NICU - Discharge requirements

When we got discharged D. was exactly 36 weeks old. Her age was not an indicator alone for the discharge decision though. Here is the list of the requirements WE had to meet to go home:

• Weight: There is a certain weight to reach as per your doctor's decision. If the weight and the average weekly weight increase is promising, doctors will let you know.

• Incubator stay: Preemie babies might require an incubator stay until they learn to regulate their body temperature. Moving into a crib from the incubator is one of the requirements for the discharge.

• Breathing: Having weaned off H2N2 flow. This means your baby is able to breathe without the help of a machine. I understand there are also cases where babies were sent home with a nasal canula if they meet all the other requirements and no longer need hospital stay/intensive care. However, in our case, we waited for her to wean off the machine as she did not need huge breathing support through the end of our stay.

• Feedings: In the hospital we stayed, they required all the feedings to be finished by bottle before you are ready to go. If your baby is able to latch, that is another story. However, our doctors did not completely rely on the breast until 36th week. They make sure your baby can get it all in before she leaves the hospital.

• Car seat test: This is done within the week before you leave to make sure your little one is ready for a car ride. You bring her car seat to the hospital, which he will sit in for 2 hours. During the test, the nurse monitors her heartbeat and breathing. Test is repeated until your baby passes it.

As preemies are smaller than most of the newborns, car seat test can get tricky. There was a family who left a few weeks before we did. They repeated the test several times. Somehow, their little one couldn’t pass the test even though he was all good to go home. Eventually, they found out car seat was not reclined enough. Once they changed the inclination setting, he passed it right away.

• Night stay at the hospital: Sometimes, they require you to spend a night at the hospital as a family in a room. This is an excellent practice for the family. I am so glad they made us stay the night and go through all the steps at night alone. If you need help, nurse is as close as a phone ring.

The biggest challenge for me was not having the monitors with us. In the past two months we relied on the monitors so much, I had no idea how we were going to survive without the screens. Spending a night there gave me courage to bring her home where we did not have any monitors to check her heart rhythm, oxygen levels and pulse.

• Blood test indicators: They run some final tests before you leave and give you supplements if needed or ask you to come in to check again in a few weeks time. D.’s hemoglobin level was low. We received one last blood transfusion the day before we got discharged to avoid any deficiency and were recommended to continue iron supplement. Her vitamin D level was also not close to the higher range, so we got prescribed vitamin D as well. We were also invited back in two weeks time to redo bone profile as we had a few indicators that required follow up.