Premature babies often need time to "catch up" in both development and growth. In the hospital, this catch-up time may involve learning to eat and sleep, as well as steadily gaining weight. Depending on their condition, premature babies often stay in the hospital until they reach the pregnancy due date.
If a baby was transferred to another hospital for specialized NICU care, he or she may be transferred back to the "home" hospital once the condition is stable.
Consult your baby's doctor for information about the specific criteria for discharge of premature babies at your hospital. General goals for discharge may include the following:
- Serious illnesses are resolved
- Stable temperature. The baby is able to stay warm in an open crib.
- Taking all feedings by breast or bottle
- No recent apnea or low heart rate
- Parents are able to provide care including medications and feedings
Before discharge, premature babies also need an eye examination and hearing test to check for problems related to prematurity. Parents need information about follow-up visits with the pediatrician for baby care and immunizations. Many hospitals have special follow-up health care programs for premature and low birthweight babies.
Even though they are otherwise ready for discharge, some babies continue to have special needs, such as extra oxygen or tube feedings. With instruction and the right equipment, these babies are often able to be cared for at home by parents. A hospital social worker can often help coordinate discharge plans when special care is needed.
Ask your baby's doctor about a "trial run" overnight stay in a parenting room at the hospital before your baby is discharged. This can help you adjust to caring for your baby while health care providers are nearby for help and reassurance. Parents may also feel more confident taking their baby home when they have been given instructions in infant CPR (cardiopulmonary resuscitation) and infant safety.
Premature infants are at increased risk for sudden infant death syndrome (SIDS) and should be sleeping on their back before being sent home from the hospital. Please talk with your infant's health care providers about these recommendations from the American Academy of Pediatrics (AAP) to reduce the risk for SIDS and other sleep-related infant deaths in infants from birth to age 1:
- Make sure your baby is immunized. An infant who is fully immunized can reduce his or her risk for SIDS by 50%.
- Breastfeed your infant. The American Academy of Pediatrics (AAP) recommends breastfeeding for at least six months.
- Place your infant on his or her back for sleep or naps. This can decrease the risk for SIDS, aspiration and choking. Never place your baby on his or her side or stomach for sleep or naps. If your baby is awake, allow your child time on his or her tummy as long as you are supervising, to decrease the chances that your child will develop a flat head and strengthen the baby's stomach muscles.
- Always talk with your baby's doctor before raising the head of their crib if he or she has been diagnosed with gastroesophageal reflux.
- Offer your baby a pacifier for sleeping or naps, if he or she isn't breastfed. If breastfeeding, the AAP recommends delaying the introduction of introducing a pacifier until breastfeeding has been firmly established. If your baby has already been taking a pacifier before he or she was mature enough to feed directly from the breast, don't panic. Ask for help from a lactation consultant for the transition to feeding from the breast if the baby is strong enough to do so.
- Use a firm mattress (covered by a tightly fitted sheet) to prevent gaps between the mattress and the sides of a crib, a play yard, or a bassinet. This can decrease the risk for entrapment, suffocation and SIDS.
- Share your room instead of your bed with your baby. Putting your baby in bed with you raises the risk for strangulation, suffocation, entrapment and SIDS. Bed sharing is not recommended for twins or other higher multiples.
- Avoid using infant seats, car seats, strollers, infant carriers and infant swings for routine sleep and daily naps. These may lead to obstruction of an infant's airway or suffocation.
- Avoid using illicit drugs and alcohol, and don't smoke during pregnancy or after birth.
- Avoid overbundling, overdressing or covering an infant's face or head. This will prevent him or her from getting overheated, reducing the risks for SIDS.
- Avoid using loose bedding or soft objects — bumper pads, pillows, comforters, blankets — in an infant's crib or bassinet to help prevent suffocation, strangulation, entrapment or SIDS.
- Avoid using cardiorespiratory monitors and commercial devices — wedges, positioners and special mattresses — to help decrease the risk for SIDS and sleep-related infant deaths.
- Always place cribs, bassinets and play yards in hazard-free areas — those with no dangling cords or wires — to reduce the risk for strangulation.