Questions to Ask Your Neonatologist (at Rounds, Before Discharge, and When Things Change)

Morning rounds in the NICU last ten minutes, maybe fifteen. Your baby's neonatologist will present a summary of the overnight, discuss the plan for the day, and move to the next bedside. If you're not ready with questions, the window closes.

This list is for parents who want to use that window well. It covers what to ask at rounds, what to ask before discharge, and the questions that come up when something changes.

At daily rounds

• What is the plan for today? What are you hoping to see by tomorrow?
• What happened overnight that I should know about?
• What are the numbers we're watching most closely right now, and what are you hoping to see?
• Is there anything that happened since yesterday that concerned you or changed your thinking?
• What would need to happen for us to move to the next step? (Extubation, stepping down oxygen support, starting feeds, etc.)
• Is there anything I can do today at the bedside that would help my baby?
• What's the one thing I should tell my family/partner tonight about where things stand?

About your baby's specific condition

These questions are for common premature complications. Not every baby will experience all of these — ask the ones that are relevant to your situation.

Breathing and oxygen

• What support is my baby on right now — ventilator, CPAP, high-flow, or room air?
• What does the plan to wean look like, and how fast does it typically happen?
• My baby had several bradycardia/apnea events last night. Is that trend concerning or still within expected range?
• What is the target oxygen saturation range for my baby at this gestational age?

Feeding

• What volume is my baby receiving per feed, and what's the plan to increase it?
• How are you measuring feed tolerance? What would make you slow down or stop advancing?
• When do you think we'll be able to try breastfeeding or bottle feeding?
• Is my baby receiving my breastmilk, fortified breastmilk, or formula — and why?

Brain health

• Has my baby had a head ultrasound? What did it show?
• When is the next one scheduled?
• I've heard about IVH (intraventricular haemorrhage) — what grade was my baby's, if any, and what does that mean for us?
• Will my baby need an MRI before discharge? What would you be looking for?

Eyes

• Has my baby been screened for ROP (retinopathy of prematurity)?
• What was the finding, and when is the next screening?
• Does my baby need a referral to a paediatric ophthalmologist?

Infections and labs

• What do the current blood labs show? Are there any values you're concerned about?
• My baby is on antibiotics — what is the suspected or confirmed infection, and how long is the course?
• How are you monitoring for late-onset sepsis?

Before discharge

The discharge conversation should happen over several days, not in the last hour before you leave. Start asking these questions about one to two weeks before the expected discharge date.

• What criteria does my baby need to meet before we can go home?
• How will I know when discharge is getting close?
• What equipment or monitoring will my baby need at home? (Apnea monitor, supplemental oxygen, etc.)
• Will my baby be on any medications at home? Can you walk me through each one?
• Who will my baby's outpatient pediatrician be, and have you communicated with them?
• What does the follow-up schedule look like? What specialties will we see?
• What should I watch for at home, and when do I call the pediatrician versus going to the ER?
• Is there a NICU follow-up clinic my baby will attend?
• If my baby comes home on supplemental oxygen, how do I manage that? Is there a home health nurse?
• When is it safe to have visitors? What precautions should we take about RSV and other infections?

When something changes unexpectedly

• Can you explain what happened and what it means in plain language?
• Was this expected or is this a new development?
• Does this change the overall trajectory or prognosis?
• What happens next — what's the plan from here?
• Is there a specialist who should be involved that isn't already?
• Should we call family? Is there anything about the severity I should understand that I might not be grasping?

About long-term outcomes

These questions can be hard to ask and hard to hear. They're also important. Your team will tell you when it's appropriate to discuss them — but you also have every right to bring them up yourself.

• Based on what you're seeing now, what do you expect my baby's long-term development to look like?
• Are there any conditions related to prematurity we should be watching for as my baby grows?
• What does the research say about outcomes for babies born at my baby's gestational age and birth weight?
• What early intervention services should we pursue after discharge, and how do we access them?
• How do I use my baby's adjusted age when tracking milestones?

One last thing

You don't need to ask every question on this list. The best questions are the ones that are keeping you up at night — bring those. Write them down before rounds so you don't forget, and don't hesitate to ask for clarification on anything you don't understand. Your baby's neonatologist has answered the same questions from hundreds of families. There are no questions too basic, too emotional, or too much.