At our hospital, it was generally considered bad karma to tell parents about a discharge date too far in advance. Most doctors and nurses stuck to the vague "around her due date" answer and we didn't push it because we didn't want our hopes dashed. As it became clear that discharge was close, the neonatal team gave us a target week, then a window of several days. Then one day during rounds we were told "if today's test come back clear, you can take her home the next day." Two days later we left the hospital as a family for the first time.
Here are some other preemie moms' experiences:
What kind of warning did you have before taking your baby home?
- "With DS we knew a week ahead of time, but didn't have a "set" date. With DD we had a weekend."
- "We called in the morning to check in before we went to see him. They said he would probably be going home that day - bring clothes for him. When we got there they started packing him to go. "
- "With Ian, we had about 3 days notice. Enough time for us to go through all the prep work for discharge. With Jack, we got about 5 minutes notice, lol! Apparently the NICU had called me to tell me that we could take Jack home, but phone was dead and I hadn't noticed. So we found out we were taking him home when we went to visit him. Luckily, they "counted" the discharge prep-work from taking Ian home to Jack's discharge and we'd already had both carseats in the car because we thought we were taking Jack home the next day, so it all went smoothly regardless of our lack of notice."
- "The NICU staff told us from the beginning that our son would be sent home on/around his due date, but he was actually discharged a few weeks earlier because he was doing so well. We had about 3 days notice that he would likely be able to come home that weekend. Our son had to be breathing on his own (still on oxygen, but no CPAP or ventilator) and eating consistently and gaining weight well without the aid of the gavage tube. My husband wants me to write that we felt rushed, which is true, but we also were relieved that the baby was doing well enough to come home."
- "Not too much - they told us a few days in advance."
As with everything else NICU-related, this varies a lot from hospital to hospital. So we asked preemie moms to share their experiences about discharge tests and trainings. Here are their experiences.
What kind of tests, trainings, or evaluations did your NICU require of babies and parents before sending them home?
- "We had to watch a CPR video and then be "quized" by the nurse."
- "We received training on the medical equipment we were sent home with (oxygen concentrator and spare travel tanks and apnea monitor) as well as a course on infant CPR for us and our son's grandparents who babysit frequently."
- "We had the eye test, hearing tests, and echocardiogram (our son has a murmer) in the last few days before discharge. The doctors scheduled all his tests for the same day, which really wore our baby out! I will never forget coming in after his eye test (the last test of the day) and seeing him in his bassinet, completely non-responsive to me (he was breathing and alive, just not happy or wakeable like normal) thinking he seemed like he'd lost the will to live. I would recommend having those tests not all scheduled back to back if you have any say in it."
- "We were lucky to leave without monitors so we had Pharmacy Training, where the hospital pharmacist comes by to make sure you understand how to administer the babies medicines, CPR, baby basics class, and that's about it"
- "We'd had to watch videos on CPR, shaken baby syndrome and something else prior to discharge (We saw them over the weekend since we knew the open air crib was a good sign). We had brief training on the apena monitor too. Other than that, nothing, not even a car seat test. We came in with the car seat, signed, the docs, and walked out of the hospital. It was kind of odd to be honest."
- "Each baby had to pass a car seat test. And they both had a modified barium swallow shortly before discharge as well as MRI's to check on the resolution of their brain bleeds. DD was also evaluated by the hospital's developmental clinic prior to discharge and the therapist gave us things to work on at home while we waited on her EI eval."
- "He had a hearing test and car seat test. We sign the okay for the hearing test when he was born and the car seat was brought in within 3 days of him leaving."
- "Car seat test, hearing test (we failed the first one) and all her medical tests (Head US, ekg, EEG, heart US, blood work etc.)"
- "Once a d/c date was set we have a hearing test, car seat test, and set up a visit by a home care nurse to check in and check his weight once he got home."
|Enjoying a strip of red pepper .|
I’d never heard of baby-led weaning (BLW) before reading about it on TheBump. I’d been planning to make my own baby food before I learned babies didn’t need to start on purees.
My blog can be found at Urban Flowerpot where I talk about raising Tristan and other fun things.
And, why not watch this sweet video made by Housewife Confidential?
