Am I allowed to discharge my baby if I feel he's ready to come home?(34 Posts)
Hi all, I'm a new dad and this is my first post here. Please be nice!
My son was born 3 weeks ago at 34 1/2 weeks gestation and has been in NICU since then. After a few minor complications with feeding (not digesting milk fast enough) he finally got the knack of breastfeeding. We've been rooming in with him for 3 days now and have been looking after him ourselves unsupported by the nurses.
We're itching to get him home now and feel that he is ready, but the doctor wants us to wait a few more days. His only concern is that he's only just caught up to his birth weight, but other than that he's fine.
Can we insist on taking him home? The nurses have been brilliant throughout his stay, but we really feel that he needs no more support from them now.
Thanks in advance!
have you got 24 hour emergency medical support in your home? if so, go for it. If not, why on earth would you go against the doctors? It's the NHS, they don't throw money around for no reason so assume that if they want him in, it's for a reason. Even a minor relapse could cause serious problems. What's 3 days in a lifetime?
Are you in the UK? ("rooming" sounds American to me)
Only reason I ask is, the good old NHS would chuck you out as soon as it was medically safe. So I wouldn't go against their advice. But if this is a hospital that is making money out iof you, not so sure.
(obviously, apologies if you're a paediatric doctor and therefore you "feeling" your son is ready to go home is a qualified and reasoned decision based on the medical facts)
It might be fine, it might not. Want to risk it?
I understand how desperate you can feel to get out of hospital, but just give it a few more days. You'll be home by the weekend.
the other question is: do you know what to do if he has a fit?
I am super cautious- I have disabled children. Trust me, for three days, I wouldn't be risking it.
Sorry, bloody iPhone. Do they have a community neonatal nurse who could support your discharge?
I'm siding with the doctor. They know better than you.
I agree with beast if you are in the UK they will be desperate to get you out ASAP ,so if they're saying you should stay then you should . If you are paying for your care then its a bit more difficult a decision ,but I would still stay purely because if anything went wrong would you be able to forgive yourself ?
Hello, congratulations on your DS and sorry you've had the stress of NICU.
I am not sure what the answer to your question is from a legal point of view. I think legally the answer may be that you are able to take your DS home but it would be against medical advice, and if the hospital felt very strongly that it was against your DS's interests they could go to court to block you from taking him home (suspect v unlikely in your case though). I do have a relative who took her twins home before the hospital wanted her to (they were still being tube fed). Obviously however you don't really want to get into that sort of combative position... better to see if you can persuade the hospital to agree.
Can you press the doctor to change his mind? Or ask for a second opinion? If you've been rooming in for 3 days and DS has put on weight during all that time, it seems very cautious to keep you in longer. What is DS's weight? Is he very tiny for his age? What do the nurses think?
For comparison (in case it is helpful), my DD was born at 34 weeks (normal weight for that gestation) and spent 24 days in NICU. We roomed in for 2 days/nights at the end of that time - the first night she lost weight so she had to stay, the second night she gained so we were allowed out. In our hospital, gaining weight was the only criterion for going home, she did not have to be back to her birth weight (I can't remember whether she was back to birth weight when we left but I suspect not as she lost a huge amount straight after birth).
Depends. Have you done car seat challenge, gone through feed and meds prep with the nurses, resuss training, vaccination schedule and follow up care planning?
Do you think they are being hesitant because there's a problem, or because they're just not being very efficient?
Why risk it? Personally I wouldn't
I can really sympathise with that longing to get him home.
But IME they are normally really keen to shift you on once you've been rooming in for a couple of days, so if they want you to stay, I'd be tempted to listen to and be guided by the doctors. It may be that your DS isn't putting on weight as fast as they'd anticipated once fully BF, and they just want to check there's no underlying issue. Much better to go home and stay home, than go home and have to come back in.
Hang in there - in a few days time you will have your lovely DS at home with you and those bleary NICU days will just be a distant memory!
I totally understand the desperation to get out of NICU/nursery ward/ transitional care. It's awful, waiting to be told you can finally get back home.
BUT it gets a zillion times harder once you are at home. You will be petrified. Seriously. Neither of you will sleep for weeks - not just the normal anxiety, but the total, dreadful paranoia that he might have stopped breathing that prematurity brings out in us all.
Don't even think about it.
Cross posted with all the other posters. As you can see I take a slightly different view! I wonder if they have had a NICU experience.
One thing I would say: we were desperate to get DD home, however, it was incredibly stressful once we did get her home, because she wasn't great at feeding (later turned out to have tongue tie, but that's a different story) and we were terrified of her losing weight as she was still so small. So, although I do think your doctor is being unnecessarily cautious based on what you've said, you might save yourself some stress by staying in an extra few days just to let him put on a bit more weight - even though at the moment that seems like defeat...
Why not take him home for the afternoon and come back? I've spent long periods of time in a hospital it is a bit grim, but I would ask them why. As others have said they do tend to be release happy not the other way round. Walk up to the cafe or outside for a bit. Order a pizza.
I've been in pretty much exactly the same situation, my dc was exactly 34 weeks not 34.5 and had a few other complications at first, once these were treated and dc was feeding regularly and had just regained birth weight they wanted us to stay in another week for them to monitor feeding. We insisted on speaking with the consultant pead and they immediately agreed she could be discharged- the reg's (and very rude nursery nurse in the low level care dc was in by then) were just much more cautious. I would ask to speak with the consultant and see what they say.
If the consultant raises concerns listen to them, but if it is as you say then we were totally successful and home that day- bliss!
Do you think they might be taking into account that the possible trauma to your baby of actually moving them from the hospital? Particularly since he has just got back to birth weight? If they say no, I would be inclined to be led by them if my child's health was at stake. What are your reasons for feeling it warrants moving him against the recommendations of health care professionals - is it convenience? And I'm not judging you - I'm just wondering whether you have considered your reasoning?
We had a seven week stretch in NICU - no major issues, just putting on weight / feeding etc. It wouldn't even have crossed my mind to try and get them discharged before they thought they were ready to go home.
it's funny that so many people's experience is that they are tigger happy to release- I had the opposite experience 4 years ago, and my sister who gave birth a month ago also had HCP's very nervous to discharge. These experiences were in different areas so not a particular hospital either.
I really sympathise with you as dd was in scbu and i was desperate to get her out of there. It was a long commute to the hospital on public transport and i didn't feel the environment was conducive to establishing breastfeeding.
in our case, the Drs went from saying she might be discharged in a few days, to suddenly one morning discharging us. Apparently they don't like to get people's hopes up by suggesting that discharge is imminent.
however, dd was discharged before she even started to gain weight, it was enough that her weight was stable and she was no longer jaundiced. i wouldn't recommend going against medical advice but perhaps you could speak to the Drs and question them about why they feel he needs to stay in.
These units are so busy that I very much doubt they would want you there if they felt your baby was well enough to go home.
Congratulations by the way.
They want to see him putting a bit of weight on first. I wouldnt try and discharge, im not sure you can woth a baby in nicu tbh, the women in the bed next to me was told ss would be rang if she tried before they were ready to discharge.
Id wait a few days, ive had 2 born early. Ds3 was born at 32 weeks and came home 10 days later in my experiance they discharge as soon as they think they are ready, feeding well, holding temp, starting to gain weight again.
I had different experiences within the same hospital hotair! One doctor happy to let us go as soon as she gained weight overnight, another saying needs another week...
So like you I don't agree they are always release happy, some are overcautious some are possibly undercautious, there is a range of views.
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