According to March of Dimes, 1 out of every 10 babies will be born prematurely – meaning before 37 weeks gestation. For these preemies, the journey from hospital to home can take weeks, typically beginning with an extended stay in the hospital’s neonatal intensive care unit (NICU).
Premature babies receive highly specialized care and attention during their stay in the NICU in order to help them grow strong enough to be discharged from the hospital. Once released, what can preemie parents expect when they’re home with their tiny miracle?
Criteria for discharge from the NICU
Melissa Nurre is a neonatal nurse practitioner in the NICU at the University of Cincinnati Medical Center. When evaluating whether or not a premature baby is ready to be discharged and sent home, she says that nurses and physicians will consider the following:
- The baby should be able to maintain a normal body temperature while fully clothed in an open crib (as opposed to an enclosed isolette).
- There should be no instances of apnea (sudden pauses in breathing) for between 5 to 7 days.
- The infant must be able to eat a prescribed volume of food consistently for at least 48 hours.
- Consistent weight gain must be demonstrated.
- Vital signs (like blood pressure) are within normal limits.
Although highly trained NICU staff take extra measures to ensure that every preemie they send home is ready to go, Tiffany Arnold, owner and director of Nightingale Nannies in Cincinnati, and a registered nurse with over 15 years of experience working with infants, says it’s normal for parents of preemies to feel particularly nervous about their baby’s homecoming.
“I’ve learned that most parents are worried about circumstances that may have happened while their infant was in the hospital, such as temperature drops, breathing issues and feeding problems.” She says most hospitals work hard to help teach preemie parents how to identify and react to any issues they may face at home in order to help them feel more confident.
Nurre reiterates how important it is for hospitals to properly educate preemie parents on what to expect when bringing their baby home. “What and how we teach parents about the care of their premature baby after discharge from a NICU can alleviate their fears, strengthen parental bonding and decrease hospital readmission.”
Caring for preemies at home
Parents should know that if their premature baby has been discharged from the hospital, it’s because hospital staff have determined that the infant is healthy enough for home care. Still, there are a few things preemie parents will want to be prepared for.
Oxygen and feeding tubes
According to Nurre, obstetrics and neonatal medicine have come a long way in improving the lives of even the tiniest of patients. “Two unique challenges we still face, however, are how to safely discharge babies who may need supplemental oxygen and who are not completely finishing their prescribed feeding volume.”
Because of this, some preemies will get sent home with nasal cannulas for oxygen, or with nasogastric feeding tubes. NICU staff members are trained to help parents learn how to use and care for these tools, and follow-up visits help determine when babies are strong enough to discontinue them.
Attending follow-up consultations
Arnold says it’s very important for parents to attend all scheduled consultations post-discharge, as these meetings are specifically designed to address the baby’s unique needs. “Some babies will need occupational or physical therapy for muscular strengthening, speech therapy for feeding issues, or respiratory and cardiology consultations.”
Preemie developmental milestones
Pay attention to your preemie’s development milestones, but try not to become too anxious about their progress. Arnold assures parents that it’s normal for early babies to be a little late to the game. “We want parents to know that preemies’ developmental stages are based on a special preemie scale – not a full-term infant scale.” Nurre adds that while preemies are uniquely at risk for developmental delays, early intervention can help prevent them.
All new babies, bring joy – and jitters – to their parents. Nurre wants moms and dads to know that medical professionals are always there for support. “Trust your instincts,” she says. “If something doesn’t seem right, call your infant’s nurse practitioner or pediatrician to help you sort through any issues.”