spent some time in the NICU (Neonatal Intensive Care Unit). You know that they are going to be coming home soon and you are both excited and scared. Don’t be alarmed by how you are feeling; under the circumstances, that is perfectly normal. After all, you aren’t a doctor or a highly trained, experienced professional. Rest assured, your medical team takes many factors into account when they consider discharging your child, and certainly at the top of this list are medical factors, but they also consider how ready you are and the level of care that will be needed at home. Also of concern to the doctors is the length of hospital stay. They want you to be able to bond with your infant, which is difficult in a hospital environment, and they want to reduce the risks of exposure to hospital acquired infections. They also know that a parent that is prepared for discharge and will be attentive to follow-up care needs and will work to reduce the risks posed to your child. With advances in technology, many pre-term and ill infants are discharged with the need for ongoing supportive care. Chief among these are nutritional and respiratory support, including supplemental oxygen.

Nutritional Support

Ideally, your child learned to suck from the trained professionals in the NICU, however sometimes premature babies aren’t able to metabolize their food properly and may need supplemental feedings. If your baby hasn’t learned to suck and the doctors think that they may need long term tube feeding, your child may need to have a Gastrostomy tube inserted. This tube is surgically inserted into the stomach through the abdomen. Through this tube your child will receive formula, fluids, and medicines. Before discharge, you will receive education on the care of the gastrostomy tube.

Respiratory Support

If your child still has complications of prematurity that are affecting their respiratory system, they may be discharged with supplemental oxygen. Your child also may need to have machines that monitor their heart, breathing, and oxygen levels. Some more critically ill infants may be discharged with mechanical ventilation. In this case your child will also need home-nursing support, at least for part of the day.

Discharge Planning

Discharge planning begins shortly after your child is born. Your medical team knows that to transition your child from the NICU to your home multiple criteria will need to be met. Chief among these criteria are:

Parental Expectations During the Hospitalization

  1. You need to spend as much time as possible with your baby while they are in the NICU, and assume as much of their care as you are able. This will help your confidence level as discharge becomes imminent and prepare you for assuming the lead caregiver role.
  2. Attend all educational trainings offered and ask questions when you don’t understand something.
  3. Identify at least two caregivers that will assume the bulk of responsibility upon discharge. Both caregivers need to be competent in all aspects of your baby’s care.
  4. If your medical team does not make a list of skills that you need to learn, ask them to.
  5. If your baby has older siblings, you need to talk to them about the baby and the baby’s illness. They need to understand that the baby will require extra help. It is important for older siblings to understand that the child’s illness is not their fault.

Discharge Tips

  1. Although ill, your baby still needs to receive standard immunizations.
  2. You will need to utilize a car restraint system, either a car seat or a car bed as appropriate to your baby’s needs.
  3. Identify your social support system. You need to care for yourself and for your relationships. Expect to feel overwhelmed, scared, and angry. Rely on your family and friends for support, whether it is visiting your baby when you can’t, or for a shoulder to cry on.
  4. If your child needs technology assistance on discharge, develop a relationship with the company that supplies their durable medical equipment (machines, oxygen, supplies). Know the company’s hours of operation, their policies, and have all their contact information readily available.
  5. Develop an emergency plan and have it posted in multiple places in the home.
  6. If your child has nursing staff, establish house rules for them. Remember that they are in your home and that this is your baby. If you are concerned with the care or behavior of nursing staff, speak up.
  7. Be kind to your child’s caregivers. They are part of your support team.
  8. Don’t forget that you are your baby’s strongest advocate.
  9. Follow-up care is essential to your baby’s continued progress. Keep a well-documented calendar of scheduled appointments.
  10. Take care of yourself. If you become ill, you can’t care for your baby.
  11. Screen visitors for illness. You can’t be too vigilant. A cold or major illness can be extremely dangerous for your baby.
If you are the parent of a premature infant that will be discharging from a greater Cincinnati NICU in the next month, contact RSVP Home Care. They are the #1 provider of pediatric home care in the greater Cincinnati area. With a full line of durable medical equipment and medical staff that are experts in respiratory therapy, they are your go-to source for meeting your baby’s needs.