NICU

NICU stands for neonatal intensive care unit. This is a specialized hospital unit that provides advanced care to newborns. NICUs have a specialized layout, equipment and clinical staff. These are all focused on caring for newborns who have special medical needs.

Why are babies cared for in the NICU?

Babies often need NICU care when they:

• Are born preterm (before 37 weeks of gestation)
• Have a low birth weight
• Have a medical condition that needs a higher level of care

Babies in the NICU often need support in certain areas. These include:

• Feeding and growing: Your baby’s weight is a key measure of their overall health. Some babies in the NICU need extra help getting enough nutrition, gaining weight and growing safely. That’s why nutrition is such a key part of NICU care.
• Warmth: Underweight and preterm babies often have trouble controlling their body temperature. They need a lot of warmth to help them stay well.
• Breathing support: Preterm babies often don’t have fully developed lungs. That puts them at risk for breathing trouble and respiratory diseases and infections. NICU care protects and supports them while their lungs finish developing.

What kind of care can NICUs provide?

The type of care that a NICU can offer mainly depends on its level. There are four levels of newborn care. NICUs make up two of them. The four levels are:

• Level I: Basic care nurseries
• Level II: Special care nurseries
• Level III: Standard NICUs
• Level IV: Regional NICUs

Level I: Basic care nurseries

These are the nurseries you can find in any hospital that offers labor and delivery services. They’re equipped to take care of:

• Babies born on time and stable (they can breathe without help and don’t need heating support)
• Babies born after 35 weeks who are stable
• Babies who need interim care before they go to a higher level of care

Level II: Special care nurseries

These are newborn units that care for babies with needs greater than a level I nursery can manage. Some experts include these under NICUs.

Special care nurseries can care for:

• Babies born at 32 weeks or later who weigh more than 3 pounds, 4.9 ounces (1.5 kilograms)
• Babies who improve enough to leave the care of a Level III NICU
• Babies who need breathing support for no more than 24 hours

Level III: Standard NICUs

These NICUs are a common feature of many mid-sized and large hospitals. They can provide care to:

• Babies born before 32 weeks and weighing less than 3 pounds, 4.9 ounces (1.5 kilograms)
• Babies who are critically ill
• Babies who need breathing support for more than 24 hours
• Babies who need surgery

Level IV: Regional NICUs

Level IV NICUs, also known as regional NICUs, are the highest level of newborn care. They’re typically only in large hospitals, especially those in major cities. They care for babies who need very specialized care, especially for birth defects and severe diseases.

What conditions require NICU care?

NICUs can care for newborns with many conditions. These include, but aren’t limited, to:

• Anemia
• Birth defects, like cleft lip and palate
• Breathing trouble
• Congenital heart diseases (heart conditions your baby has at birth)
• Feeding problems
• Hydrocephalus
• Jaundice
• Low blood sugar
• Necrotizing enterocolitis
• Neural tube defects, like spina bifida
• Newborn sepsis
• Temperature instability
• Vitamin K deficiency and related bleeding

Before your baby goes home, the NICU team will make sure they’re feeding safely, staying warm, growing and breathing well, and ready for the next step in their care. Some babies go home with medicines, special feeding plans or supplemental oxygen. Some need to return for follow-up appointments. Your baby’s NICU providers can tell you more about what to expect for your baby.

What’s the difference between a NICU and a PICU?

A pediatric intensive care unit, or PICU, is an intensive care unit for children ranging from newborns all the way up to teenagers. NICUs care for newborns only.

Newborns in the NICU may need transfer to a PICU when they need certain types of care. PICUs may be able to provide newborn care that NICUs may not have available.

Your baby may move from the NICU to the PICU if they’re older, no longer need newborn-specific intensive care or need ongoing support that’s usually managed in the PICU at that hospital. This can include some babies with breathing tubes, tracheostomies, feeding tubes or other long-term medical needs. Transfer decisions vary by hospital and by each baby's condition.

Your baby's healthcare providers can tell you more about what your baby needs and offer recommendations.

What’s the difference between an ICU and a NICU?

An intensive care unit (ICU) is a hospital unit that cares for critically ill adults. They can’t provide newborn care. Some hospitals that don’t have a dedicated PICU use the ICU to provide care for older children. That’s because NICUs can’t care for children who aren’t newborns.

Can parents stay with babies in NICU?

Yes. Many modern NICUs are designed to help parents stay close to their babies. Parents and other loved ones are a key part of NICU care. It’s important for babies to bond with their families. When safe, parent involvement — including holding, skin-to-skin care, feeding and comforting your baby — can support bonding, feeding and development. And research shows babies with that kind of support from parents and loved ones improve faster, have shorter NICU stays and do better long term.

What equipment is used in a NICU?

NICUs use a lot of the same equipment that you might see in other hospital units. The main difference is that most of it is smaller, since it’s only used for babies.

One key exception to that is a device called an incubator. This is like a combination of a crib and a greenhouse. It keeps heat inside, so your baby stays warm, and it's comfortable for your baby to lie in. Incubators commonly have special openings or ports on their sides. Those allow things like IV lines and monitor wires to pass through and connect to your baby.

You may also see monitors, IV lines, feeding tubes, oxygen, breathing support machines, phototherapy lights for jaundice, and pumps that give fluids, nutrition or medicines. Your baby’s nurse can explain what each device does.