Every hospital has a slightly different discharge process. Some require all parents to "room in" or spend the night caring for the baby in the hospital before coming home. Others require classes for parents and test for babies. We asked moms to share their experiences to help give you some perspective on what you might expect. Remember that these are just some people's experiences and your hospital may have a different approach!
What was the process like?
- "At our hospital we had to "room in" and stay a night (or two) prior to discharge. We had to be trained on the O2 and on the monitor. We also had to do CPR training...<--- This was at the hospital DS was discharged from. The hospital where DD was transferred and later discharged, we also had to watch videos on SIDS, a G-Tube training video and a few other "caring for preemie" videos. We also had to have pump training for DD's feeding tube and training on how to care for her G-Tube."
- "They just told us he was going home the morning of. The night he was admitted they told me he would come home around his due date. I didn't ask again. On Wednesday one of the nurses told me to start getting ready he would be home by the weekend -he was home Thursday. He came home at 35 weeks (1 week in NICU)"
- "Basically, we were given a packet of information we had to go over prior to discharge. They gave us the packet about 3 days prior to Ian's discharge. We also had to demonstrate that we knew how to change diapers, give baths, dress them, swaddle them and feed them. Luckily, we only had to demonstrate once and we got signed off for both boys. We also had to watch an infant CPR video and pass a quiz (I was exempt from this because I'm required by job to be CPR certified anyway, so I just showed my certification card to the staff). A day prior to discharge, the boys were circumcised (we're raising them Jewish, so it was for religious reasons, but we didn't want to circ them out of the NICU for obvious reasons!). They had to be monitored for 24 hours before they'd be released to us. The day we left with them, the nurses performed a carseat test. Luckily we didn't need any special training on any support devices because the boys weren't released with any. They also had to pass a hearing test and they got their first dose of the Hep B vaccine before discharge."
- "We roomed in the night before our son was discharged. We spent the night in a private room in the NICU that was designed to look like a hotel room with hospital equipment hookups. It allowed us to try up to a full day of "on-our-own" baby care with nurses just steps away if they were needed. We did wind up needing some help when our monitor was malfunctioning, but otherwise, we were pretty capable of taking care of his needs after weeks of doing cares in the NICU."
- "Normally the parents sleep in a transition room with the baby the night before (or multiple nights for parents whose children have medical issues) we slept in the transition room but she stayed in her own room. Discharge wasn't too difficult - we had some paperwork to go over and sign and then they just kind of disconnected her from her monitors and sent us on our way."
- "At our hospital parents only "room in" under some circumstances. Any baby going home with monitors, oxygen, or other equipment has to room in so the parents can make sure they know how to do everything. Doctors often also made parents room in if they did not feel like the parents knew how to care for their preemie. This was often parents who had not been very present during their child's NICU stay. Because I basically lived at my baby's bedside and she did not come home on a monitor, we did not have to room in. We just had to make it through a discharge exam and be released by several teams. Then the nurses packed us up and walked us out to the car!"
When my daughter was in the NICU, we didn't know when to expect her to come home. One doctor got our hopes up with "she'll be home for Easter!" then "Mother's Day!" We were elated each time but quickly learned that we couldn't get our hopes up that much. So we waited. And waited. It felt like forever. But finally she came home, about 2 weeks before her due date.
The whole time we wondered what the discharge process would be like. Here are some preemie mom's experiences with the discharge process to give you some perspective. Keep in mind that every baby, every doctor, and every hospital will have its own story so these may or may not be what you experience.
What was discharge like for you?
- "With the twins they came home at two separate times. When DS came home first it was bittersweet, I cried, oh did I cry. Leaving behind our "home away from home" for months, and leaving behind DD. We were so happy to have DS home, but leaving DD behind was sooo much harder then the first day leaving the hospital empty handed if you will. They days leading up to it we were excited and nervous. We found out that he was going to need O2 (for feeding) and a monitor about a week before he came home and it was so much chaos getting that all coordinated."
- "Exciting and rushed. There was some confusion because he was suppose to be circumcised and the NICU blamed the docs and the doc blamed the NICU if he got circumcised he would have to stay another 24 hours. We took him in to get circumcised to the doc office about 2 weeks after discharge."
