Safe Transition to Home: Preparing the Near-term Infant for Discharge

Near-term infants, although often mature in appearance, are at risk for developing several complications, including hypothermia, hypoglycemia, infection, inadequate feeding, airway compromise, and hyperbilirubinemia. In many cases, these infants are discharged home with their mothers within 48 to 72 hours of delivery with similar discharge education and follow-up as full-term infants. This practice is not evidence-based and places these infants at risk for serious complications. In this article, the physiologic mechanisms that increase the risk of complications in this population are reviewed to provide the reader with an in-depth understanding of the importance of tailoring discharge education and follow-up to this specific population. Implications for practice are proposed and a near-term infant discharge checklist is introduced. The proposed changes in clinical practice aim at better meeting the needs of near-term infants and their families to promote the safe transition to home and prevent the development of complications and need for rehospitalization.