homeNICU Guide · 7 min read

NICU Discharge Checklist

The day you bring your baby home is one you have been waiting for. This guide helps you prepare,so you can walk out the door feeling ready, not just relieved.

Medical readiness criteria

There is no single discharge weight or age that applies to every premature baby. Readiness is assessed holistically. Most NICUs require the following:

  • Temperature regulation: Your baby can maintain their own body temperature in an open crib at room temperature,typically demonstrated over 24–48 hours without external heat support.
  • Full oral feeding: Your baby consistently takes all feeds by breast or bottle without significant desaturations, bradycardia, or signs of fatigue. (Some babies go home with NG tubes if oral feeding is progressing but not yet complete,ask your team about their policy.)
  • Steady weight gain: Your baby is gaining weight consistently, not just hovering. Most teams look for several consecutive days of appropriate gain.
  • Apnea-free period: The number of days required varies by hospital,typically 5–7 days without a significant apnea or bradycardia event. Ask your unit what their specific threshold is.
  • Newborn hearing screen: Typically completed before discharge.
  • Metabolic and genetic screenings: Standard newborn screens (PKU, etc.) completed.
  • Ophthalmology screening: ROP (retinopathy of prematurity) evaluation for babies born before 30–31 weeks,follow-up may continue outpatient.

Questions to ask before discharge

Write these down and ask your team before you leave:

  • What medications is my baby going home on, and exactly how do I give them?
  • Does my baby need any home medical equipment (oxygen, apnea monitor, feeding pump)?
  • What are the specific warning signs that require me to call the NICU? To go to the ER?
  • When is our first follow-up appointment and with whom?
  • What weight gain should I expect to see at home, and how often should I weigh my baby?
  • How do I know if my baby is getting enough to eat?
  • Are there any activity restrictions (visitors, outings, crowds)?
  • What's the plan for RSV prophylaxis (Synagis) if applicable?
  • Who do I call after hours if I have a concern?
  • Is there a NICU graduate support program or follow-up clinic we should attend?

The car seat challenge

Before discharge, most NICUs require premature babies to pass a car seat challenge(also called a car seat tolerance screening). Your baby sits in their own car seat for 90–120 minutes while monitored for oxygen desaturations or bradycardia.

This test exists because the semi-reclined position of a car seat can compress a preemie's airway and restrict breathing. Most babies pass,but the test ensures yours is ready for the trip home.

Bring your car seat to the hospital a day or two before anticipated discharge so nursing staff can check that it is properly positioned and fits your baby correctly. Car seat technicians at many hospitals can help with installation if needed.

Preparing your home

  • Safe sleep setup: Firm, flat mattress in a crib or bassinet. No loose bedding, pillows, positioners, or bumpers. Baby on their back for every sleep. Room-sharing (not bed-sharing) is recommended for at least the first 6 months.
  • Temperature: Room temperature 68–72°F (20–22°C). Avoid overdressing.
  • Limit visitors initially: Premature babies have immature immune systems. Limit exposure to crowds and sick contacts, especially in the first weeks home. RSV season is particularly high-risk.
  • Handwashing: Everyone who touches your baby should wash hands thoroughly first. This is non-negotiable.
  • Infant CPR: Complete an infant CPR class before discharge if you haven't already. Ask your hospital if they offer one,many NICUs provide this training to parents before going home.

Equipment checklist

Standard items every family needs:

  • Properly-fitted infant car seat (rear-facing, appropriate for birth weight)
  • Digital rectal or axillary thermometer
  • Feeding supplies (bottles, nipples appropriate for preemie, breast pump if continuing to pump)
  • Baby scale,if your team wants you to track weight at home

Items some families need based on their baby's situation:

  • Home oxygen and pulse oximeter (if going home on supplemental oxygen)
  • Apnea monitor
  • Feeding pump (for tube-fed babies)
  • Medications: iron supplements, vitamin D, caffeine, diuretics, reflux medications,varies widely by baby

Your NICU team will arrange home nursing visits, DME (durable medical equipment) delivery, and any medication training before discharge if your baby has complex needs.

Follow-up appointments to schedule

Book these before or immediately after discharge:

  • Pediatrician: Within 2–3 days of discharge. Choose a pediatrician experienced with premature infants if possible.
  • NICU follow-up clinic or developmental clinic: Many hospitals have dedicated outpatient clinics for NICU graduates,neurodevelopmental follow-up, physical therapy screening, etc. Get a referral before you leave.
  • Ophthalmology: If ROP screening is ongoing, your ophthalmologist will schedule follow-up appointments.
  • Cardiology, pulmonology, or other specialists: If your baby had specific complications (BPD, heart defects, etc.), specialist follow-up will be arranged.
  • Audiology: If hearing screen results need follow-up.
  • Early Intervention program: In the U.S., children under 3 who qualify receive free developmental support services through state Early Intervention programs. Ask your NICU social worker about a referral,the sooner the better.

Warning signs: when to call and when to go to the ER

Call your pediatrician or NICU follow-up team if your baby:

  • Is not feeding well or showing decreased interest in feeds
  • Has not regained birth weight by 2 weeks (full-term equivalent)
  • Has a temperature above 100.4°F (38°C) rectally or below 97.5°F (36.4°C)
  • Has jaundice that appears to be worsening
  • Seems unusually lethargic or difficult to wake for feeds

Go to the ER or call 911 immediately if your baby:

  • Stops breathing or turns blue/pale and does not respond to stimulation
  • Has a seizure
  • Has severe respiratory distress: nasal flaring, grunting, or chest retractions (skin pulling in between ribs)
  • Is unresponsive or extremely limp

Trust your instincts. You have spent weeks watching your baby closely. If something feels wrong, it is always appropriate to call.

Continuing to track after discharge

The intensive tracking that helped in the NICU continues to matter at home. Your pediatrician will want to know feeding volumes, weight trends, and any events at early visits.

Continue logging feedings, daily weights (if instructed), and any significant events. A consistent record makes it much easier to have productive conversations at follow-up visits and to identify patterns that might not be visible in a single appointment.

Keep tracking after the NICU

Lumen NICU goes home with you. Continue tracking feedings, weight, milestones, and more, with the same app your family used in the NICU, now built for life at home too.