NICU Patient Discharge Information
Before going home
Hearing screen
Hearing screens are performed prior to discharge from the NICU. This hearing screen is required by the Commonwealth of Virginia, and it is the first step in identifying potential hearing problems. If additional follow up is required post-discharge, an appointment with a hearing specialist will be made for you by your discharge planner.
Vision screen
Premature infants are at a greater risk for retinopathy of prematurity. This is an eye disease which results from the abnormal development of blood vessels in the retina (the lining inside the back of the eye). Premature infants born at less than 28 weeks gestation are at the greatest risk for retinopathy. Detecting problems early can lead to better outcomes, so our preemies’ eyes are followed very closely while they are patients in the NICU. A pediatric ophthalmologist will continue to follow preemies’ eyes after discharge. An appointment will be made for you by your discharge planner.
ALTE Watch
As your baby gets closer to discharge, you will hear the health care team mention an ALTE Watch. This stands for acute life-threatening event. During an ALTE, your baby may experience a drop in heart rate, oxygen saturation, or respiratory rate, either by itself or all at one time. This is also known as apnea and bradycardia. Your baby must be free from apnea and bradycardia for seven days prior to discharge. If your baby has an event during this watch period, the watch will be reset and the seven-day count started over.
Car seat test
Most babies discharged from the NICU will be evaluated for 90 minutes in a car seat that you provide. Your baby will successfully pass this car seat test if he fits properly in the seat and does not experience an ALTE during the 90 minutes. If your baby does not meet these criteria, an occupational therapy consult will be ordered, and the therapist will make suggestions so your baby can safely go home.
CPR and infant safety
Please plan to attend a CPR and infant safety class prior to your baby’s discharge. Anyone caring for your baby is welcome and encouraged to attend this educational class. Classes are offered Tuesdays and Thursdays at 10 a.m. and twice a month at 5 p.m. on Wednesdays. You can sign up for a class with the receptionist.
Breast milk/formula preparation
As you approach discharge, please ask your baby’s nurse and dietitian to teach you the proper way to fortify breast milk or mix formula to the proper calorie level. This is a very important step in your discharge learning process, so ask to practice it at the bedside until you feel comfortable.
Immunizations
Your baby begins to receive immunizations while in the NICU based on the age recommendations of the Centers for Disease Control. You will receive information on each immunization, so please let the medical team know if you have any questions. Your discharge planner will make your first pediatrician appointment for you following your baby’s discharge from the NICU, and your pediatrician will continue the immunization schedule.
Rooming in
Once your baby is on full feeds and you have completed a CPR and infant safety class, you are able to room in with your baby prior to discharge if you choose to do so. Rooming in gives you the opportunity to independently care for your baby before going home.
Rooming in is from 8 p.m. to 8 a.m., and you will provide all care to your baby overnight, while your baby is monitored remotely by a nurse. You must remain with your baby at all times while you room in.
You and your baby will spend the night in one of the pump rooms, if your baby is on the 4th floor. If your baby is in the NICU Step Down Unit, they will try to arrange rooming in in the larger, 2-baby room. It is possible that your baby may have to come back to a 4th floor pump room if accommodations cannot be made upstairs.
Arrangements can be made for rooming in with the charge nurse or your bedside nurse.
Equipment needs
If your baby will be going home with any equipment, like oxygen or a feeding pump, you will receive extra training on those items. Your case manager will coordinate with a home health agency to deliver the equipment to the hospital and train you on how they work. They will also deliver supplies to your home. In many cases, it’s a good idea to room in with your baby using the equipment you will have at home to help you gain confidence in providing that care.
Discharge paperwork
On the day of discharge, you will review any specialized teaching, including mixing formula/fortifying breast milk, with the nurse. The recipe for mixing the formula and/or breast milk will be included in your paperwork. You will also review drawing up to the correct dose and giving any medications your baby may need, including vitamins. You should bring your baby's medications with you on the day of discharge.
You will also receive a discharge summary. This document is a summary of every issue your baby has encountered since birth and whether it is resolved or ongoing. Please be sure to keep a copy of this summary with you as you go to first appointments with caregivers outside the hospital.
Your case manager will make of all of your baby’s first appointments for you, and you will receive a list of these scheduled visits on the day of discharge. This includes the name of the provider and the date, time, and address for the following:
- Pediatrician appointment.
- Any specialist appointments, including ophthalmology.
- A date for a NICU follow-up clinic appointment, if your baby qualifies.
NICU follow-up clinic
The NICU runs a follow-up clinic to monitor the development of babies born prematurely or with other complications or diagnoses. If your baby is identified as a candidate for the clinic, your first appointment will be within six months after discharge.
The clinic is staffed by NICU registered nurses, a neonatologist, a neonatal nurse practitioner, a social worker, and a developmental pediatrician. For the first few years of life, this team will do developmental testing to be sure your baby is receiving all the services he needs to catch up developmentally, and to be sure you are coping with the stress of bringing home your NICU baby.
Early intervention
Early intervention services are provided to babies who are born prematurely or with other diagnoses. If your baby qualifies for EI services, you will be asked to sign a consent for the NICU to send your baby’s medical record to the EI office in your home city. Then, once your baby goes home, your local EI office will call to schedule an assessment to determine eligibility for services. Services can include physical, occupational, or speech therapy, depending on the needs of your child. If your child qualifies for services, your therapists will come to your home and teach you various techniques to help your child progress. This program is available through age three.
Care Connection
Care Connection for Children, sponsored by the Virginia Department of Health, is a statewide network of regional programs that provides healthcare services, community support, and resources to children with special healthcare needs. The team- based approach pulls together case managers, medical personnel educators, and family members to determine how children with special healthcare needs can reach their maximum potential. Care coordinators connect families with local healthcare providers, specialized health insurance programs, resources from the community, and other families experiencing similar situations. You can reach Care Connection for Children at (757) 668-7132.
Discharge reminders for babies receiving SSI
If you applied for SSI (low birth weight program) for your baby, you must contact your local social security office when your baby is discharged and notify them of the discharge date. If you continue to receive SSI and Medicaid when you are not eligible, you will be required to pay the money back.
In addition, if you applied for SSI or if your baby is already receiving SSI, you must go to your local social security office after your baby goes home in order to determine continued eligibility. This is important because you may receive an increase in benefits once your baby is home.
When you go to your local social security office, please bring these items:
- Your baby’s discharge summary.
- Your baby’s social security number.
- Pay stubs to show your income.
- Any bank account statements you have.
- Information on any other income you receive.
- Your personal identification.
This must be done within 30 days of discharge. Remember, to reapply you must go into the social security office to see a claims representative. This cannot be done over the phone. Be sure to write down who you talked with and when.
Phone number for SSI questions:
1 (800) 772-1213
Website:
Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.
Reviewed on: 6/2024