What Parents Need to Know About Leaving the Neonatal Intensive Care Unit | Critical Care Medicine | JAMA Pediatrics | JAMA Network
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JAMA Pediatrics Patient Page
November 30, 2020

What Parents Need to Know About Leaving the Neonatal Intensive Care Unit

Author Affiliations
  • 1Department of Pediatrics, University of Florida College of Medicine, Gainesville
  • 2Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville
JAMA Pediatr. 2021;175(1):112. doi:10.1001/jamapediatrics.2020.5045

Infants born prematurely or ill spend anywhere from a few hours to many weeks in neonatal intensive care units (NICUs).

Although NICU stays are stressful for parents, the continuous monitoring and excellent bedside care can be reassuring. Leaving the NICU when an infant is able to eat, grow, and develop safely can be both exciting and nerve-racking.

Ask questions. Understand your infant’s needs to anticipate and avoid problems. Before going home, select a primary care physician (PCP) you like and who is comfortable caring for medically complex infants. Prior to discharge, schedule follow-up appointments and fill any prescriptions or recommended vitamins. Obtain a car seat or possibly a car bed, depending on your infant’s needs.

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    1 Comment for this article
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    A Newborn's Mental Wellbeing as Important as its Physical Health
    Frank Sterle Jr. |
    Besides its physical health, the newborn’s psychological wellbeing must also be thoroughly considered.

    Commonsensically, new parents generally will know, for example, not to yell when baby is sleeping in the next room; however, will they know about the intricacies of why not?

    For example, will they realize that, since it cannot fight or flight, a baby stuck in a crib on its back hearing parental discord in the next room can only “move into a third neurological state, known as a ‘freeze’ state … This freeze state is a trauma state” (Childhood Disrupted, pg.123).

    This causes
    its brain to improperly develop; and if allowed to continue, it’s the helpless infant’s starting point towards a childhood, adolescence and (in particular) adulthood in which its brain uncontrollably releases potentially damaging levels of inflammation-promoting stress hormones and chemicals, even in non-stressful daily routines.

    How many new parents will be aware it’s the unpredictability of a stressor, and not the intensity, that does the most harm?

    When the stressor “is completely predictable, even if it is more traumatic—such as giving a [laboratory] rat a regularly scheduled foot shock accompanied by a sharp, loud sound—the stress does not create these exact same [negative] brain changes.” (pg.42)

    Also, how many will be aware that, since young children completely rely on their parents for protection and sustenance, they will understandably stress over having their parents angry at them for prolonged periods of time?

    New parents should know, long before leaving a neonatal ward, the details of WHY they must not behave in certain ways around their infant, the latter whom are exceptionally vulnerable to whatever parental environment in which they happened to have been placed by fate.
    CONFLICT OF INTEREST: None Reported
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