Table 1 Criteria to be met before discharge of a term neonate (modified from American Academy of Pediatrics 2015)

1.

Clinical course and physical examination at discharge have not revealed abnormalities that require continued hospitalization

2.

Infant's vital signs within normal ranges and stable for the 12 hours preceding discharge

3.

The infant has urinated regularly and passed at least 1 stool spontaneously

4.

The infant is able to coordinate sucking, swallowing, and breathing while feeding

5.

The clinical risk of development of subsequent hyperbilirubinemia has been assessed, and appropriate management and/or follow-up plans have been instituted as recommended in guidelines for management of hyperbilirubinemia

6.

The infant has been adequately evaluated and monitored for sepsis on the basis of maternal risk factors and in accordance with current guidelines for prevention of perinatal group B streptococcal disease.

7.

Availability and evaluation of maternal screening results for syphilis, hepatitis B, HIV and appropriate treatment instituted when needed

8.

Newborn metabolic and hearing screenings completed

B)

Maternal competency

1.

Breastfeeding (positions, latch-on, efficacy of swallowing, importance and benefits) or bottle feeding

2.

Appropriate urination and defecation frequency for the infant

3.

Cord, skin, and genital care for the infant

4.

Infant safety

5.

The ability to recognize signs of illness and common infant problems, particularly jaundice

C)

Assessment of family, environmental, and social risk factors and discussions with social services when plan to safeguard the infant is needed

1.

Untreated parental substance abuse or positive urine toxicology results in the mother or newborn

2.

History of child abuse or neglect or history of domestic violence

3.

Mental illness in a parent who is in the home

4.

Lack of social support, particularly for adolescent mother or single mother who live in a shelter, a rehabilitation home, or on the street

5.

Communicable illness in a parent or other members of the household

6.

Assessment of barriers to adequate follow-up care for the newborn, such as lack of transportation to medical care services or language barriers to make suitable arrangements to address the family

D)

Plan for continuing medical care

1.

Identification of medical services for postnatal checks

2.

Date of first appointment after discharge

3.

Planning bilirubin check or other individualized controls when needed