Policy on early discharge of the newborn from the hospital include that the
baby must be feeding well at breast or bottle. (these guidelines have come
out of out state AAP chapter but apparently the national AAP is working on
similar guidelines. Thus if the baby is not eating well (certainly not
latched on) then MOTHER AND BABY STAY. What about the insurance company. It's
all in the documentation. 24 hours is for normal UNCOMPLICATED deliveries.
If baby is not latching on it is now a COMPLICATION. In these situations when
we had 24 hour dc in NJ, I would write in chart. "baby is not latched on well
(or other lactation difficulty) and is not ready for discharge home.
Separation of mother and baby at this point would interfere with the
initiation of lactation and is medically contraindicated" With this strong
wording I have not been denied yet. (The insurance company would be crazy as
they are opening themselves to legal risk). Often an additional 24 hours for
mom and babe make all the difference
--
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*  Deena Zimmerman MD MPH                          *
*  Department of Pediatrics                        *
*  UMDNJ-Robert Wood Johnson Medical School        *
*  1 RWJ Place                                     *
*  New Brunswick, NJ 08903                         *
*                                                  *
*      phone (908) 235-7248                        *
*      fax   (908) 235-7345                        *
*      email  [log in to unmask] (internet)        *
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