https://doi.org/10.1177/0009922817698807 Clinical Pediatrics 1–3 © The Author(s) 2017 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0009922817698807 journals.sagepub.com/home/cpj Brief Report Introduction In the 1970s, the average length of stay for a vaginal delivery was 4 days. As the emphasis on decreasing length of stay and increasing profits grew by the early 1990s, babies were being discharged in as little as 8 hours. 1,2 The number of babies having adverse conse- quences associated with early discharge grew to point where the government passed the Newborns’ and Mothers’ Health Protection Act of 1996. 3,4 This law required health insurance plans to provide mothers the option for hospital stay of 48 hours for a vaginal deliv- ery and 72 hours for a cesarean section. Studies on out- comes of newborns discharged early have been favorable. 5-12 However, other research gives cause for some concerns about higher rehospitalization rates 13,14 and group B and Escherichia coli infections. 15 There is general agreement that adequate follow-up within two days especially when discharge occurs less than 48 hours is essential. 16-19 Now, 2 decades later the topic of early discharge of the newborn has returned. In response, the American Academy of Pediatrics (AAP) set strict criteria for babies that could be discharged at 24 hours of life. 20 The purpose of this study is to investigate the out- comes of newborns meeting the AAP criteria for early discharge. We hypothesized that among babies that meet early discharge criteria based on the current AAP guide- lines there would be some babies who have negative events and would have benefited from a minimum of 48 hours of inpatient hospital observation. Methods After institutional review board approval had been obtained, a retrospective review of 1608 charts was con- ducted on newborns admitted between July 2012 and December 2012 to the Florida State University pediatric resident teaching service. The standard of care on the service is to discharge at an average age of 48 hours for babies born via vaginal delivery and 72 hours for cesar- ean section. A 10-item questionnaire (Table 1) that contained American Academy of Pediatrics criteria for early dis- charge was created by the research team and applied for each record. If any criterion for early discharge was not met, then they were excluded. The research team reviewed the medical records to determine if there were any negative consequences/complications that occurred during the subsequent time spent in the nursery after 24 hours for those who met criteria for early discharge. Of note, all problems identified were assessed by a physi- cian. Also, readmission rates in the first week of life were measured for the babies that met early discharge criteria. Results There were 1608 babies born between July through December 2012. Out of 940 babies admitted to the Florida State University residency newborn service, 260 met early discharge criteria (27.7%). Among the 260 babies who met criteria, 21 developed problems after 24 hours of life (8.1%) while still admitted in the nursery. Problems included jaundice, poor feeding, rule out sepsis, abnormal bleeding, congenital heart disease, neurologic problems including seizures and abnormal magnetic resonance imaging, stridor, abdominal disten- sion, weight loss, respiratory distress, hydronephrosis, cyanosis, bradycardia, arrhythmia, vesicular rash erup- tion, and abdominal distention from small left colon. Five out of the 260 babies that met early discharge 698807CPJ XX X 10.1177/0009922817698807Clinical PediatricsGorman et al research-article 2017 1 Florida State University, Pensacola, FL, USA 2 University of West Florida, Pensacola, FL, USA 3 University of Florida, Pensacola, FL, USA Corresponding Author: James J. Burns, 58 Narvaez Lane, Pensacola, FL 32508, USA. Email: james.burns@ufl.edu Potential Adverse Consequences of Early Discharge for Newborns Who Meet American Academy of Pediatrics Criteria Stephanie Gorman, DO 1 , Amy Lee, MD 1 , Raid Amin, PhD 2 , and James J. Burns, MD, MPH 3