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When NICU Discharge Day Approaches: Getting Mentally Prepared

By Heather Cresswell, NP


It is normal for parents to feel nervous when that much-anticipated NICU discharge date finally approaches. Read on for some things to consider that may help you mentally prepare before bringing your premature baby home.


Discharge Dates May Change


“About the due date” is a common answer in those early NICU days when parents ask when their baby might go home. But discharge readiness is not about a specific date or age, but about when a baby is mature enough and medically ready to go home. Each baby is different, but there are some typical things healthcare providers will look for to know when a baby is ready.


Premature babies may be ready to go home when:

  • The baby can feed well without a feeding tube and gain weight;

  • The baby does not need monitoring for pauses in breathing or sudden drops in heart rate or oxygen levels (sometimes called spells);

  • ·The NICU team (including parents) are satisfied that the baby is medically ready (this may look different for each baby.


Some babies may need to be in the NICU until their due date or beyond. However, many babies are ready to go home many weeks before their due date. Communication between parents and the NICU team about discharge criteria can help parents plan.


Spend as much time as you can in the NICU.


For some, the NICU journey will be long, lasting weeks or many months. For others, it may only be a few days. Spending time in the NICU caring for your baby, especially as discharge approaches, can help build confidence.


It is common for parents to feel nervous at first when it comes to caring for their preemie and doing things like diaper changes, baths and feeds. As babies get closer to going home, parents who spend time in the NICU doing all of these things for their baby may feel more confident when discharge day comes.


There are a lot of factors that can make it hard for some parents to spend time in the NICU. Sometimes, parents have to work, care for other children, have transportation challenges, or just need a break from the NICU. Communicating with the NICU team can help parents and nurses plan together (for example, planning bath time for when parents will be present).


Get Organized, But Know That You Can’t Plan for Everything


Thinking about what life may look like once a baby comes home can help parents feel prepared.


Here are a few things parents may want to think about:

  • Who will be the baby’s doctor after discharge? Talk to your NICU team to see if they plan to refer your baby to a pediatrician (not all preemies will need this). In most of Canada, pediatricians provide consulting care, meaning the baby will still need a family doctor for routine check-ups.

  • Think about your supports. Friends and family may be looking for ways to support parents when a baby comes home from the NICU. Keep a list of people you can call if you need help with an errand, meals or housework, or getting a nap or shower!

  • Make sure you have the essential supplies. Part of feeling mentally prepared is knowing you have the necessities for your baby. Check out this blog post for a reminder of the must-haves before you bring your baby home.

  • Know that routines can change. A baby’s feeding, sleeping, and pooping schedule may change after discharge. Different lights, sounds and routines can affect the baby. Expect some changes while the baby adjusts to being home.

  • Make a list of questions. Keep a notebook handy or make notes on your phone for those questions that pop into your head. Some examples are in the box below.


 

Examples of questions to ask yourself (and your NICU team) before discharge:

  • Am I comfortable feeding my baby?

  • Are there any special diet instructions?

  • What medicine or vitamins will my baby need at home? Do I know when and how to give them?

  • Have I had enough practice bathing and dressing my baby?

  • Can I stay overnight with my baby before discharge?

  • What appointments do I need to make for my baby?

  • Is the NICU arranging any special follow-up appointments?

  • How will I know if my baby gets sick at home, and what should I do?

  • Do I have a safe space for my baby to sleep, and do I know the safe sleeping guidelines?


 

Reach out for Support


Any parent will tell you that having a new baby at home is exhausting. NICU parents may have additional stress as they process their birth and NICU journey. You are not alone.

The Canadian Premature Babies Foundation is here to support NICU parents. Visit the CPBF website and consider subscribing to emails to stay updated about all they have to offer, such as:



Before discharge, ask your NICU team what other parent supports they recommend.


If you are concerned that you may be experiencing post-partum depression or anxiety, reach out to your family doctor or healthcare provider right away.


Parents and caregivers: What are your suggestions for parents who may be getting ready for the big discharge day? Drop your tips in the comments!


Parent Resources:

· Canadian Premature Babies Foundation (social media, virtual support groups, education sessions, and more).

· Parent Care Program (links to mental health professionals)

· Canadian Mental Health Association (information about post-partum depression)


You can find more blog posts on various topics here: https://www.cpbf-fbpc.org/blog/categories/blog



References:


Heather Cresswell is a Neonatal Nurse Practitioner and health writer. As a nursing student in 1995, Heather discovered the NICU during a clinical placement and never looked back. She has spent her entire nursing career (more than 25 years and counting) caring for NICU patients (premature babies are her favourite!). When not caring for her tiny patients, Heather is also a health writer and is happy to contribute to the Canadian Premature Babies Foundation.

Heather lives with her family in Burlington, Ontario, and is a proud mom to one son.


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