Monitoring After Discharge from Neonatal Intensive Care Unit

1 of every 10 babies born every year in Israel is treated in the neonatal intensive care unit (NICU), most of whom are premature. The duration of the hospitalization and complexity of the accompanying morbidity are primarily affected by the week of pregnancy in which the baby was born, the birth weight and the complications of pregnancy and delivery. Even treatment and monitoring in the Family Care Center by other professionals will be based on the week of birth and the medical condition. Comprehensive monitoring, following discharge from the hospital NICU and after, in the first years of life of the premature infant can help promote the normal development. It is therefore important to adhere to the monitoring process and treatments recommended by the medical staff treating the child, including growth monitoring, vaccinations, and so on.

The care of premature infants and children who are born sick can cause you, the parents and the entire family, physical and emotional stress, and this is perfectly natural. Do not stay alone with your questions, concerns, deliberations and challenges. It is important that you receive support from the nurses at the Family Care Center, associations that specialize in caring for premature infants (such as LAHAV, the association for premature infants in Israel), and other practitioners in your HMO.

Preparing for the premature infant’s discharge from the hospital

As soon as possible following the hospitalization of the baby, it is important to register him or her at the Family Care Center nearest to your place of residence and the HMO in which you are insured. This is also the time to choose a pediatrician from your HMO who will care for the child and perform the necessary follow-up.

Early affiliation is key for the continuity of future care. It is also important to make sure that the summary of the medical and nursing information, and information on the unique follow-up needs of your baby, are sent at least one week before the intended discharge from the NICU to the physician you have chosen, to the child development center of the district HMO, and to the Family Care Center at which you will be treated.

You need to make sure that a representative of the HMO at the hospital submits the information, and if this does not happen, make sure to request copies of the summary of medical and nursing information from the hospital staff and send the information yourself to the professionals in the community.

The period of hospitalization in the NICU can be complicated for you and full of concerns and questions. Shortly before discharge of the premature or sick infant from the hospital, a preparatory meeting will be held, with the parents, the attending physician and a nurse of the NICU. Other parties may occasionally participate in this meeting. The recommendations in the discharge summary will include the details of the monitoring required in the community and the schedule of its implementation.

Before heading home and before the transition to care in the community, you must schedule a meeting with the physician you selected for your child in the HMO to plan the continued care and monitoring in the community.

Monitoring by a pediatrician

The purpose of the first meeting with the baby's pediatrician, which should take place within two weeks of discharge from the hospital, is to perform a medical examination and personal introduction. Schedule the visit to off-hours so that the baby will not be exposed to infectious diseases.

The appointment will take place at the HMO clinic, and the physician will rely on the summary sent to the HMO. You must bring the discharge summary with you. The physician will review the course of hospitalization with you, examine the baby and create a plan for further treatment and monitoring. During the monitoring appointments, the physicians will conduct various tests, including physical and neurological tests aimed at early detection, monitoring and treatment of common diseases in premature babies, assess growth and achievement of developmental milestones, adjust a dietary plan based on the baby’s requirements, determine the required vaccination based on the age of the baby, issue a referral for auditory monitoring and so on. Depending on the needs of the premature baby and the recommendations of physicians, you may receive referrals for further assessments by a physical therapist, an occupational therapist or a dietitian.