- "Unfortunately, Jack stayed another 2 weeks in the NICU after Ian was discharged. That was hard, leaving Jack behind but we were thrilled to finally have at least one of our babies home with us. Ian left the hospital around 9pm on a Friday night, so there weren't many people there and it was pretty quick and painless. Jack left around 11am on a Saturday morning, again quick and painless due to prep."
- "We tried not to get too excited about discharge because we had seen our "neighbors" have set backs on discharge days so we didn't want to jump the gun so to speak. When we knew she was getting close we started to prepare but never said "its our last day." We roomed in the night before she was discharged but she couldn't stay in the rooming in room with us because of her MRSA infection so I slept in her room in the recliner. It never felt "real" until we were in the car on the way home the next day. I remember I sat in that recliner holding her all night and all the next day as "discharge" was taking place - It took forever - and I just sat there until the nurse came and took her from me to remove her leads."
- "It was fast. The neo called me Monday morning to tell me the results of her sleep study/reflux test that was run over the weekend (she'd moved into an open air crib upon hitting 4 lbs the previous Friday) and said we could pick her up anytime. I was at work and was like "anytime? do you mean the nurse will tell us when she's released?". I'm sure he thought I was an idiot."
- We had our discharge date changed three times in the course of week. First they wanted to get our baby's 2 months shot done before she was released, then we had more test to run, another ultrasound...it seemed like it would never end. Even on the day she was scheduled to come home we ended up waiting half the day for pulmonary results to find out if we were going home with a monitor or O2 after not being on it for over a month. But we made it home after everything!
1) I used a special needs feeder by Medela (the sell them on Amazon) to help teach him proper sucking techniques. It only allows milk to flow when the baby actually sucks (unlike a bottle that will constantly drip), so I think it helped "train" him to breastfeed. Here’s the link, but you can buy them cheaper than this.
2) I used ultra-slow flow nipples after I went back to work. Our NICU did a study to understand which nipples are the slowest flow, and they figured out it was the Similac Slow Flow nipples. They're sold as disposable, but you can wash and reuse them. We bought a case of 50, and we still have a bunch left. Here’s the link.
3) I used a nipple shield. That helped my son get milk when he was very tiny. After awhile, though, I felt like it was actually hindering his ability to get milk. I had to use a very small size for his tiny milk, and it hurt my nipple. I also think it sort of constricted the flow.
I just gradually increased the number of feedings I did by breast. My son was in the NICU so long that he came home on a pretty regimented 3-hour schedule. He'd take bottles at 3, 6, 9, and 12. the nursing didn't replace the bottles 1:1 (I usually had to nurse more often than I would have had to give bottles), so I'd allocate time periods where I would only nurse and not give bottles. So, at first, I'd nurse between 12pm and 3pm every day (replacing 2 bottles). Then I'd extend it to 6pm. Then 9pm. By that point, he was strong enough where he was nursing well, so we just went cold turkey to nursing, and we never looked back.
My son is still nursing at 10.5 months, and he's always gotten breastmilk. I went back to pumping when I went back to work, but it sure was nice to have a little while where we could just nurse on demand.
The likelihood of Placenta Previa persisting until term is something like 3%. I was pretty convinced it would resolve itself. None the less, I read up. I did my homework. I knew what the consequences could be. So when I woke up on April 29th – just 35 weeks and 4 days – bleeding, I knew we needed to head to the hospital. I had a feeling this baby was coming. We were lucky. They held out a few days. They wanted 36 weeks. As I spent my weekend in hospital, I spent my time googling…how bad could a 36 weeker be? It wasn’t that premature after all.
Crane makes a whole bunch of cute animals - or, this tuff dragon! raWr!
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Preemie Mom Blogs
- 2013 (10)
- 2012 (50)
- Did you have much warning before discharge?
- Before Discharge
- Attachment Parenting While Miles Away by Stephanie...
- No Mush, No Fuss! by Stephanie
- A NICU Christmas Story
- When enough (milk) isn't enough....by Melissa
- The Discharge Process
- How did you feel during the discharge process?
- Leslie + Reagan
- Amanda + Grayson
- Balancing Breastfeeding and Pumping With Our Micro...
- Caroline + Maura
- Michelle + Cameron
- My PTSD Journey
- Product Review: Crane Humidifier