What to Expect on Discharge Day

March 5, 2018

discharge dayRemember the saying, “Expect the unexpected?” It applies here too. On NICU discharge day.

Just like there are processes and procedures while your baby is in the NICU, there are processes and procedures for leaving the NICU. The NICU nurses will not send you home unprepared. Getting ready to leave and being prepared at home is all part of the NICU journey.

Here are some things you can expect, or inquire about, as you prepare for D-day.

Expect to be given some tools and training.

Often NICUs have the option for the parents to “room-in” prior to discharge. Many have a parent room with a bed and a bathroom. The nurses will wheel your baby’s NICU crib into the room and allow you spend the night with your child off the monitors. It’s a practice round for real life. The nurses and neonatologists are available if you need them. But the idea is for you to care for your baby on your own as much as possible. Spending the night with your baby in the hospital brings up questions you may not have otherwise thought to ask prior to leaving. If your NICU offers a chance to room-in I highly recommend taking advantage of this extra night at the hospital.

Your baby will do a Car Seat Test. You will bring your infant carrier to the NICU. It will be properly adjusted to your baby’s size. Then, your baby will be in the seat for a period of time while on monitors. This is a precaution so that you know your child is big enough and safe enough to ride in the car.

Another common preparatory tool is for you to watch videos about bringing your NICU baby home. One video we watched before our oldest son left the NICU was a CPR video. It was a great crash course prior to going home. The second was a video called “Never Shake a Baby.” My husband and I were a little put off by this one, until we got home and a few nights later were like, “Ooh! Now, I get it. Never shake a baby.” We joked that it would be nice if we could check our baby back into the NICU and let the nurses deal with all of the mid-night wakening, feedings, burping, etc. until he matured. But of course, it was a good prep for real life.

Expect to be overwhelmed.

You have been anticipating D-day for a long while. (Even if it’s been a short stay, it can still feel like a long time.) It’s exciting. You finally get to bring your little bundle home to all of the baby gear you registered for and are longing to use. It’s also scary. You now need to know how to look for signs and symptoms of distress. Also, you need to make sure your baby is eating well and gaining weight. You may even go home with some medical equipment like oxygen or a feeding tube. This requires a whole other level of education that the NICU nurses will help you feel comfortable with before you leave. It’s normal to be overwhelmed.

Expect to be a little bit sad.

Sad? Yes, even though you’ve been waiting to get out of the sterile hospital for a long while, it may still be hard to leave all of the nurses you’ve grown attached to on this journey. It’s hard to make that break to independence when you’ve had a medically complex child. As you welcome your baby home, you will be saying good-bye to the nurses and doctors who cared well, not just for your baby, but your whole family.

Expect to follow up with your pediatrician and/or specialists.

Just because you are leaving the NICU doesn’t mean you are leaving a medical team all together. Many preemies and medically fragile babies are discharged from the NICU with instructions to follow-up with specialists. And most certainly follow-up with your pediatrician for well visits and weight checks. You are not alone.

Expect to have lots of fun cuddling.

There are so many expectations with the big NICU discharge day. As you wade through all of the emotions of excitement, worry, and sadness, remember to enjoy your baby! You can cuddle all you want now. In fact, now kangaroo care can be fun instead of stressful. Give yourself grace and time as you acclimate to caring for your baby at home. You can always call the NICU with questions. They will help guide you. But remember, you’ve got this!