CRITICAL ISSUES IN THE EARLY DISCHARGE OF THE NEWBORN

Early discharge (ED) of healthy “late preterm” and full term newborn infants has become a common practice because of current social and economic necessities. The average length of stay of mothers and infants after delivery shortened steadily from 1970 until the mid-1990s and in 1995, the American Academy of Pediatrics (AAP) defined early and very early discharge as stays of 48 and 24 hours, respectively, after uncomplicated vaginal delivery. The length of stay (LOS) of a child after birth has been a controversial topic over the past few decades. A Cochrane Review in 2002 found that early postnatal discharge showed no adverse effects on breastfeeding and maternal depression when accompanied by a policy of nursing/midwifery home visits. Even if this practice has become more and more widespread, there was an increased rate of early post discharge readmission for jaundice, feeding problems, excessive weight loss (WL), dehydration and hypernatremia. For this reason, it is recommended that early discharged neonates should be evaluated shortly after discharge. Our aim was to review the available data about the safety of ED as regards to the most common problems causing hospital readmission.