Feeding and weight loss

Babies need to demonstrate that they are able to feed well enough to be safe for discharge, whether bottle or breast fed.

Babies are born with extra water in their bodies. They are meant to lose weight, and can lose up to 10% of their body weight in the first 4-5 days of life. They are supposed to be back to their birth weight by 2 weeks of age. Babies who are losing weight faster than normal the first day or two may need to go home on supplemental feedings if breastfeeding, or increased formula feedings, and follow-up the next day or two with a pediatrician.

Schedule your baby’s first doctor’s visit

Guidelines for discharge recommend that a follow-up plan for the baby must be established before discharge from the hospital. Ideally, the appointment will be scheduled before discharge. If not, there must at least be a follow-up plan in place. All babies must be seen 1-3 days after discharge; it cannot wait on arranging insurance or finding a doctor for your baby.

Birth certificate, Social Security, and insurance

Before discharge, staff will have you complete the state birth certificate form. You may also complete Social Security registration in order to receive a number and card. If you qualify for Medicaid, the hospital may help register your baby for Medicaid.

Discharge requirements checklist

  • Urinate at least once (and if circumcised, once after that)
  • Poop at least once (babies who don’t urinate in 24 or poop in 48 hours after birth need to be evaluated)
  • Jaundice risk level screening
  • Critical congenital heart disease screening
  • Hearing screening
  • Newborn genetic & metabolic screening sent to state lab (after 24 hours of age)
  • Required lab results on mom are back. Usually these are done during pregnancy, but if mom did not complete her prenatal care, or mom was scheduled to deliver at another hospital and her medical records are not available, then they have to be obtained before the baby can leave. These include hepatitis B during pregnancy, and HIV and syphilis testing during the third trimester (required by law in Georgia).
  • Results of testing for infection if needed
  • Newborn exam by doctor or other clinician
  • Any identified issues are dealt with, such as a heart murmur that needs to be checked before discharge
  • Baby is able to feed well
  • You have a car seat for the baby
  • If baby is less than 37 weeks old, should stay 48 hours for observation
  • If baby is small for gestational age, has to pass the car seat test (maintain airway, breathing, and oxygen level while sitting up in seat). If not, have to obtain a car seat bed for the baby.
  • If there were any issues with drug use during pregnancy, then that has to be addressed before discharge to ensure the safety of the baby.
  • Hepatitis B vaccine (unless refused)
  • Circumcision if desired; must urinate once after circumcision
  • Have to have a follow-up plan for your baby for 1-3 days with a pediatrician