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Going Home With Your Premature Infant

Congratulations to you and your family!

Your baby is gaining weight, learning to eat and graduating into an open crib! These are all signs that he or she is getting closer to going home.

You can help prepare your baby to go home by feeding, bathing, comforting, and taking charge of more of the daily care of your baby’s needs. This will make you feel more confident when you take your baby home.

Getting Ready
Finding a Pediatrician
Car Seat
Car Seat Safety Study
Classes
Hearing Screen
Eye Exam
Special Formulas
Feeding Readiness
Feeding at Home
Medications
Immunizations
Safe Sleep
Smoking
Noise
Follow-Up Phone Call
To Do List:
Online Health Information Articles

Getting Ready

Once your baby is in an open crib, you can start preparing to take your baby home. You will need to find a pediatrician, get a car seat that is the right size for your baby, sign up for the discharge class, and learn infant CPR. We also recommend that you arrange to spend a full day and optimally a night caring for your baby before you take him or her home.

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Finding a Pediatrician

Your baby’s doctor in the NICU and a social worker can help you find a pediatrician who will care for your baby after discharge. If you already have a pediatrician, be sure to tell your social worker.

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Car Seat

There are several car seats that are designed for a smaller baby. We also have 2 nurses who are specially trained in selecting and installing car seats. Should you need assistance, please ask the charge nurse to see if they are available.

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Car Seat Safety Study

Your small baby may not be strong enough to hold up his or her head while sitting in a car seat. All babies need to be in a car seat when traveling. For infants born under 37 weeks of gestation, we require a 90-minute evaluation prior to going home to ensure that she or he can breathe adequately while in a semi-upright position.

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Classes

To prepare to take your baby home, sign up at the NICU front desk to attend the free discharge class, offered weekly. Classes for infant CPR and discharge teaching are regularly available in English and Spanish. If you need another language or have specific learning needs for your family, please tell your nurse or social worker.

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Hearing Screen

All babies born at Alta Bates Summit Medical Center are given a hearing screen prior to discharge. The screening will be done when your baby is off
antibiotics, off oxygen and in an open crib. Larger babies with an expected
short stay may be screened on the second day of life.

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Eye Exam

Babies born under 30 weeks or under 1500 grams need their eyes checked for a condition called “retinopathy of prematurity” (ROP). This exam should happen no sooner than 4 weeks after birth. If your baby is going home before he or she is 4 weeks of age, you must schedule an outpatient appointment. If your baby has ROP, you must make a follow-up appointment before you go home with your baby. It is very important that you keep that appointment.

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Special Formulas

Babies sometimes require supplemental formula to maintain good “catch-up” growth and development. Your bedside nurse can help you practice preparing formula or fortifying breast milk. Continue feeding your baby preterm formula and/or fortified breast milk as long as your doctor advises.

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Feeding Readiness

It takes some babies longer to learn how to feed. Babies sometimes tire quickly while others may have dips in heart rate and oxygen levels (known as bradycardic, & apneic episodes, with desaturations As, Bs, & Ds) with feeding. Work with your bedside nurse, lactation consultant, and physical therapist/ occupational therapist to establish the right feeding practice for your baby. There are several feeding techniques that might help your baby reduce As, Bs, & Ds. Your bedside nurse can help you practice these techniques as you learn to feed your baby comfortably.

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Feeding at Home

Before you go home, take time to learn how to feed your baby, recognize “hunger cues” and know how much your baby should eat. Your baby may need to be awakened every 3 to 4 hours, even at night, to be certain he or she gets enough calories to grow. Your baby should have at least 6-8 wet diapers in 24 hours. Know your baby’s stooling pattern. Your breast-fed baby may continue improving his or her skills at home. Many preterm infants are able to consume their full volume of milk by breast feeding by their due date. As your baby gradually breast feeds better, you may gradually pump less.

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Medications

Babies often go home on multi-vitamins (poly-vi-sol) and iron supplements (fer-in-sol). Some babies may need additional medications. Your nurse will help you practice giving the medications to your baby. Check with your nurse about the medications your baby will need at home.

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Immunizations

We typically give all babies the Hepatitis B vaccine before discharge. Babies greater than six weeks of age may receive additional immunizations. In the winter months, for smaller babies only, we may give
Respiratory Syncytial Virus prevention medication. Your baby will need additional doses after discharge. Your pediatrician will help you with these arrangements. In addition, we recommend that caregivers of babies get immunized for Pertussis (whooping cough) and get the flu shot in the winter months.

Get more information at the Immunization Action Coalition website - www.immunize.org External Site .

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Safe Sleep

For Sudden Infant Death Syndrome (SIDS) prevention, babies should always sleep on their backs. Babies should also transition from swaddling for warmth to the use of sleep sack or blanket sleepers. Your baby’s crib should be flat, free from toys, pillows, bumpers, or blanket rolls. Your
baby should not share a bed with you or siblings, but must have his or her own safe sleep location near you. You must put your baby to sleep on his
or her back; however, tummy time is important for your baby’s development of upper body strength and the prevention of flat spots on your baby’s head. Encourage tummy time when your baby is awake and you are watching him or her.

Get more information from the California SIDS Program website - www.californiasids.com External Site .

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Smoking

Please do not smoke anything around your baby or allow visitors to smoke in your home. Babies’ lungs are fragile and easily damaged from smoke. Additionally, being around smoke can add to the risk of SIDS or childhood asthma.

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Noise

Exposure to loud noise can affect an infant’s long-term hearing. Help keep loud noises away from your baby. Turn televisions and music down around your baby. When your baby is in the car, remember to turn down the volume of your music as well. Vacuum cleaners or noisy toys can
also be overwhelming for your baby. Loud sounds can disturb your baby’s sleep and may impact his or her development. Your baby prefers the sound of your heartbeat and your voice and can enjoy this the most when he or she is held quietly, skin to skin.

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Follow-Up Phone Call

After your baby has been home for 1 or 2 weeks, you will receive a phone call from one of our NICU nurses. This is an opportunity for you to talk about your baby and ask any questions that you may have. Call 510-204-2091 to reach the nurse.

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To Do List:

Identify a Pediatrician
Add Baby to Insurance Plan
Attend CPR and Discharge Class
Obtain Car Seat and Bring to NICU for Car Seat Safety Study
Practice Bathing Your Baby
Practice Feeding and Mixing Formula (if needed
Practice Giving Medications
Follow Up Programs (if needed)
Make Pediatrician and Other Necessary Appointments