AAP Issues Recommendations on Newborn Hospital Discharge Readiness

Readiness for discharge of a healthy baby is often determined by obstetrical care providers after careful review of each mother-infant dyad. However, the degree of readiness can vary greatly, and a number of factors need to be taken into account.

 

To help identify those factors, the American Academy of Pediatrics (AAP) offers guidance to pediatricians and other health care providers in an updated policy statement, “Hospital Stay for Healthy Term Newborn Infants”.

 

Specific criteria should be met to ensure that the mother is prepared to care for herself and her baby after leaving the hospital. These include the health of the mother, the health and stability of the baby, the ability and self-assurance of the mother to take care of her baby, the level of support she will receive at home, and access to appropriate follow-up care.

 

Additional criteria that need to be met before discharge of a healthy newborn include:
•Clinical and physical examinations reveal no illness or reason for continued hospital stay.
•The infant has completed at least two successful feedings, either bottle or breastfed.
•An appropriate car seat is available, and the mother is properly trained on positioning and use.
•Family, environmental and social risk factors have been assessed. Risk factors include untreated parental use of drugs or alcohol, history of child abuse or neglect in the home, mental illness in a parent, or history of domestic violence.
•An established relationship with a medical home for appropriate follow-up and care.

 

Policy authors conclude that before a term newborn is discharged from the hospital, input from the mother and the obstetrical health care doctors and nurses is necessary. It is important that all efforts are made to keep the mother and her newborn together to prevent risk which can result in readmission.