Transition to neonatal follow-up programs: is attendance a problem?

Neonatal follow-up (NFU) programs provide health services for infants at high risk for developmental problems after they transition home from the neonatal intensive care unit (NICU). The purpose of the study was to assess current patterns of NFU attendance and explore time points when mothers and infants withdrew from NFU programs during the infant's first year of life. The study was conducted in 3 Canadian tertiary-level NICUs that referred to 2 affiliated, regional NFU programs. A total of 357 mothers and 400 infants were consecutively recruited during NICU hospitalization. Attendance at NFU programs was tracked at each of the 3 scheduled appointments from existing NFU databases. Attendance at NFU decreased over time from 84% at the first appointment to 74% by 12 months, with the highest withdrawal from NFU after NICU discharge, followed by withdrawal after the first NFU appointment. Nonattendance at NFU results in less access to required services and underreporting of the developmental outcomes of these infants. Given these findings, mothers should be screened earlier in the NICU to identify those at greatest risk of not attending NFU. Strategies should be implemented to address potential barriers and provide effective transition and access to the NFU program.