Bringing Your NICU Baby Home: A Discharge Checklist

Key takeaways

The AAP describes babies as ready for discharge when they are breathing on their own, keeping their temperature, feeding by breast or bottle, and gaining weight steadily.
The AAP says babies born preterm should be screened in their car seat before going home to make sure they can ride safely semi-reclined.
Before discharge, ask about hearing, newborn blood, and heart (CCHD) screening results, RSV protection, and infant CPR training.
Safe sleep for every sleep: on the back, alone, on a firm, flat surface in your room — never in a car seat or swing.
Plan follow-up early: your pediatrician, the NICU follow-up clinic if referred, and early intervention when recommended.

This page is general information, not medical advice. Every baby is different — talk with your baby’s NICU team or pediatrician about what is right for your family.

How the team decides your baby is ready

There’s no single due date for leaving the NICU. Babies go home when they’ve reached certain milestones. The American Academy of Pediatrics (AAP) says that before discharge, a baby should be:

Breathing on their own. Some babies still go home with oxygen or a monitor, and you’ll be trained on any equipment before you leave.
Keeping their own temperature. Nemours KidsHealth describes this as maintaining body temperature in an open crib, with no warmers, for at least 24–48 hours.
Feeding by breast or bottle. KidsHealth notes this usually means taking feedings without supplemental tube feedings. (Some babies go home with a feeding tube and a plan for using it.)
Gaining weight steadily.

Any other medical problems should be resolved, or home care set up, before your baby leaves. If you’re not sure where your baby stands, our questions to ask the NICU team can help you start the conversation. You can also use our corrected age calculator to keep track of milestones after you’re home.

The car seat test (“car seat challenge”)

Car seats hold babies semi-reclined. That position can be hard on some small or early babies’ breathing. So the AAP says babies born preterm should be screened while still in the hospital to make sure they can sit safely in a semi-reclined position. The AAP first endorsed this kind of screening in 1991.

Many hospitals ask you to bring in your own car seat for it. Your baby is buckled in and connected to a monitor that watches their heart rate, breathing, and oxygen levels for a set period of time. The staff are watching for pauses in breathing, a slow heart rate, or a drop in oxygen.

If your baby needs to lie flat to travel, they may be able to ride in a car bed that meets federal safety standards. The AAP says those babies should be screened again in the hospital to make sure they can lie safely in the car bed. Ask your NICU how its test works and what happens if your baby doesn’t pass the first time.

At home, car seats are for travel only. If your baby falls asleep in the car seat, move them to a firm, flat sleep surface on their back as soon as you can.

Screenings before discharge

Hearing screen

The CDC says all babies should have a hearing screen no later than 1 month of age, ideally before leaving the hospital. If your baby doesn’t pass, they should have a full hearing test as soon as possible, and no later than 3 months. A noisy room or a crying baby can make results unclear, so a retest is common and doesn’t always mean something is wrong.

Newborn blood screen

A few drops of blood from your baby’s heel are tested for rare but serious conditions. The AAP recommends that results be reviewed before NICU discharge and shared with your baby’s pediatrician. Ask for them if no one has mentioned them.

Heart screen (CCHD)

Screening for critical congenital heart defects uses pulse oximetry, a painless sensor on the skin that measures oxygen in the blood. The CDC says it’s done once a baby is at least 24 hours old.

RSV protection

RSV can be serious for babies who were in the NICU. Ask whether your baby is protected this season before you go home. Read our guide to RSV after the NICU. It’s the illness that sent Maverick back to the hospital after he came home (our story).

Getting yourself ready

Infant CPR. The AAP says parents will be taught infant CPR before discharge. March of Dimes also suggests taking an infant CPR class and any discharge class your hospital offers.
Rooming-in. Many hospitals let parents “room in” with their baby for a night or two before going home. You do the care on your own while the NICU staff are still close by.
Medicines and equipment. March of Dimes suggests asking a nurse or NICU pharmacist to help you make a medicine chart, and practicing with any equipment before discharge.
Car seat check. March of Dimes recommends having a certified Child Passenger Safety Technician check how your car seat is installed.
Discharge summary. Get a copy before you leave. It describes your baby’s NICU care and follow-up needs, so you can share it with future providers.
Vaccines for caregivers. The AAP suggests asking anyone who will be around your baby to get up to date on vaccines such as flu, COVID-19, and whooping cough (pertussis).

