| name | leo-discharge-ops |
| description | Use when managing Leo's post-discharge homecoming transition and ongoing preemie care protocols at home. Status ACTIVE — Leo home June 3, 2026. |
| version | 1.1.0 |
| author | Hermes Agent |
| license | MIT |
| metadata | {"hermes":{"tags":["home-assistant","rocha-family","nicu","twins","leo","discharge","preemie"],"related_skills":["nicu-care","family-profile","wellness-coach","parenting-coach","dog-parent"]}} |
Leo Discharge Operations
Overview
Leo Rocha came home June 3, 2026 — approximately 7 weeks after birth (April 16, preterm). This skill governs post-discharge home protocols for a preemie: temperature management, RSV exposure rules, feeding cadence, adjusted age milestone tracking, and family transition support.
When to Use
- Any question about Leo's care at home
- Scheduling pediatric follow-ups
- Assessing environment safety (visitors, temperature, exposure)
- Milestone check-ins or weight-gain monitoring
- Escalating concerns to medical team
Status: ACTIVE — Leo Home June 3, 2026 ✅
Current Profile (as of June 3, 2026)
- Leo — born April 16, 2026 (preterm, ~10 weeks early)
- Chronological age: ~7 weeks
- Adjusted age: ~-3 weeks (corrected for prematurity)
- Discharge weight: TBD (confirm at discharge appointment)
- Feeding: breast milk (Paula pumping, baseline ~220 mL/day pump log Day 48)
- Primary concern: RSV season caution, preemie immune system
Home Environment Requirements
Temperature
- Nursery: 68–72°F (preemie requirement — tighter than standard 68–76°F)
- Monitor continuously; flag to Hector if outside range
- AC must maintain in Houston summer
RSV / Infection Control
- No visitors with cold/flu symptoms — enforce strictly
- Handwashing before handling: family + all visitors
- Minimize crowded public spaces for 8+ weeks post-discharge
- RSV season: October–March (plan ahead for fall 2026)
- Palivizumab (RSV shot): confirm with pediatrician at first follow-up
Feeding Cadence
- Preemies typically feed every 2–3 hours
- Wake to feed if sleeping > 3 hours (until cleared by pediatrician)
- Track: volume per feed, frequency, any refusal
- Paula's pump output is the primary supply — flag decline to wellness-coach
Pediatric Follow-Up Schedule
| Appointment | Timing | Notes |
|---|
| First pediatric visit | Within 48–72h of discharge | Weight check mandatory |
| 1-month corrected age | ~April 2027 adjusted | Developmental screen |
| Cardiology/pulmonology | As directed by NICU team | Any discharge conditions |
| RSV prophylaxis | Before October 2026 | Coordinate with pediatrician |
Hermes role: Proactive reminders for all follow-ups. Create tasks when dates confirmed. Do NOT diagnose — route all medical questions to healthcare team.
Adjusted Age Standard (MANDATORY)
- All milestone reporting uses adjusted age (chronological age − 10 weeks)
- Leo at 7 weeks chronological = ~-3 weeks adjusted (not yet at term equivalent)
- Never compare to full-term newborn milestones at this stage
- At term equivalent (~June 25, 2026): newborn milestone baseline begins
Mia Status (twin, still in NICU)
- Mia remains in NICU as of June 3, 2026
- Discharge date: TBD — confirmed only when NICU team announces
- Hermes tracks Mia NICU status via nicu-care/SKILL.md
- NEVER speculate on Mia's discharge date
Family Transition Context
- Paula: Postpartum + split-care stress (Leo home, Mia NICU) — dual-track monitoring active
- Hector: Managing two households (hospital + home) + work
- HJ: 4-year-old sibling adjustment — Leo intro protocol per parenting-coach/SKILL.md
- Bella (dog): Phase 1 baby introduction ACTIVE — scent-first protocol per dog-parent/SKILL.md
Escalation Triggers
Escalate to Hector immediately (with speak param):
- Leo not feeding for > 4 hours
- Nursery temp outside 68–72°F and not correctable
- Any respiratory distress (grunting, flaring, labored breathing)
- Fever > 100.4°F in a preemie — treat as URGENT
- Paula's pump output drops > 20% for 3 consecutive days
Common Pitfalls
- Using chronological age for milestones: Always use adjusted age
- Speculating on Mia's discharge: TBD until confirmed
- Relaxing RSV protocols early: 8 weeks minimum; pediatrician clears
- Skipping first pediatric visit: Must happen within 72h of discharge
- Over-alerting Paula: Route Leo concerns to Hector first; brief Paula gently
Verification Checklist
