title: Neonatal management and safe discharge of late and moderate preterm infants.
abstract: Late and moderate preterm infants form the majority of admissions for prematurity to special care neonatal nurseries. Although at risk for acute disorders of prematurity, they do not suffer the serious long term risks and chronic illnesses of the extremely premature. The special challenges addressed here are of transition and of thermal adaptation, nutritional compensation for postnatal growth restriction, the establishment of early feeding, and the avoidance of post-discharge jaundice or apnea. These 'healthy' premature infants provide challenges for discharge planning, in that opportunities may be available for discharge well before the expected date of delivery, which should be pursued. Barriers to early discharge are rigid conservative protocols and unwarranted investigations; facilitators of discharge are individualized care by nurses expert in cue-based feeding, early management of the thermal environment, support of family preferences and encouragement of mother-baby interactions. Safe discharge depends on recognizing these opportunities and applying strategies to address them.
authors.affiliation: Dalhousie University, IWK Health Centre G2216, 5980 University Avenue, Halifax, Nova Scotia, Canada B3J 6R8. Robin.whyte@dal.ca
authors.forename: Robin K
authors.initials: RK
authors.lastname: Whyte
mesh_terms: D001833:Body Temperature Regulation; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007235:Infant, Premature, Diseases / Q000451:nursing / Q000628:therapy*; D007363:Intensive Care Units, Neonatal; D017283:Neonatal Nursing / Q000379:methods*; D010351:Patient Discharge / Q000592:standards*