Birth Injury Answers

NICU Binder pack

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The short answer

Print this, put it in a ring binder, and keep it at the bedside.

Teams change, memories blur, and in two years you will want to know exactly what happened in week three. You will also be asked the same questions by every new specialist for years.

The numbers, up front

Why a binder
A high-risk newborn discharge involves a written follow-up plan, and the record you keep alongside it is what carries forward to every new team 1
What to ask on rounds
What is the plan today, what are you watching for, and what would change the plan 2
Corrected age
For a baby born early, development is judged from the due date rather than the birth date for the first two years 3

Tab 1: contacts

Name / role / how to reach them / date met

Include: the attending neonatologist, the nurse practitioner, your bedside nurses, the respiratory therapist, the social worker, the lactation consultant, the case manager, and any specialist.

Tab 2: daily log

One line a day. Weight. Support. Feeds. What changed. What was said.

Date / weight / breathing support / feeds / what changed / what I was told

Tab 3: questions

Write them as they occur to you. Ask them at rounds.

Question / date asked / answer

Three questions that work every day

  1. What is the plan today?
  2. What are you watching for?
  3. What number or change would make you change the plan? 2

Tab 4: medicines

Medicine / dose / started / stopped / why

Newborn doses are calculated per kilogram of body weight, so ask which weight is being used. 4

Tab 5: results

Test / date / result / what it means

Ask specifically for:

  • Every head ultrasound, with dates. 5
  • Whether a term-equivalent MRI is planned. 5
  • Every bilirubin value with the time and the age in hours. 6
  • Every glucose value with the time. 7
  • Eye screening dates. 3
  • Hearing screening result and method. 8

Tab 6: before we go home

  • Written follow-up plan with actual dates 1
  • Hearing screening result, and any follow-up appointment booked 8
  • Bilirubin recheck arranged, if discharged in the first days 6
  • Early intervention referral made 9
  • Developmental follow-up clinic booked 1
  • Medicine list with doses and how long to continue
  • Equipment, with training
  • Infant CPR training
  • Written plan for what to do if we are worried at home
  • Copy of the discharge summary, not a leaflet

Where these facts come from

  1. American Academy of Pediatrics, Pediatrics. Hospital Discharge of the High-Risk Neonate. 2008. publications.aap.org/pediatrics/article/122/5/1119. Link checked September 3, 2026.
  2. American Academy of Pediatrics, Pediatrics. Levels of Neonatal Care. 2012. publications.aap.org/pediatrics/article/130/3/587. Link checked September 3, 2026.
  3. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Preterm Labor and Birth. 2025. www.nichd.nih.gov/health/topics/preterm. Link checked September 3, 2026.
  4. American Academy of Pediatrics. Neonatal Resuscitation Program. 2025. www.aap.org/en/learning/neonatal-resuscitation-program/. Link checked September 3, 2026.
  5. Elsevier. Volpe's Neurology of the Newborn, Sixth Edition. 2018. www.elsevier.com/books/volpes-neurology-of-the-newborn/volpe. Link checked September 3, 2026.
  6. American Academy of Pediatrics, Pediatrics. Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. 2022. publications.aap.org/pediatrics/article/150/3/e2022058859. Link checked September 3, 2026.
  7. American Academy of Pediatrics, Pediatrics. Postnatal Glucose Homeostasis in Late-Preterm and Term Infants. 2011. publications.aap.org/pediatrics/article/127/3/575. Link checked September 3, 2026.
  8. CDC. Early Hearing Detection and Intervention (EHDI) Hearing Screening and Follow-up Survey. 2024. www.cdc.gov/hearing-loss-children/hearing-screening/index.ht. Link checked September 3, 2026.
  9. U.S. Government Publishing Office, Electronic Code of Federal Regulations. 34 CFR Part 303, Early Intervention Program for Infants and Toddlers with Disabilities. 2025. www.ecfr.gov/current/title-34/subtitle-B/chapter-III/part-30. Link checked September 3, 2026.