A neonatal intensive care unit, commonly referred to as a NICU, is a special unit in a hospital dedicated to caring for premature or ill newborns. The staff in such units typically has specialized training that enables them to care for these tiniest of patients.

Babies are usually admitted to a NICU right or shortly after birth, before they go home for the first time. Children are rarely admitted to a NICU after being brought to the emergency room. The most common reasons for admittance to a NICU include premature delivery and difficulty breathing. The level of NICU a baby is sent to depends on the nature of the medical needs. There are four levels of NICU:

  • Level 1 nursery is for well babies and slightly premature babies born between 35-37 weeks. All hospitals with labor and delivery units in the United States must have at least a level 1 NICU.
  • Level 2 nurseries are for babies born around 32 weeks. These babies may have jaundice, might require special feeding care, or need an isolette (a special type of incubator with controlled temperature and humidity) to maintain their body temperatures. Babies in a level 2 NICU can possibly be breastfed and are typically discharged after a short stay.
  • Level 3 NICU is for babies born after 28 weeks gestation. These babies may not be able to breathe on their own and require a ventilator (a tube from the mouth down the trachea that helps them breathe). They often require IV support for feeding and hydration and cannot breastfeed or bottle-feed as they have yet to develop their suck reflex. Babies in a level 3 NICU may spend weeks or even months in the NICU. This kind of facility is usually reserved for babies who require surgery soon after birth or who are very sick, very premature, and/or had a low birth weight. “Micro-preemies,” or babies that are severely underweight, are typically sent to a level 3 NICU.
  • Level 4 NICUs are similar to level 3, and in fact, some facilities don’t designate a level 4 NICU. Instead, they have specialized capabilities in the level 3 NICU. Level 4 NICUs are designed to care for the sickest and most medically fragile children in a controlled environment, where they are monitored round the clock by specially trained medical staff, including doctors and nurses. As with a level 3 NICU, babies can spend weeks or even months in a level 4 NICU before becoming strong enough to go home.

While having a baby admitted to a NICU can be a terrifying experience for new parents, the special training of the nursing staff and support staff will ensure that they will try to make the experience as supportive as possible for parents and families.

Takeaways

  • NICUs have different levels of designation, depending on the type of care they can offer.
  • All labor and delivery hospitals are required to have Level 1 nurseries.
  • Staff in these nurseries have specialized training to care for the infants there.
  • Despite NICUs being a scary place, care is taken to ensure parents and families feel supported while offering baby the best care possible.

References

  1. Pediatrics, “Levels of Neonatal Care,” Vol. 114, No. 5 November 1, 2004, pp. 1341–1347 (doi: 10.1542/peds.2004-1697).

Comments

  1. If a neo infant had digested feces inside the womb, what are the long term prognosis?

    Reply
    1. This is a good question but really depends very much on the baby, the age at which they were born, the circumstances surrounding the birth and so much more. When something like this happens it is best to talk often with the team of doctors and nurses taking care of the newborn so that you can understand what is happening both in the moment and what is expected in the future.

      Reply

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