Transitional care provides a less intensive atmosphere for babies and families as they prepare for discharge from the Neonatal Intensive Care Unit (NICU). This type of care focuses on the closer bonding between parents and baby and helps the parents cope with their infant's physical, emotional and developmental needs. The nursing staff works closely with the parents through the day of discharge.
Physical Care and Feeding
Every infant continues to be on a cardiac monitor 24 hours a day. Most babies remain in the Isolette® (incubator) until they reach a weight of three pounds and five ounces and steady weight gain is demonstrated. The progression from gavage feedings (in which the infant is fed by a tube that is passed through the nostrils or mouth directly into the stomach) to nipple feedings may seem slow to new parents. Greater intake must be achieved gradually to accommodate the baby’s small digestive capacity.
Special Care
Some infants may still require respiratory support through oxygen therapy or intravenous (IV) therapy for supplemental nutrition or the administration of medicine. This does not interfere with the baby’s progress toward discharge. If needed, the neonatologist and nurses instruct parents in continuing oxygen therapy at home, in the use of a home apnea (arrested breathing) monitor, and in gavage tube feedings. When an infant is hospitalized for a long period of time, a developmental specialist may aid the nurses in performing special stimulation exercises to promote developmental progress. The nurses teach the parents how to do these exercises at home.
Discharge Planning
Each baby’s discharge date depends on individual circumstances. For premature babies, the major criteria for discharge include steady weight gain, taking all feedings by nipple, maintenance of a stable body temperature in an open crib, and normal breathing. Most premature babies weigh four and a half to five pounds at discharge. Generally, a premature infant will be ready for discharge around the time of the original due date of birth. On discharge, the pediatrician, who has been kept informed of the baby’s condition throughout the hospital stay, will assume responsibility for continued care. Babies needing special equipment, such as oxygen, home monitoring and gavage feeding, will be followed by the neonatologist as outpatients.
