Canadian Journal of Public Health

, Volume 93, Issue 1, pp 26–30 | Cite as

The Safety of Canadian Early Discharge Guidelines

Effects of Discharge Timing on Readmission in the First Year Post-discharge and Exclusive Breastfeeding to Four Months
  • Sharon Yanicki
  • Paul Hasselback
  • Mark Sandilands
  • Chris Jensen-Ross



Few studies have examined earlier discharge in relation to Canadian guidelines for earlier discharge and infant feeding. We addressed differences in readmission (1 year post-discharge) and exclusive breastfeeding (4 months) for newborns and mothers discharged within 48 hours compared to those with a longer hospital stay.


A cohort of 1,357 vaginally delivered singleton normal newborns and their mothers (births between January 1, 1996 and March 31, 1997) were studied by linking five databases and a chart audit.


Overall there were no differences in infant and maternal readmission or rates of exclusive breastfeeding.


Canadian guidelines for earlier discharge appear appropriate for vaginally delivered singleton normal newborns and their mothers with timely home visitation.



Rares sont les études qui portent sur le congé précoce après l’accouchement à la lumière des recommandations canadiennes sur le congé précoce et l’allaitement des nouveau-nés. Nous avons examiné les différences entre le taux de réadmission (dans l’année suivant la sortie de l’hôpital) et le taux d’allaitement exclusivement au sein (pendant quatre mois) chez les nouveau-nés et les mères ayant obtenu leur congé de l’hôpital dans les 48 heures suivant l’accouchement et chez des sujets ayant séjourné plus longtemps à l’hôpital.


Nous avons étudié une cohorte de 1 357 bébés uniques normaux nés par accouchement vaginal entre le 1er janvier 1996 et le 31 mars 1997, avec leurs mères, en vérifiant leurs dossiers médicaux et en appariant cinq bases de données.


Globalement, il n’y avait pas de différence dans les taux de réadmission des mères et des nouveau-nés, ni dans les taux d’allaitement exclusivement au sein.


Les recommandations canadiennes au regard du congé précoce semblent appropriées pour les bébés uniques normaux nés par accouchement vaginal et pour les mères qui bénéficient de visites à domicile en temps opportun.


