Bringing Baby Home

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It is natural for you to have mixed emotions when taking your baby or babies home from NICU. You are thrilled to have the baby home where you can hold it and have it all to yourself, but you struggle with doubts if you can really care for the fragile baby. We wanted to give you some tips on things to help you feel more confident of taking care of your sweet thing.

Go through the medical records before going home. Read through and take copies of things you think might help you in the future. For the first while you will probably need to take the baby to different doctors and you can get the best care if you have all the information with you. You may want to make a book just for all the information you get from NICU so when you are ready you can actually go through things. You can obtain a book from Utah Family Voices by emailing them at utahfamilyvoices@juno.com

To obtain your medical records you can go to the medical records department at the hospital and sign a permission slip. You need to present photo ID and you’ll need to pay a copying fee. Many times while you are in NICU you can go through the records at the nurses desk as well.

Some things you will want to make sure to get are the following documents

Admission history and physical examination

Most recent specialist evaluations -- the reports on the state and follow-up of the eyes (ophthalmology), heart (cardiology), brain and nerves (neurology) and so on.

Discharge summary: This is a summary of the entire hospital stay, and may not be available until after discharge. Ask the NICU doctor “covering” your baby when to expect it to be ready.

Discharge orders: These are written and signed by the “covering” doctor on the day of discharge. You should be given your own copy (make sure it is signed), and should include the items listed in the box to the right.

Discharge orders should include:

Feeding instructions
Medication instructions, including oxygen administration
Monitoring instructions, with the settings of “normal range” for each monitor, how to reach the company supplying the monitor, and what to do in the case of monitor malfunction
Equipment instructions: catheters, feeding tubes, dressings: how and how often to change them, where to purchase them, and how many to get.
Things left undone in the NICU:

Your baby should have had a hearing test: If it could not be done, or is not a “Pass,” a second test should be done in the near future. Your baby should have had the routine, State mandated blood test to screen for treatable, inherited conditions. Some call it the “PKU” test. In all the bustle of the NICU, sometimes this routine test goes unperformed.

Follow-up instructions:

Specialist follow-up appointments: Doctor’s name, phone number, date of appointment (or range of dates in which to make appointment), and reason for specialist. Studies (x-rays, ultrasounds, blood work) with accompanying order forms stating when, where, and what is to be studied, and why. Flag on studies that have been performed during the NICU stay whose results have not yet arrived. Tests on chromosomes and for “metabolic” or chemical abnormalities may take days or weeks to complete. Date of expected return of results, and how to obtain them. Pediatrician follow-up: your very own “baby doctor,” charged with coordinating specialist care and providing routine baby care.

For the purposes of developmental benchmarks and the follow-up process, you will need to start thinking about your baby’s age in two ways:

the baby’s actual or chronological age, which is the age measured from the day the baby was actually born
the baby’s corrected age, which is the age measured from the day the baby was expected to be born

Suppose a baby was born two months premature. If that baby’s actual age is now six months, his corrected age is four months.

This can make a big difference in terms of how you and health care providers think of your baby’s progress. For example, most full-term babies can sit up when they are about seven months old. However, if your baby was born three months early, although his actual age is seven months, his corrected age is only four months. This child will have to wait a few more months before he can sit up on his own.

Though the corrected age is used as benchmark for a baby’s behaviour and development, the actual age is used for vaccinations. This distinction between the actual and corrected age is very important because all assessments of development must be based on the biological age of the brain.

Call your pediatrician or family doctor if your baby:

· Has a fever of 100.5°F or higher

· Is feeding poorly

· Is having difficulty breathing

· Is extremely irritable

· Is listless and tired

Resources

http://www.canadianparents.com/article/bringing-your-baby-home-from-the-neonatal-icu

http://www.aboutkidshealth.ca/PrematureBabies/Ongoing-Care.aspx?articleID=7538&categoryID=PI-nh4-04