Parents' Knowledge and Experiences with Preterm and Full Term Infant Care after Hospital Discharge

Purpose:

The purpose of this literature review is to update the literature on how parents handle infants after hospital discharge and highlight show areas for which the needs of parents are not met through discharge planning, preparation and educational follow-up.

Methods:

A limited search of PubMed and CINAHL was performed to identify English language published papers on patients’ education on transition from hospital to home on newborn care from 1991 to 2014.  Articles were excluded if they were not related to maternal knowledge and experiences with newborn after discharge from the hospital.

We found 15 articles (8 quantitative, 6 qualitative and 1 multiple design) with sample sizes ranging from 10- 386. Of 15 articles included in this review, all but three articles were published within a ten year period.  The 15 studies  considered discharge teaching, mothers’ readiness for discharge, and mother's emotional responses after discharge and sources of information.  Eight of the studies examined mothers who had preterm babies. Three evaluated first time mothers and five studies examined mothers with full term infants.

Results:

Transition from the NICU to home for mothers with preterm babies is met with mixed emotions: joy, anxiety, and relief.  First time mothers reported not being prepared during the antenatal period for their babies’ discharge.  They were initially fearful, with emotions transforming into excitement, confusion and surprise in the postnatal period. First time mothers may be over utilizing health services because of insufficient knowledge regarding how to handle problems that arise at home and when to contact a provider or ancillary services for support. First time mothers had unique needs related to breastfeeding, felt that they were inadequately prepared for breastfeeding, their needs for learning to breastfeed were unmet in the inpatient setting, and were most interested in being better prepared pre-discharge.  Mothers with healthy infants were concerned about early discharge; they desired more time in the hospital to recuperate physically and emotionally before being discharged but they reported receiving quality teaching and were somewhat, although not entirely, ready for discharge. Mothers with preterm infants were separated from their newborns during NICU admission, and did not have the opportunity to care for their newborn in the presence of supportive and knowledgeable staff, and thus faced difficulties and strived to cope with infant care after discharge

Conclusion:

Mothers’ perceptions of their needs and readiness to transition from hospital or NICU to home varied by parity, previous experiences with newborn care and the health of their babies. Health care providers providing prenatal care education and newborn discharge teaching should consider parity, preterm or full term birth, and breastfeeding to better prepare the mothers to safely and confidentially care for their babies at home.