Controversies of early discharge of infants from the well-newborn nursery.

A reduced hospital length of stay for normal newborns has become common, largely in an attempt to reduce hospital costs. Although evidence in the literature suggests that this is a safe practice, the overall quality of the studies is weak, and controversy exists regarding the advisability of this practice. A review of the rather modest literature and experience with shortened hospital stays lead us to conclude that early discharge of newborns is safe if it is but one component of a larger program designed to transfer portions of care traditionally provided in the hospital to pre- and postnatal care provided outside the hospital.

Acute otitis media: who needs posttreatment follow-up?

Objective: Because the optimal timing for follow-up of acute otitis media (AOM) is unknown and clinicians' recommendations for timing follow-up are highly variable, a study was conducted to determine which risk factors or symptoms could predict the resolution, recurrence, or persistence of AOM after treatment completion.

Methods: Three hundred four children from a general pediatric practice in a staff-model health maintenance organization, ages 6 months to 4 years diagnosed with AOM were enrolled in a prospective study of the clinical outcome of AOM at 10 to 21 days from diagnosis. Risk factors, symptoms, and parental observations were obtained by questionnaire at both the initial and follow-up visit 10 to 21 days later.