Commentary by Jillian Connors, MD, FAAP
Published November 2022

Preterm birth, congenital disorders, and critical illness are frequent causes of prolonged hospitalization in the neonatal intensive care unit (NICU). Many of the issues that these newborns face are not yet resolved at the time of NICU discharge and will require continued outpatient management by the primary care physician (PCP) and pediatric subspecialists. While some newborns are ready to go home after NICU discharge, others will require continued inpatient care in a less acute setting. In addition, many newborns are dependent on technology such as oxygen, ventilators, or feeding tubes when they leave the NICU. For this module, we have selected resources including review articles, book chapters, and American Academy of Pediatrics (AAP) policy statements and clinical reports to aid in and guide the care of newborns with medical complexity as they transition out of the NICU.

This review article from Pediatrics In Review provides a broad overview of the multidisciplinary discharge planning process and many of the chronic health concerns that NICU graduates face after leaving the intensive care unit. It also highlights the neurodevelopmental concerns for newborns and infants with medical complexity and summarizes AAP-recommended developmental surveillance: Discharge of Medically Complex Infants and Developmental Follow-up | Pediatrics In Review

Further Reading: Hospital Discharge of the High-Risk Neonate | Neonatal Care: A Compendium of AAP Clinical Practice Guidelines and Policies | AAP Books

Keywords: NICU; anemia of prematurity; home monitoring; chronic lung disease; hydrocephalus; apneic spells; medical home; home ventilation; feeding plan