Safe sleep at home

The AAP updated its safe sleep recommendations in 2022. The core of them for parents:

Place your baby on their back for every sleep, naps and nighttime alike.
Use a crib or bassinet with a firm, flat surface. Anything inclined more than 10 degrees isn’t safe for sleep.
Keep pillows, blankets, bumpers, and soft toys out of the sleep space.
Share a room, not a bed, preferably for at least the first 6 months.
Don’t use weighted blankets, sleepers, or swaddles.

Two notes matter most for NICU families. Preemies sometimes sleep on their stomachs in the NICU, but the AAP says to place them on their backs as soon as they’re medically stable. Bed-sharing is riskier for babies born preterm or at a low birth weight. If your baby has a condition that your doctor says needs a different sleep plan, follow your doctor’s specific instructions.

Follow-up care in the Treasure Valley

The AAP notes that preemies often need frequent medical and developmental follow-up after the NICU, and fewer visits as they grow and gain skills.

Your pediatrician

Nemours KidsHealth says the first pediatrician visit is usually within 2–4 days of discharge, unless your pediatrician has already been caring for your baby in the hospital. Ask your NICU team when your baby’s first visit should be, and book it before you leave.

NICU follow-up clinic

The St. Luke’s Children’s NICU Follow-up Clinic offers ongoing developmental follow-up for NICU graduates at 305 E. Jefferson St., Boise. It’s open Monday–Friday, 8 a.m.–5 p.m. Phone: (208) 381-7075.

Early intervention

Your baby’s team may recommend early intervention, such as physical, occupational, or speech therapy. In Idaho, that’s the Infant Toddler Program (Department of Health and Welfare). It serves children from birth to age 3 who have a significant developmental delay, or a condition likely to cause one. Parents can make a referral by phone, email, or online form; call (208) 334-5514.

More local options are on our Treasure Valley NICU resources page. If you have a friend heading home from the NICU, here’s how to help.

Printable “first weeks at home” checklist

Print this out and put it on the fridge. Cross off what doesn’t apply to your baby.

Before you leave the hospital

☐ Car seat installed and checked; car seat screening done if our NICU requires it
☐ Hearing, newborn blood, and CCHD screening results reviewed (and any retests scheduled)
☐ RSV protection plan for this season discussed
☐ Infant CPR class taken by everyone who will care for the baby
☐ Medicines, doses, and times written down; equipment training done
☐ Copy of the discharge summary in hand
☐ NICU phone number and after-hours number saved

Appointments to book

☐ First pediatrician visit (ask the NICU when — often within a few days of discharge)
☐ NICU follow-up clinic visit, if referred
☐ Eye exam follow-up, if our baby is being checked for retinopathy of prematurity
☐ Any specialist visits listed on the discharge summary
☐ Early intervention referral (Idaho Infant Toddler Program), if recommended — or if we have concerns

Every day at home

☐ Baby on their back, alone, in a crib or bassinet with a firm, flat surface — for every sleep
☐ Moved out of the car seat, swing, or carrier and into the crib if they fall asleep there
☐ Feeds and wet/dirty diapers tracked the way the NICU suggested
☐ Hands washed before holding the baby; sick visitors asked to wait
☐ Caregivers up to date on flu, COVID-19, and whooping cough vaccines

For us, the parents

☐ One person we can call when we’re overwhelmed
☐ A plan for sleep in shifts, if there are two of us
☐ Postpartum checkup booked for mom
☐ Mental health support numbers saved (see our parent mental health guide)

When to call: Ask your NICU team and pediatrician which symptoms mean you should call them, and which mean you should call 911. Write the answers here: ________________________________

Coming home can bring up a lot of feelings, too. Our guide to mental health for NICU parents has free, confidential places to turn.

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