Family-Centered Care, Education, and Discharge Planning
Family-centered care
Care is planned with the family: rooming-in, skin-to-skin contact, unrestricted parental presence, teaching at the bedside, and culturally and linguistically appropriate communication through a trained interpreter - never a family member for consent. Use teach-back to confirm understanding; documented teaching is not the same as learning.
Anticipatory guidance
Safe sleep (supine, firm surface, no loose bedding, room-sharing without bed-sharing), car seat use (rear-facing, correct harness, tolerance screening before discharge for preterm infants), the feeding plan, jaundice surveillance and follow-up, and clear "call us" criteria: fever, poor feeding, fewer wet diapers, lethargy, yellow palms and soles, projectile or bilious emesis. Include cord and circumcision care and maternal postpartum depression screening.
Discharge planning
AAP-style criteria: stable vital signs, established feeding, at least 24 hours of voiding and stooling, weight loss within acceptable limits, jaundice risk assessed and follow-up arranged, metabolic and hearing screening completed or scheduled, vitamin K and eye prophylaxis documented, and a follow-up visit within 48–72 hours for infants discharged before 48 hours of life. Screen for social risk - transportation, housing, feeding plan, support at home - before the day of discharge, not on it.
Traps
Teaching in jargon at 2 a.m. to a sleeping parent, assuming that a signed handout equals understanding, and discharging an early-discharge infant without a documented appointment.
Rule of thumb
Name the warning signs in plain language and have the parent repeat them back before they leave.