THE PARADOXES OF EARLY DISCHARGE

Key words: Early newborn discharge, Breastfeeding, Maternal depression, Neonatal jaundice, Neonatal screening

The evidence on the health consequences of early newborn discharge are reviewed. Most of the studies on early discharge are aimed at showing that early discharge is safe and that no serious negative side effects are produced, rather than showing any benefit. In fact, marginal benefits from early discharge were shown only on breastfeeding. In many settings early discharge is accompanied by home visiting and follow up programs to reduce the risk of negative heakth events but the ultimate effect of this policy is to provide more services to low risk families. Finally, little attention has been paied to the consequences of early discharge on the familiar context rather than only on newborn health. For example, studies do not address the problem of maternal depression which could be affected by discharge policies. The author reports data from his own maternity service showing a high prevalence of health and social problems among the mothers soon after discharge from maternity. In conclusion, the debate on early discharge is diverting the attention from the real problems linked with the whole birth experience and the role that health services can play to promote a better start.