Iatrogenic prematurity should be prevented by prolonging pregnancy whenever feasible. To that end, the American College of Obstetrics and Gynecology have come out with recommendations that prohibit induction or scheduled repeat cesarean delivery before 39 weeks, to which most hospitals now adhere. Because late preterm infants are at risk for certain medical problems, previously outlined, specific management strategies should be developed for both their initial hospitalization as well as their care after discharge. Early monitoring of respiratory status, temperature, feeding ability, bilirubin, and glucose levels are critical. The AAP has issued specific recommendations for minimum discharge criteria for late preterm infants. In addition to those things performed for term infants, the late preterm infant requires:
Accurate gestational age assessment.
Individualizing the time of discharge based on the baby's condition with regard to temperature stability and adequacy of feeding.
Identification of a medical home following discharge.
Normal vital signs for 12 hours before discharge.
Passing of one stool spontaneously.
The absence of excessive weight loss.
Screening for hyperbilirubinemia.
A car seat study for apnea, bradycardia, or oxygen desaturation.
Formal breast-feeding education when applicable.
Discharge follow-up. Strategies should include closer follow-up of issues such as weight gain and development, as well as good family support.