When will my baby go home?
Whether your baby arrived a few weeks or a few months early, he/she needs at least that much time to grow and develop into a baby ready for discharge home, so keep your due date in mind.
When your baby reaches all of the goals below, he/she will be ready for discharge:
- Maintains temperature in an open crib
- Breathes well without extra oxygen, or with only a small amount that can be provided at home (usually ½ liter per minute or less)
- Eats everything by mouth
- Gains weight consistently
- Has no significant episodes of drops in heart rate (bradycardia), oxygen levels (desaturation), or breathing rate (apnea)
- Can ride in a car seat safely — A car seat test (also called an angle tolerance test) will be done to make sure breathing and heart rate remain normal while your baby sits in his/her car seat
There are also some things you can do to prepare for discharge:
- Find a pediatrician for your baby. If you don’t have one in mind, we can help you find someone in your area who will take good care of your baby after he/she leaves the NICU.
- Complete infant CPR and safety class.
- Stay with your baby for at least 24 hours to make sure you are comfortable mixing formula, feeding, giving medicines, and providing other care.-Learn the following:
- How to comfort your baby
- How to change your baby’s diapers and clothes
- Feed your baby
- Give your baby a bath
- Put your baby in a car seat the right way
- Give any special care that your baby will need at home
Don’t forget the UAMS Patient Education Department hosts a FREE infant CPR and safety class on Monday’s at 11 AM and Friday’s at 2 PM (except on holidays). This class is for caregivers of baby’s in the NICU at UAMS. You must sign up at the information desk on the 5th floor of the main hospital.
Other important information/resources for when your baby goes home
Understanding ROP (Retinopathy of Prematurity)
Information on Early Intervention (referral made by SW at d/c)
https://dhs.arkansas.gov/dds/firstconnectionsweb/#fc-home
Following Baby Back Home (referral must be made by a social worker at discharge)
This website provides information on all of the home visiting programs in Arkansas and shows which counties they’re available in (including FBBH):
http://www.arhomevisiting.org/
How to order birth certificates online:
https://www.healthy.arkansas.gov/programs-services/topics/order-birth-records
Medicaid transportation:
https://afmc.org/individuals/arkansans-on-medicaid/non-emergency-transportation-net-program/
Applying for SSI online (your social worker will discuss SSI with parents if they qualify):
https://www.ssa.gov/applyfordisability/
To apply for state benefits such as SNAP, TEA, ARKids:
https://humanservices.arkansas.gov/about-dhs/dco/programs-services/support-services
NICU support websites that offer small amounts of financial assistance (if your application is chosen):
https://www.projectsweetpeas.com/financialassistance.html
Spit-up
Spitting up is common in healthy babies—almost all babies spit up now and then. Good news! Most babies outgrow it after only a few months. Only 1 percent of babies are still spitting up after their first birthday.
What is the difference between spitting up and vomiting?
Spitting up is the easy flow of a baby’s stomach contents through his or her mouth, possibly with a burp.
Vomiting occurs when the flow is forceful — shooting out inches rather than dribbling from the mouth.
Does my baby have reflux?
Reflux is short for gastroesophageal reflux or GER. Normally, a muscle (lower esophageal sphincter) between the esophagus and the stomach keeps stomach contents where they belong. Until this muscle has time to mature, spitting up might be an issue — especially if your baby is relatively full. Babies may spit up more if they are fed more volume than their stomach can hold.
How can you feed your baby if he had reflux?
If your baby had reflux in the NICU, the nurses may have shown you how to feed and position your baby to minimize spit-up. These tips may help:
- Hold your baby upright during feeding unless you have been instructed to feed your baby in a specific position to help them safely eat.
- Try smaller, more frequent feedings
- Burp your baby often, especially if you are feeding him with a bottle
- Keep your baby still and upright after feeding
- Keep a stack of cloth diapers or burp cloths handy. Use them to protect your clothes, your baby’s clothes and your furniture.
Will reflux cause problems for my baby?
Spitting up is messy, but it is normal during your baby’s early months. It rarely involves choking, coughing, or pain. As long as your baby seems comfortable, and is eating well and gaining weight, there is little cause for concern. Keep in mind it is easy to overestimate the amount your baby has spit up based on the size of a spit-up stain.
When should you call your baby’s health care provider?
