When can I bring my baby home from the NICU?

By Tammy Hoff, RN, MS, NE-BC

When your preemie is in the neonatal intensive care unit (NICU), you dream of the day when they can come home. Every baby’s timeline in the NICU varies; however, every preemie needs to meet certain milestones before they are given the green light to go home. Here are some of those milestones.

Breathing on their own

One of the first things required of your baby is the ability to breathe on their own, without support from a ventilator or CPAP machine. Oftentimes, premature babies need help to breathe because their lungs have not finished developing. The amount of time a baby needs breathing support varies depending on how early they were born. Although some babies may still require supplemental oxygen when they are discharged, they must still be able to breathe on their own.

Maintaining body temperature

Full-term babies are born with a layer of fat that helps keep them warm. When a baby is born too soon, this fat layer is missing. In addition, a preemie is not able to shiver. As a result, the baby may have trouble staying warm, and it is difficult for them to regulate their body temperature. This is why preemies are placed in an incubator with a heated bed. When a baby begins regulating their own body temperature, they are moved from an incubator to an open crib.

Feeding by mouth

While most full-term babies are able to take nutrition from their mom’s breast or a bottle, most preemies need help to eat. The majority of preemies will need to be fed through a tube until they are strong enough to take in enough milk by eating from breast or bottle. And most preemies will also need the help of special products, such as a fortifier, that can be added to mom’s milk or donor milk to increase the calories and fat they receive.

Healthy growth

In the NICU, healthy growth is measured not only by weight gain but also by growth in length and head circumference. Taken together, all of these measures tell your doctors whether your baby is growing at a pace similar to how they would have grown if still in the womb.

Sitting safely in a car seat

Once a baby is able to breathe on their own, regulate their body temperature, and appropriately feed and gain weight, they will undergo their final test – sitting safely in a car seat. In this test, the baby is strapped into an infant car seat for 90 to 120 minutes (or the length of their car ride home, whichever is longer) to make sure that they can breathe in a sitting position. Once your baby can reach all of these milestones, they will be much closer to going home!