At Home

Newborn skin to skin with mom
Leaving the NICU and going home

At a certain point, most premature babies are well enough to leave the Neonatal Intensive Care Unit (NICU). Depending on their circumstances, their destination may be another ward at the hospital, a different hospital, or directly home with the rest of the family. Leaving the NICU can be a time of apprehension; many parents worry that their baby may still need all the support that an NICU provides.

This apprehension is both understandable and ironic. When a premature baby is admitted into an NICU, one of the things parents are often shocked by is the number of machines and staff on the unit. After a while, parents get used to both the machines and the human attention their baby is getting. After that, they are often comforted by the machines and attention which may have reinforced a sense that their baby is much more fragile than she really might be. Parents imagine that the attention both from machines and the staff at the NICU are essential for the baby to get well and grow.

While the overall level of care does at least initially contribute to the well being of a premature baby, at a certain point, most babies are capable of sustaining themselves and it is time to “cut another cord.” This time, however, instead of the umbilical cord, it is the cord of support provided by the NICU that is no longer necessary.

No premature baby will be released from the NICU before she is ready to leave. This is not to say that a baby has to be absolutely and perfectly healthy in order to leave the NICU. Babies may be transferred to another unit in the hospital or to another hospital closer to home to complete their recovery because they no longer need the intensive support of a NICU. Examples of this might be the completion of a feeding regime or a course of treatment with antibiotics. However, as parents of a premature baby, you will have to take some precautions and steps to prepare for your baby’s arrival at home. Staff at the hospital, specifically those responsible for patient discharge from the NICU and those at the hospital’s follow-up clinics, if they exist, can help you get ready for this day.

Stress

Parents of premature babies may have certain stresses and worries once they get home with their baby. They may feel that since their baby was premature and had to spend time in the NICU, their baby is more vulnerable to illnesses and minor accidents. While many of these fears are understandable, for the most part, they are unfounded. If there are specific precautions parents should be taking with their premature baby, they will be told what these precautions are.

Parents should remember that all babies, including those born full-term, get sick at some point. Just because a baby was born premature, it does not necessarily mean that she is more fragile than other babies, or more susceptible to minor diseases or injury.

Leaving the hospital

The end of treatment is an important milestone for your baby and your family. The goal of treatment has been to try and return your family to a normal life, and now you can begin to do this. Take the opportunity to celebrate your baby’s and family’s accomplishment.

There will be a transition phase as you start to return to your family routines. It’s not unusual for parents to have mixed feelings during this time. The happiness and relief at the end of treatment can be accompanied by anxiety or fear.

You may need to take action to regain that sense of safety and support. Stay in contact with the treatment team. Make sure that your baby gets the appropriate medical care and attends all follow-up clinic visits if they are available at the hospital. Learn about any symptoms or issues you should be watching for, and what you should do if problems arise. It may help to find or continue your relationship with parent support groups in the community or online.

Think of the end of treatment as the start of your family’s new life.

The Reverend Michael Marshall, M. Div.

Andrew James, MBChB, FRACP, FRCPC

10/31/2009


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