- Your baby is not gaining weight
- Your baby arches his back or cries during feeding
- Your baby refuses to eat, or is very irritable after feeding
- The spit-up looks like something other than formula or breast milk (yellow or green color)
- There is a large amount of spit-up (more than 1 or 2 tablespoons)
- Your baby vomits with great force (projectile vomiting)
- Your baby has fewer wet diapers than normal
- Your baby seems very tired or lethargic
- The spit up or vomiting is new, or is accompanied by other new symptoms (fever, loose stools, fussiness)
Constipation: Is my baby’s poop normal?
Parents often worry that their baby is not pooping as they should. Constipation is a common problem in children of all ages. Every baby is different. Babies who are constipated typically have bowel movements (poops) that look hard or pellet-like, cry a lot while trying to poop, and sometimes don’t have as many poops as they used to. When checking to see if your baby poops enough, you should consider the following:
- The effort it takes for them to poop
- How often are they pooping?
- Texture (consistency)
- Color of their poop
Effort: How difficult is it for a baby to poop?
It is common for babies to strain during a poop. Sometimes their face will turn red. Young babies have a hard time coordinating all the muscles involved in pooping. Pooping can be a major event for a baby, and their face may show it! If a baby is really fussy or straining for more than 10 minutes to poop, they may be constipated.
Frequency: How often does a “normal” baby poop?
Some babies go several times a day, while others may skip a day or two between poops. Babies’ poop habits change as their digestive systems mature and their diets change.
Formula-fed babies usually have a bowel movement at least once most days, but may go 1 to 2 days between poops.
Breastfed babies usually poop more than formula-fed babies. After they are a few months old, they may still have poops after each feeding or they may go a few days between poops.
The frequency of bowel movements alone does not determine if a baby is constipated. You should consider what is normal for your baby. The frequency of poops along with the texture, color, size, and ease of passing stool are all important factors when determining if there is a problem.
Texture: What stool texture/consistency is “normal?”
There isn’t a “normal” consistency for poop. Each baby’s individual digestive system and current diet will affect the texture. In general:
- Formula-fed babies have soft, mushy stools.
- Breastfed babies or babies fed formulas that have prebiotics can have loose, seedy stools.
- Babies eating solid foods will have more solid stools.
- Hard, dry, pellet-like stools are a common sign of constipation.
- Watery stools lasting for 24 hours could be diarrhea, and you should contact your baby’s doctor.
Color: What colors of stool are “normal”?
A wide range of colors can be considered normal- from bright green to yellow to dark brown. Just like the texture of poop, the color of stool depends on a baby’s diet and their particular digestive system. When babies start eating solid foods, you might see purple in their poop after blueberries or red after beets.
If your baby has black, tarry, red-streaked, or white colored poop, call your baby’s doctor.
The American Academy of Pediatrics (AAP) suggests asking yourself the following questions:
- Is my baby really fussy?
- Is my baby spitting up more than usual?
- Is my baby having a lot more or fewer poops than before?
- Are my baby’s stools unusually hard, or do they have blood related to hard stools?
- Does my baby strain for more than 10 minutes without success?
If your baby shows these signs, they may be constipated. Call your baby’s doctor to report these signs and ask what you can do to help your baby.
What can parents do?
Just like constipated adults, your baby may need a change in physical activity or diet.
Physical activity
- Bicycling legs- Move your baby’s legs up and down as if they are riding a bicycle
- Squats- During bath time, hold your baby in a tub of warm water with his knees pulled up to his chest in a squatting position.
- Massage- Give your baby a tummy massage, moving your hands in a clockwise motion to help stool travel through their digestive system. Ask your baby’s doctor or physical therapist to show you this massage to make sure you are doing it correctly.
Diet changes
- If your baby is one month old, you can try giving them a little fruit juice to help soften their stool (one month after their due date if your baby was premature).
- Start by giving 1 ounce of prune, apple, or pear juice a day. The sugars in these fruit juices aren’t digested very well, so they draw fluid into the intestines and help loosen stool.
- Once your baby starts eating foods, offer them fruits like prunes, pears, plums, and apricots.
Your well-meaning family and friends may offer suggestions on how to help your baby poop. Some of the typical remedies include giving your baby Karo syrup, performing rectal stimulation, or giving glycerin suppositories or over-the-counter laxatives. Each of these remedies could be harmful to your baby.
DO NOT give your baby Karo syrup, glycerin suppositories, laxatives, or stimulate their rectum unless your doctor has instructed you to do so.
Always talk to your baby’s doctor FIRST before you do anything different with your infant.