Going Home - Preparing your baby’s discharge home
Preparation for discharge home
Things you should do to get ready for your baby’s discharge home:
- Get used to looking after your baby in the neonatal unit before they are discharged home. Try to arrange your visits to coincide with your baby’s care giving. See Care giving activities you can do for your baby.
- Go to the classes arranged by the neonatal unit for getting read for discharge – these provide information and demonstrations on caring for your baby at home. These classes may be available online/virtually – ask staff for details.
- Make sure that you have all of the things that your baby will need before they go home from the neonatal unit. Your baby will need a safe place to sleep, a car seat that you can correctly and safely install in the car, a pram or a buggy, and a thermometer for use in small babies. Your baby will also need clothes and blankets. See Car seat
- Check what medicines your baby will need to take at home, e.g. prescribed medicines, iron or vitamins. You will be able to get your baby’s prescription before they go home to give you time to get the medicine from your own pharmacy. You will need to learn how to safely give your baby their medicine before they can go home from the neonatal unit.
- Contact your baby’s local public health nurse (PHN) and general practitioner (GP) prior to your baby’s discharge home and link with them on their arrival home. You need to register your baby with a GP, before discharge if possible.
- Learn about emergency first aid for babies. If your baby was born very preterm, or very unwell the discharge team in your baby’s neonatal unit will offer classes in baby first aid including CPR training on a doll. This demonstration may be available online/virtually – ask staff for details
Preparing for feeding at home
- Ask your baby’s nurse and dietitian for details about their feeds for home and check if your baby will need a fortifier for your breast milk or special feeds.
- Prepare for breastfeeding by making sure that you have somewhere comfortable and supportive to feed your baby, and make sure that you have met with the lactation team before discharge so that you know that you have found the best feeding positions for you and your baby. Link up with local Breastfeeding Support groups if available. Ask your local Health Centre/Primary Care Centre for details. See feeding section and reference section
- If your baby gets breast milk or formula milk from a bottle:
- Makes sure that you have enough bottles, teats and equipment for sterilising bottles and warming feeds. Ask your baby’s nurse for advice on suitable bottles and teats for your baby before buying them.
- Your baby will have to get used to feeding from the type of bottles that you will use at home so bring in your own sterilised bottles for your baby to use for feeds in the neonatal unit before discharge.
- If you do not plan to feed breast milk for all feeds, you will need to buy a supply of formula milk to use when there is no breast milk.
- Learn how to prepare bottle-feeds safely. Check with staff about classes that may be available – these may be online or virtual. Information is also available from the HSE website www.mychild.ie.
Before your baby comes home
- Some neonatal units let parents have a chance to ‘room-in’ with their baby before their discharge home. ‘Rooming-in’ lets parents care for their infant by themselves overnight with the support of the nursing staff should any questions arise. Ask if this can be accommodated for you and your baby.
- If you have twins, triplets, or other multiple births, be prepared that each baby may be ready for discharge home at a different time and that one baby may go home before the other(s).
- At the time of discharge, your baby’s doctor will prepare a ‘discharge letter’ to send to your baby’s GP outlining their medical history and details of their stay in the neonatal unit. Ask for a copy for your reference.
- Make note of your baby’s recent weight and other growth measurements.
- Some neonatal units provide a pack providing information for parents to refer to at home. Ask your baby’s nurse for a copy if one is available.
- Further information for home time is provided in a range of information leaflets available in the neonatal unit and from other sources, see Sources of online information and useful contacts.
If your baby has special requirements following their discharge home, like if they have a stoma or requires oxygen support or tube-feeds, your baby’s neonatal team will make sure that you are completely prepared.
Car seat for the journey home
- Small babies should not be in a car seat for a long time without a break. This is important for their heads, necks and airways.
- Keep the instruction manual for your baby’s car seat.
- Do not use a second-hand car seat unless you can guarantee that it has definitely not been in any accidents.
- Check the weight recommendations for your baby’s car seat – try to match it to their weight and size. Many car seats come with adjustable straps at the shoulder and nappy area. Try choosing one that allows for adjustments so it will support a small baby.
- Look for the E Mark on the car seat that shows that it has been crash tested and meets EU standards. Always ask for advice from where you buy your baby’s car seat. The RSA Check It Fits does virtual appointments providing free child car seat checks to everyone. Visit the Website www.checkitfits.ie for more information on locations near you.
- Read the RSA leaflet, Child Safety in Cars Website: (www. rsa.ie) for important and helpful information on buying and fitting child car seats and keeping your children safe while travelling.
- Do not dress your baby in bulky coats/ jackets like snow suits as they are not safe in car seats.
- Shoulder straps should be tight enough so that only two fingers can fit between the top of the child’s shoulders and harness but your fingers should be able to rotate (turn) in that position. Make sure that there is no gap between the buckle and nappy area as a gap can cause your baby to slide down the seat causing an incorrect and unsafe position for travelling.
- Many baby seats have a newborn insert for when baby is small. They have a weight and length limit. Make sure you remove this when – and only when – you’re supposed to. You may have to adjust your baby’s seat as they get bigger – check the instructions that come with it.
- If there are two adults travelling in the early days, sit in the back of the car beside the infant so you can observe when travelling. Rear view mirrors can also be useful if you are on your own.
- Keep journeys short, limit time in car seats (30-40 minutes) especially in the early days. If your baby has spent a long time in the car seat it is best to use the bassinet part of the travel system if you have one.
- Before your baby is discharged from the neonatal unit ask the discharge coordinator to check how your baby fits in their car seat.
Preparing your baby’s brothers and sisters
You will be spending a lot of time with your new baby when they come home. Prepare your other children for this by explaining in simple language why you need to spend a lot of time with the new baby and working out with them ways that they can be involved too and help.
Prepare for this before your baby leaves hospital by talking about it and involving sisters and brothers in preparations for their new sibling, like choosing toys, blankets or clothes.
After the baby comes home, include brothers and sisters by involving them in choosing clothes, nappy changing and bathing.
By including brothers and sisters in your baby’s care, they will feel more involved and important and not feel left out.
