Q&A: preparing to go home

Discharge co-ordinators from the neonatal unit Alison and Robyn answer some common questions about preparing to take your baby home. In their roles Alison and Robyn support babies and families to go home.

How will I know when my baby is ready to go home?

Robyn: "Different units have different criteria for discharging babies. Some may wait until your baby has reached a particular gestational age or weight, but this is not the case for all units.

"The health professionals on your unit will work with you to decide what is best for you and your baby. They will also be looking at a number of things to see if your baby is ready, such as if your baby can maintain their own temperature, if they are able to suck feed (either breastfeeding, bottle feeding or combination) and if they are gaining or maintaining weight."

Alison: "How you feel as a parent is also an important part of the decision. A baby will go home when they are well enough to do so and when you feel confident and ready to care for them at home.

"Before you go home you will get to 'room in' with your baby. Talk to your health professional about how you feel. It may be you feel you need longer rooming in. However you feel they can support you."

On some neonatal units a baby's discharge is organised by a discharge co-ordinator, and on other units it can be organised by a nurse.

How do I prepare to go home?

Alison: "In preparation for going home you’ll need to register your baby’s birth. We always tell parents to register their baby's birth as soon as possible. When this is done you can focus on being with your baby.

"Registering the birth needs to be done in the register office local to the hospital where your baby was born rather than local to their home address. If parents are married, one parent can register the birth, but it is different for parents who are unmarried. You can find out more from gov.uk.

"Also a parent needs to register their baby with a GP before they can go home, so it’s helpful to do this as early as you can. This is important to be able to get a prescription for special preterm formula or a repeat prescription after going home.”

In England, Wales and Northern Ireland a baby must be registered within 42 days of being born and within 21 days in Scotland. Find out more here.

What should I expect from discharge day?

Robyn: "Discharge takes time to plan and prepare. Ideally, plans for discharge should be completed the day before. This can involve making sure hearing tests for your baby are completed and any medication is organised.

"The health professionals should tell you roughly when your baby will be ready for discharge so you can prepare the home and make arrangements for the day of discharge. This may include child care for siblings, ordering a taxi or it may be that relatives are able to drive you home."

Alison: "Your baby's discharge summary will be sent to your GP and your baby's health visitor will be contacted. The health visitor should make contact with you by day 14 at home at the latest, but it may be the health visitor has been in touch with you whilst your baby is on the unit."

What should I bring to the hospital on discharge day?

Robyn: "Bring some clothes, a little hat and a blanket. If you're travelling by car you will need to bring a car seat. If you don't have a car but you need a car seat for the journey home the hospital may have one you can borrow."

How do I transport my baby? They’re very small for normal car seats

Alison: "It is recommended that babies leave the unit in a car seat. For smaller babies, we would advise getting one with inserts and sometimes health professionals will insert extra padding. They will also help you put your baby in the seat so they are secure."

What if one of my babies is ready to go home before their sibling/s?

Alison: "We know this can be really hard for parents. Your health professionals will work with you to find a way that is best for you to to bring in their sibling to the unit, so your babies can be together."

Never be afraid to ask for help. Everybody needs support, so if people offer to help, do take it.

Alison, discharge co-ordinator

I’m really anxious about caring for my baby at home. Who can I talk to if I have questions about my baby?

Alison: “Before you leave the unit, the health professional organising your baby’s discharge should give you some helpful contact numbers and information. Many parents like to have the number for the unit in case they feel like they need to ring with questions once they are home."

Robyn: "Some hospitals have post-discharge groups that offer support with things such as breastfeeding, weaning and sleeping. Find out if your hospital has one by asking someone on the discharge team."

And where can I get support?

Robyn: “There may be a support group in your community or at local children's centres. You could ask your health visitor or community nurse about this."

Sometimes it can be helpful to talk to other parents in a similar situation. The Bliss Netmums forum is a peer support messageboard for parents, families or carers of babies born premature or sick.

What happens if my baby becomes ill again?

Robyn: "You know when your baby is not right. If you are worried about something, see your GP or ring 111 or in an emergency call 999."

Alison: "If you don't have an appointment to see the GP you can always go in and ask for your baby to be seen. If you are worried, it is always best to get your baby checked over."

How can my friends and family support me?

Alison: "Never be afraid to ask for ask for help. Everybody needs support, so if people offer to help, do take it."

Robyn: "It could be you've had visitors involved in supporting you and your baby on the unit who can support you at home. If there are family members going to be helping you at home, like grandparents, they may want to sit in on basic life support training.

"Don't feel like you have to open up the floodgates to visitors when you get home- this is the message I always give to parents. Give yourself some time with the most important people who can help with practical things like cooking, daily chores or help with other children. This can help give you time with your baby."

What should I do if I am worried about my mental health after I have gone home?

Alison: "Many mothers struggle with their mental health when they are at home with their baby- it's more common than you might think.

"Health visitors and GPs are very helpful. Don't be afraid to talk about how your feeling, and don't be afraid to ask for help. It's ok to feel how you are feeling."

How can I prepare if my baby is going home on oxygen?

Robyn: “The first thing to do is to contact your insurers (home and car) and your landlord if you have one. A health professional will visit your home to support you with the practical issues of going home on oxygen, for example where the oxygen tanks can be stored. Depending on where you live, it may be a community nurse team that supports your baby’s oxygen care once you go home.”

Alison: “Make sure you have a smoke detector that works. I also remind parents to conduct their normal day as much as they can. Home oxygen doesn’t mean having to stay at home. Portable oxygen allows you to go outside with your baby. Going outside and getting some fresh air is good for you and your baby."