Discharge readiness and follow-up for low birth weight neonates
THE CONTEXT
Discharge requires physiological stability, adequate feeding and growth, completion of preventive care, and prepared caregivers.
Temperature, growth, and feeding
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The clothed neonate should maintain normal body temperature outside a radiant warmer or incubator.
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Weight should have increased consistently for a few days. Weight, length, and head circumference can be tracked on growth charts; separate charts are available for term and preterm infants.
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The neonate should breastfeed well or accept feeds by paladai or spoon, and the mother should be adequately trained in feeding.
Medical and preventive care
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There should be no significant morbidity or continuing need for treatment such as intravenous antibiotics. Parents should understand how to administer medicines or supplements after discharge.
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ROP, hearing, and metabolic screening should be performed before discharge. Some infants may require ROP screening after discharge.
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Ensure provision of multivitamins, iron, calcium, and vitamin D, and administration of BCG, hepatitis B, and OPV immunization.
Caregiver preparation and review
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Parents should understand how to recognize danger signs and when to return for care.
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Arrange follow-up within 3–7 days of discharge to assess adaptation to the home environment.