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Taking Newborns Home Too Early May Be Risky

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WebMD Health News

Aug. 4, 2000 -- Going home from the hospital with your newborn is an exciting, emotional time. But a new survey reinforces the fear that checking out too soon can put some little ones at higher risk of dying within the first year of life from medical problems that are not always apparent in the first hours after birth.

In recent years, managed-care companies have put pressure on hospitals and doctors to send women home with their babies as soon as possible. Congress recently passed a law requiring insurers to allow women and their babies to stay in the hospital for 48 hours after a vaginal birth and 96 hours after a cesarean delivery. Nonetheless, many mothers and newborns continue to go home sooner.

"There is always pressure to get mothers out," says Moshe Ipp, MD, a pediatrician at the Hospital for Sick Children in Toronto. "But if the mother says she wants to go, the hospital will let them go unless [physicians] feel there is a risk factor." In Canada, new moms may stay as long as 60 hours and the insurance company must pay for it.

How early is too early to go home with your baby? In the survey of women who gave birth in Washington State in 1989 and 1990, babies sent home within 30 hours were almost four times more likely to die of heart-related illnesses, and nearly five times more likely to die of infection within one year of birth, than infants discharged later. Infants discharged early were also 44% more likely to die of sudden infant death syndrome (SIDS) than those discharged later.

The survey's main author, Jesse D. Malkin, PhD, tells WebMD the study is the first to find an association between early discharge and deaths of any cause in newborns."We found a significantly increased risk of death among newborns with very short hospital stays," says Malkin, a researcher at Covance Health Economics and Outcomes Services in Gaithersburg, Md.

Heart-related problems can be tricky to diagnose and may not be apparent for several days after the baby is born. The same is true for some potentially dangerous infections.

In the survey, published in the August issue of the journal Obstetrics & Gynecology, babies of poorer mothers and mothers who had given birth previously were more likely to be sent home early. Early discharge was highest among Hispanic mothers and infants. Very late discharge (more than 78 hours after birth) was highest among babies born by cesarean section.

Of 155 deaths occurring in the first year of life, 66.5% were attributed to SIDS. In the past few years, the American Academy of Pediatrics has tried to educate mothers that putting babies to sleep on their backs can virtually eliminate the risk of SIDS.

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