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  1. 1.
    Wen SW, Liu S, Marcoux S, Fowler D. Trends and variations in length of hospital stay for childbirth in Canada. CMAJ 1998;158(7).875–80.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Canadian Paediatric Society, Society of Obstetricians and Gynaecologists of Canada. Early Discharge and Length of Stay for Term Birth. SOGC News Policy Statement No. 52 (Clinical Practice Guidelines for Obstetrics Series), 1–7. 1996.Google Scholar
  3. 3.
    Canadian Paediatric Society, Dieticians of Canada, Health Canada. Nutrition for Healthy Term Infants. Ottawa: Minister of Public Works and Government Services, 1998.Google Scholar
  4. 4.
    Health Canada. Chapter 7 — Breastfeeding. In: Family-centered Maternity and Newborn Care: National Guidelines. Health Canada [4th Ed.], 1–50. 2000. Available on line at Scholar
  5. 5.
    Liu LL, Clemens CJ, Shay DK, Davis RL, Novack AH. The safety of newborn early discharge. The Washington State experience. JAMA 1997;274(4).293–98.CrossRefGoogle Scholar
  6. 6.
    Lock M, Ray JG. Higher neonatal morbidity after routine early hospital discharge. CMAJ 1999;161(3).249–53.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Kvist LJ, Persson E, Lingman GK. A comparative study of breast feeding after traditional postnatal hospital care and early discharge. Midwifery 1996;12(2).85–92.CrossRefGoogle Scholar
  8. 8.
    Arborelius E, Lindell D. Psychological aspects of early and late discharge after hospital delivery. An interview study of 44. Scand J Soc Med 1989;17(1).103–7.CrossRefGoogle Scholar
  9. 9.
    Carty EM, Bradley CF. A randomized, controlled evaluation of early postpartum hospital discharge. Birth: Issues in Perinatal Education 1990;17(4).199–204.CrossRefGoogle Scholar
  10. 10.
    Waldenstrom U, Sundeline C, Lindmark G. Early and late discharge after hospital birth: Breastfeeding. Acta Pediatr Scand 1987;76:.727–32.CrossRefGoogle Scholar
  11. 11.
    Renfrew MJ, Lang S. Early versus later discharge postpartum (Cochrane Review). In: The Cochrane Library 4. 1998. Oxford: Update Software. 99.Google Scholar
  12. 12.
    Braveman P, Egerter S, Pearl M, Marchi K, Miller C. Problems associated with early discharge of newborn infants. Early discharge of newborns and mothers; A critical review of the literature. Pediatrics Special Edition 1995;96 (4 Pt 1):716–26.PubMedGoogle Scholar
  13. 13.
    Lee KS, Perlman M. The impact of early obstetric discharge on newborn health care. Current Opinion in Pediatrics 1996;8(2).96–101.CrossRefGoogle Scholar
  14. 14.
    Braveman P, Miller C, Egerter S, Bennett T, English P, Katz P, et al. Health services use among low-risk newborns after early discharge with and without nurse home visiting. J Am Board Fam Prac 1996;9(4).254–60.Google Scholar
  15. 15.
    Brown SG, Johnson BT. Enhancing early discharge with home follow-up: A pilot project. J Obstet Gynecol Neonatal Nurs 1998;27(1).33–38.CrossRefGoogle Scholar
  16. 16.
    Meikle SF, Lyons E, Hulac P, Orleans M. Rehospitalizations and outpatient contacts of mothers and neonates after hospital discharge after vaginal delivery. Am J Obstet Gynecol 1998;179(1).166–71.CrossRefGoogle Scholar
  17. 17.
    Behram S, Moschler EF, Sayegh SK, Garguillo FP, Mann WJ. Implementation of early discharges after uncomplicated vaginal deliveries: Maternal and infant complications. Southern Medical J 1998;91(6).541–45.CrossRefGoogle Scholar
  18. 18.
    Alberta Health. Alberta Morbidity Database 1998-1999: Import/Export Data. 2000.Google Scholar
  19. 19.
    Statistics Canada. Canadian Census. Statistics Canada, 1996.Google Scholar
  20. 20.
    Jensen-Ross C, Sandilands M, Hasselback P, Yanicki SMT. Readmission patterns in the first year of life of “normal” newborns. Annals Royal College Physicians Surgeons Canada 2001;35(4).280–85.Google Scholar
  21. 21.
    Jensen-Ross CA, Hasselback PD, Sandilands ML, Yanicki SM. One-year readmission patterns for mothers of “normal newborns”. Annals Royal College Physicians Surgeons Canada 2001;34(4).210–16.Google Scholar
  22. 22.
    Labbok M, Krasovec K. Toward consistency in breastfeeding definitions. Studies in Family Planning 1990;21(4).226–30.CrossRefGoogle Scholar
  23. 23.
    Yanicki SM, Boechler VL, Buller LL, Bursey RJ, Jensen-Ross C, Plowman DE, et al. A comparison of postnatal contact and home visit services within regional health authorities in Alberta by length of hospital stay. 2000. Unpublished Work.Google Scholar
  24. 24.
    Jensen-Ross CA, Tennant WL, Bursey RJ, Yanicki SM, Boechler VL, Buller LL, et al. Hospital stay and readmission trends in Alberta. 2000. Unpublished Work.Google Scholar
  25. 25.
    Bragg EJ, Rosenn BM, Khoury JC, Miodovnik M, Siddiqi TA. The effect of early discharge after vaginal delivery on neonatal readmission rates. Obstet Gynecol 1997;89(6).930–33.CrossRefGoogle Scholar
  26. 26.
    Dalby DM, Williams JI, Hodnett E, Rush J. Postpartum safety and satisfaction following early discharge. Can J Public Health 1996;87(2).90–94.PubMedGoogle Scholar
  27. 27.
    Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. Pediatrics 1998;101(6).995–98.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2002

Authors and Affiliations

  • Sharon Yanicki
    • 1
  • Paul Hasselback
    • 1
    • 3
  • Mark Sandilands
    • 2
  • Chris Jensen-Ross
    • 1
  1. 1.Chinook Health RegionLethbridgeCanada
  2. 2.University of LethbridgeLethbridgeCanada
  3. 3.Medical Officer of HealthChinook Health RegionLethbridgeCanada

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