There are many things to consider when taking your baby home. Depending on your baby's medical needs, you may need to purchase special medical equipment or medications. There will also be a certain level of stress on the parents who will be caring for their baby at home without a health-care team for the first time. Take time to think about and plan what you need to do to get ready to take your baby home.
Some babies are transferred out of the Neonatal Intensive Care Unit (NICU) to a hospital closer to home before they are ready to be discharged, while others go home directly. There are some planning steps that will make the transition easier whenever your baby is ready to go home.
The trip home
You need to think about how you will get your baby home from the hospital. Please consider these questions:
- Have you obtained a car seat that will accommodate a small baby? Car seats need to meet Canadian safety standards. A member of the health-care team will need to check the car seat that you have before your baby leaves the hospital.
- Does your baby need special seating? Special attachments to baby car seats are available and may need to be used for a premature baby’s trip home. Staff at the hospital should be able to tell you where you can find these and should also help you strap your baby into the car seat.
- Does your baby need a car seat challenge? Some babies, especially those who have had breathing problems, may need to be monitored to see if they can tolerate sitting up in a car seat for an extended period of time.
- Are you planning to take your baby home from the hospital by bus, train or airplane? If so, please contact the person responsible for patient discharge before booking your ticket. They can guide you in making special arrangements with the transportation company.
Caring for your baby at home
Caring for your baby when they get home from hospital will take a lot of time and energy. If you have other children at home, you may need extra help. Think about the following questions:
- Who will be caring for your baby when they come home?
- If you have a partner, how they help you with the new baby and any other children?
- Do you have other family or friends who will be able to help you if needed? You may need help with things like grocery shopping, cleaning and laundry.
Medications
Your baby may have been prescribed medications after their stay in the NICU. Here are some points to keep in mind:
- Get the medications from the pharmacy before you go home. Make friends with your local pharmacist. They can tell you about the services they offer and whether they can provide future prescriptions. Some medicines are specially made for babies and are formulated in such a way as to make them easier to administer.
- Find out if there is a cost to the medications. Some medications are covered by the provincial health plan; others may be covered by your health insurance benefits; and others will need to be paid for by you. Speak with your baby's health-care team to explore other programs that may be able to cover these costs.
Medical equipment
If your baby is to be sent home with some medical equipment, you should know how to use it and how this equipment will be set up. Consider how much space, power and maintenance the equipment will need at your home.
Staff at the hospital who are responsible for patient discharge can give you information about where you can rent or purchase these items and will assist in arranging delivery.
Future health and follow-up care
Before your baby goes home, it is important to identify which health-care providers will be caring for them after discharge. Think about the following questions:
- Do you have a health-care provider for your baby's regular check-ups? If you do not have a primary care provider for your baby, ask the health-care team for assistance.
- Have you contacted the health-care provider to arrange a first appointment?
- Does your baby need any specialist follow-up appointments? Have you been told how and when these appointments will be arranged?
- Will your baby be followed in a neonatal follow-up clinic? Which neonatal follow-up clinic will be seeing your baby? This will depend on whether your baby was born premature or if they had specific medical conditions that require referral to a neonatal follow-up clinic.
Neonatal follow-up clinics
Extremely premature babies and babies with certain medical conditions may be referred to a neonatal follow-up clinic. Some neonatal follow-up clinics are located in the hospital that cared for your baby, and others are closer to home. Each clinic has specific criteria for the babies that they follow. Before discharge, you will be told if your baby requires follow-up in a neonatal follow-up clinic.
The purpose of follow-up visits
Neonatal follow-up clinics are primarily for monitoring your baby's progress in terms of their growth and development. In general, visits to a follow-up clinic are scheduled at four, eight, 12, 18, 24 and 36 months corrected age, meaning the age of the baby if they had been born at the expected time. Extremely premature babies and babies who experienced more serious complications may be followed more frequently and for longer periods of time.
Follow-up visits are also done in an effort to identify potential problems as early as possible. Since the long-term effects of some injuries and complications common to premature babies and babies with certain medical conditions at birth are reasonably well anticipated, regular follow-up visits provide an opportunity to identify these problems as they develop. This allows for intervention at the earliest possible moment. Early therapy and other early interventions can minimize the long-term implications of many complications.
At the follow-up clinic
In addition to assessing a child's development and looking out for potential problems, follow-up clinics are also opportunities for exchanging information. Parents let the health-care team know about their child's behaviour, and the health-care team can let parents know what to do about it. Here are a few tips to help make the most of follow-up clinic visits:
- Register with MyChart if it is available at the centre seeing your child. This will give you access to a portion of your baby's medical chart.
- Start your own file. Keep track of what is said at the visits and keep a record. This will help create a running commentary on your child's progress that can be referred to later.
- Ask lots of questions, even if you think that they may not be the smartest questions. No one expects parents to completely understand all the possible behavioural and physical effects of any condition. If you don't understand something, ask and don't feel bad about it. It is better to leave a visit without any doubts.
- Make sure your baby's regular health-care provider remains aware of the assessments and recommendations of the follow-up clinics.
It is natural for parents to wonder and worry about what their baby’s life will be like in the coming years and into childhood. While it is difficult to predict the future, it is important to have your baby receive regular check-ups, immunizations and monitoring of their growth and development.
Effect on parents
Some parents have difficulty getting over the trauma of witnessing their infant in the NICU. Even after the baby has gone home and is thriving, parents can remain worried. NICU parents are at higher risk of post-partum depression and post-traumatic stress disorder, and it is important to get help if needed. Be open and honest about how you are feeling with your own health-care provider and with your baby's health-care team.
The end of treatment at the NICU is an important milestone for your baby and your family. Take the opportunity to celebrate your baby's and family's accomplishment.