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Choosing a NICU

A neonatal nurse cares for a newborn in Washington DC's level 4 Neonatal Intensive Care Unit at Children's National.

Most babies are born healthy. But occasionally, some newborns are premature or have health problems, and they need care in a neonatal intensive care unit (NICU). While no one wants to think about their baby needing NICU care, it’s good to know that if you need one, you can choose the NICU that’s right for you.

Not all neonatal care facilities are the same, and it’s important to explore your local NICU options ahead of time. 

What level of care does the NICU provide?

All NICUs care for babies who need special help, but different NICUs offer different levels of care:

  • Level I NICUs are sometimes referred to as “well baby nurseries.” They provide care for healthy, full-term babies and also stabilize babies born near term to get them ready to be moved to facilities that provide special care.
  • Level II NICUs offer nursery care for babies born at or after 32 weeks and babies who are recovering from more serious health problems. Level IIA facilities do not provide respiratory support for babies with breathing problems, while level IIB nurseries provide assisted ventilation for less than 24 hours, as well as continuous positive airway pressure (CPAP).
  • Level III NICUs care for very sick babies and offer access to a wide range of pediatric specialists and equipment, such as X-rays and ventilation support. The babies in these nurseries are generally born earlier than 32 weeks or have critical illnesses.
  • Level IV NICUs like Children’s National provide the highest level of neonatal care. These nurseries have clinical teams who can take care of babies who need special surgery for birth defects and other disorders. Level IV NICUs also have a full range of healthcare providers, including pediatric subspecialists, specialized nurses and equipment to care for very sick babies.

How accessible is the hospital?

A NICU associated with a hospital that is easily accessible by public transportation and close to your home will make it easier for you and your family to visit your baby.

How many babies are cared for each year?

NICUs that treat more babies have the experience, equipment, research and processes to give the best care possible.

Are pediatric experts available for round-the-clock care?

A good NICU should have trained pediatric medical and surgical specialists on-site 24 hours a day, 7 days a week to respond to your baby’s needs at a moment’s notice.

Is there a team of specialists to assist with your baby’s needs?

In addition to neonatologists, babies in the NICU often need care from pediatric experts such as nurses, physical therapists, respiratory specialists, social workers, newborn surgeons, developmental specialists and dietitians. Input from a team of specialists will help your baby receive the level of care that meets his or her individual needs.

How will your baby's nutritional needs be met?

Nutrition provides the building blocks for your baby’s growth and brain development and helps him or her fight off infections. Pediatric dietitians and programs that support breastfeeding or offer donor milk are an essential part of your baby’s care.

How are breathing problems managed?

Many premature and ill infants have breathing problems that require advanced respiratory support. A NICU that has the latest breathing therapies and respiratory therapists who specialize in the treatment of infants is an important part of your baby’s care.

What is the environment like?

Soft lights and low noise levels allow babies to rest peacefully. A NICU should provide an environment that is soothing and secure for both you and your child.

What kind of support will YOU get?

You are a core part of your baby’s recovery and healing. While staying in the NICU can be difficult for parents and families, counseling and other services such as social workers, family support specialists, resource libraries, support groups, and transition rooms to help you practice being at home with your baby can help make this time easier.

How will the NICU help you and your baby get ready to go home? 

When it’s time to go home, your NICU and pediatrician should work together to plan for your baby’s discharge. The hospital team also should provide you with the skills you need to care for your baby at home.