From the Guidelines
In Canada, the minimum time for an infant to be discharged home after birth is typically 24 hours for vaginal deliveries and 48 hours for cesarean deliveries, assuming both mother and baby are healthy with no complications. This timeframe allows healthcare providers to monitor the newborn for any immediate health concerns, conduct necessary screening tests, and ensure successful feeding is established. Before discharge, infants undergo important assessments including vital signs stability, feeding ability, urination and bowel movements, jaundice screening, and metabolic screening tests 1. The timing may be extended if there are any health concerns such as respiratory issues, feeding difficulties, jaundice, or if the baby was premature or has a low birth weight. Some hospitals offer early discharge programs where healthy mothers and babies can go home as early as 6-12 hours after an uncomplicated vaginal birth, but this requires follow-up care within 24-48 hours 1.
Key considerations for discharge include:
- Clinical course and physical examination reveal no abnormalities that require continued hospitalization
- The infant’s vital signs are documented as being within normal ranges, with appropriate variations based on physiologic state, and stable for the 12 hours preceding discharge
- Successful feeding is established, and the mother is educated on infant care and safety
- Follow-up care is arranged within 48-72 hours after discharge to assess the infant's health and address any concerns
It is essential to note that the decision to discharge an infant should be individualized, taking into account the specific needs and circumstances of the mother and baby. Healthcare providers should use their clinical judgment to determine the appropriate timing of discharge, ensuring that the infant's health is stable and that the mother is prepared to care for her baby at home.
From the Research
Discharge Time for Infants in Canada
- The minimum time an infant can be discharged home after birth in Canada varies depending on the health of the mother and infant, as well as the availability of support at home and access to follow-up care 2.
- For healthy term infants, many mother-infant dyads are ready to go home 24 hours after birth, and parent or guardian education and assessment of discharge readiness are important components of discharge planning 2.
- A study found that most obstetricians defined early discharge as that occurring within 24 hours after vaginal delivery and 72 hours after cesarean delivery 3.
- Another study suggested that discharge criteria and follow-up are available, flexible discharge timing and safety appear compatible, and professionals have supported flexible discharge guidelines 4.
Factors Influencing Discharge
- Factors influencing the outcomes of early discharge of both healthy first-time mothers and newborns include parental education in pregnancy, perinatal information before discharge, sources of support, and follow-up strategies after discharge 5.
- Outcomes such as breastfeeding, parents' experience, and readmission of the newborn may be influenced when first-time parents are discharged within 24 hours after birth 5.
- A survey of Canadian NICUs found that units varied widely in many discharge criteria and in their adherence to Canadian Paediatric Society guidelines, highlighting the need for standardized discharge practices 6.