Bringing Your Premature Baby Home

If your baby was born prematurely, you may have waited days, weeks, or even months to take your baby home. But when the day finally arrives, it can be hard to leave the security of the hospital.

You might feel anxious about caring for your baby at home, but the care team doesn’t let babies leave until they are well enough to go. With some preparation and planning, you'll be ready too.

When Can My Baby Go Home?

To be discharged from the hospital, your baby must meet certain guidelines to ensure good health and fewer medical problems. Some hospitals require a minimum weight for discharge, but more often, the care team checks to make sure your baby is:

• steadily gaining weight
• taking feedings by bottle or breast without supplemental tube feedings
• maintaining their body temperature in an open crib (with no warmers) for at least 24–48 hours

Most babies meet these goals in the weeks before reaching their original due date. Infants who have had surgery, were born with health problems, or who spent weeks on breathing machines and oxygen are more likely to stay beyond their original due date.

How Can I Prepare to Bring My Baby Home?

Before you all leave the hospital, the care team will make sure you feel comfortable caring for your baby on your own. Some hospitals offer a rooming-in period in a hospital room with your baby so you can get some hands-on caregiving experience. You’ll have peace of mind knowing that help is just down the hall.

If your baby is a boy, you'll need to decide about circumcision. Full-term baby boys usually can be circumcised before they leave the hospital; generally, the same applies to a healthy preemie.

As your baby progresses, get ready for the big day and the weeks that follow with these 5 steps:

Step 1: Check Medical Records and Insurance Coverage

If you haven’t already, call your health insurance company and ask to have your baby added to your policy. Many insurers require that you do this within a few days of the birth.

Some insurers offer home nursing visits for premature babies or other nursing care for those with complex medical problems. Nursing providers and social service workers/case managers can help you find out what your insurance coverage will provide.

It’s a good idea to set up a file for medical records, financial statements, and other important papers you may need for your baby’s medical care and insurance.

Step 2: Choose a Pediatrician and Schedule Follow-Up Visits

Find a doctor who has experience caring for premature babies and, if your child has equipment like oxygen or tube feeds, special health care needs. Often, someone on your care team can recommend a pediatrician.

Then:

• Schedule the first visit visit before your baby goes home. Check with the care team about when this visit is needed — it’s usually within 2–4 days of discharge from the hospital (unless the pediatrician is already caring for your baby while in the hospital).
• Schedule any needed routine tests, including blood, hearing, and vision tests. Make sure you understand the tests needed after discharge and where to get them.
• Find out if your baby needs home nursing or visits with medical specialists other than a pediatrician. If so, ask for referrals and contact info for those health care providers. In some cases, hospitals can coordinate several specialist visits so that they can happen on the same day. Ask if this service is available to you.

Many former preemies continue to see specialists — including early-intervention specialists, neurologists, ophthalmologists, and physical therapists — for several years to measure their vision, hearing, speech, and motor skills. Following up with these specialists is important to make sure your child gets the best possible care and outcomes.

Step 3: Learn CPR and Get Any Specialized Training

Consider taking an infant CPR course before your baby comes home from the hospital. This training is required for all parents whose children are on apnea monitors. Make sure your partner takes the course, as well as grandparents or other caregivers who will be alone with the baby.

The care team may be able to recommend a program or provide the training in the hospital. The American Heart Association and the American Red Cross also can provide information on training.

If your baby will be sent home with special equipment — such as an apnea monitor, oxygen tank, or feeding pump — you'll be trained to use it. Make sure you understand what to do if something goes wrong. It’s also a good idea to check to see if your county or state offers preferential parking stickers to parents with children on home oxygen. You can also call the local rescue squad to make sure they have equipment to handle a premature infant emergency and, if you live in a rural area, make sure they know how to get to your home.

Step 4: Install a Car Seat & Get Any Needed Travel Equipment

Before heading home, your preemie will need to be in an infant-only car safety seat with a 3-point or 5-point harness system or a convertible car safety seat with a 5-point harness system.

Most car seats need to be modified with head supports so that a preemie's head stays in a position that keeps the airway open. Preemies often don’t have the muscle control needed to keep their heads upright or to move them if having trouble breathing. Ask the care team before adding any extra padding to a car seat.

Many hospitals require that parents bring in their car seat for a test. The baby is placed in the seat and attached to a cardiopulmonary monitor that evaluates their heart and breathing. Some babies have respiratory problems that prevent them from traveling in a traditional infant car seat. If that's the case with your baby, ask the care team about using a special restraint system.

If your baby will be on oxygen or an apnea monitor at home, you'll need to use these devices while traveling in the car. Secure them carefully so in the event of a crash they won't be dangerous to passengers. If you have any questions about whether your vehicle is properly outfitted for the ride home, talk to the care team before you leave.

Because of potential breathing problems, it's generally recommended that parents limit the time a preemie is in a car seat to an hour or so. If you need to travel longer than that, ask your doctor if it is OK for your baby. Once home, do not leave your baby asleep in the car seat. Instead, lay your baby on their back in a crib to sleep.

Step 5: Attend a Discharge Meeting

Although it varies from hospital to hospital, expect a meeting to review medical care after discharge, confirm follow-up visits, and allow you time for questions about caring for your baby. All meetings should include a talk about home care. Make sure you understand all the instructions and advice and ask questions.

When you leave with your baby, make sure you have the telephone number for the NICU. The care team can be a valuable resource, especially in the gap between discharge day and your baby's first doctor's visit.

With preparation and planning, you’ll feel confident about safely taking your baby home.