Rachel mentioned <<I would not advocate discontinuing eye prophylaxis in a
setting like the US without a safe follow-up system in place for every baby.
Those who decline
this measure are likely to be amply equipped to watch their babies and take
adequate steps to treat if needed.>>

That is only one difficulty with the early discharge to home with no support
system in place. Not only are parents unable to observe (because they have
not been taught) for (very unlikely) symptoms of gonorrhea, they are not
likely to bring their babies back to the hospital for care. The PKU test is
typical of this attitude: newborns are tested at 24 hours, but the test is
not valid until the baby has reached a digestive milestone, at about 1 week.
But, since parents cannot be "trusted" to bring their child back, the test
is repeated when the frightened parents get a "bad result."

Eye ointment (erythromycin) is mandated in Ohio, and at least in our local
hospitals, there is no getting out of it. Even a signed release is not
accepted (despite having 2 prenatal tests for gonorrhea!). The erythromycin
isn't as caustic as the silver nitrate, but it is a thick ointment that
blurs the vision. It is placed within 2 hours of birth to be checked off on
the newborn nurse checklist. But, if we were to wait the 2 hours, the baby
is usually tired and falling asleep. Putting ointment into a sleeping baby's
eyes is so easy, and by the time they wake, the blur has resolved itself.
Meanwhile, the baby has drunk in the parents for a few hours.

Early discharge contributes to breastfeeding difficulties when mothers are
unable to work it out, do not understand instructions, or are unable to
realize that their baby is in trouble. I I would not like to see the
extended 7-10 day stays as we saw in the US in the 1950-60's, but overnight
stays to home with no support is not advantageous, either. A home health
nurse would be such a wonderful program, but it is not financially supported
in many areas that need it. To the outsiders, it may seem like a luxury, but
it is often essential to the well-being of the family.

Best wishes from chilly Ohio,
Heather "Sam" Doak