In the NICU
Leaving the NICU
But if it becomes clear that your baby will not be leaving the NICU, you will likely want to think about how you want to spend your baby's final days or hours.
Preparing for discharge
The special day you've been waiting for is almost here. Your baby will soon be ready to come home. Once your baby achieves the following milestones, she's getting closer to going home:
- Keeps herself warm
- Sleeps in a crib, not an incubator
- Weighs about 4 pounds or more
- Has learned to breast- or bottle-feed
- Breathes on her own
To help prepare you for going home and taking care of your baby full time, staff in the NICU will help you become comfortable feeding, dressing and bathing your baby. They will teach you:
- How to give her medications
- Take her temperature
- Use medical equipment at home
The more you practice caring for your baby while she is in the hospital, the easier it will be when you get home. Before your baby goes home, learn infant cardiopulmonary resuscitation (CPR). Your hospital may offer the class, or you can find one through the local Red Cross or fire department. Although you probably will never need to use CPR, it could help you save your baby's life in a medical emergency.
A team from the hospital, including your baby's primary nurse, will help you plan for your baby's discharge. They will refer you to any specialists or community services you may need, including equipment-supply companies. The social worker at the hospital often can help make arrangements for equipment deliveries, payment and other important issues.
If your baby is almost ready to go home, but not quite, your baby may move to the "step-down" or intermediate-care nursery for some additional recovery time. Although you are happy your baby is getting better, you may be a little nervous about leaving the familiar staff and routines of the NICU. A visit to the step-down nursery before your baby is moved may help ease your concerns.
The step-down nursery may be in the same hospital as the NICU, although not every NICU has one. Sometimes, babies are transferred to a community hospital closer to home. Your baby's doctors will discuss any transfer plans with you in advance. If you and your baby's doctors decide this is right for your baby, the baby probably will be moved in an ambulance.
The step-down nursery is usually quieter than the NICU. There are fewer machines because these babies no longer require the type of intensive care the NICU provides. Your baby needs fewer tests now. But she still needs a lot of care and rest to continue to grow and recover.
You may be nervous about caring for your baby on your own. Many hospitals give you the chance to "room in" with your baby for a night or two before she goes home. Parents often find this is a helpful way to prepare to go home with their babies.
One or both parents can stay with the baby and take charge of her care. But the nurse is there to answer any questions, if you have any.
A final checkup before discharge
Before the big day, your baby may have a few final tests, such as blood tests and a hearing test. Your baby may also be given a "car-seat test." Your baby's heart and breathing are checked as she sits in a car seat to make sure the positioning is safe for her. When all the test results are in and the baby is ready to be discharged, you can finally take your baby home!
The big day
The day you have waited for has finally come, and you're ready to take your baby home. Remember that it is normal to feel anxious about leaving the familiarity of the NICU. Before you leave, feel free to ask as many questions as you need to about caring for your baby. While it is common to be nervous, it's important for you to feel as comfortable as possible.
Babies who have been in the NICU should be followed up by a pediatrician who is well informed about the baby's NICU history and who can monitor the baby's medical and developmental needs. Some babies in NICUs are referred to early intervention programs either by NICU staff, their follow-up providers or parents themselves. These are free programs that offer a range of services to children under 3 years of age who have or are at risk for developmental problems. Many hospitals also provide various follow-up programs to assess how babies who have been in the NICU are doing. Speak to your baby’s health care team to learn more about these resources.
You will always remember this difficult and special time in the NICU with your child. Now it’s time to create new and beautiful experiences and memories, together, at home, where your baby belongs.