NICU and its levels of neonatal care

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Every mother hopes for a pregnancy that is smooth-sailing and free from complications. With the right care, a smooth pregnancy is, of course, possible. However, at times, babies may be born prematurely, with a serious condition, or become critically ill post-delivery. At times like these, a Neonatal Intensive Care Unit (NICU) comes to the rescue. As the primary treatment centre for newborns, this unit plays an essential role in post-delivery. Therefore, learning all about a Neonatal Intensive Care Unit (NICU) can help parents be better prepared during the time that their child will be admitted.

Levels of NICU

A NICU usually comes with trained nurses, dietitians, doctors, and neonatal specialists that deal with newborn care. But not every Neonatal Intensive Care Unit is created the same. Different hospitals come with different levels of a NICU. In India, a NICU follows a 4-level system. Let’s take a look at each of these levels.

Level I

This is the most basic level of neonatal intensive care. This unit can render neonatal resuscitation, provide treatment to newborn babies, stabilise and provide care to infants born between the 35th and 37th gestational week, and treat babies born with illnesses at less than 35 gestational weeks. At times, this unit will mostly act as an interim arrangement until the baby is transferred to another facility that has the requisite level of care. This level usually consists of nurses, general physicians, paediatrics, and other medical specialists.

Level II

This unit primarily provides assisted ventilation and continuous positive airway pressure. This level comes with the capability to resuscitate and stabilise pre-term and ill infants before being transferred to a facility where newborn intensive care is provided. This unit can provide care for infants born at greater than 30 weeks gestation and weighing lesser than 1500 g who show signs of:

  • Physiologic immaturity such as inability to maintain body temperature, apnea of prematurity, or inability to take oral feedings
  • Being moderately unwell with problems that are anticipated to resolve rapidly and are not anticipated to need sub specialty services on an urgent basis.

They can also provide care to babies who are convalescing after intensive care. Some units also come with the additional capability to provide mechanical ventilation for brief duration.

Level III

The Level III Neonatal Intensive Care Unit takes care of neonates that weigh less than 1200 grams or display a gestational maturity of fewer than 30 weeks. A wide range of facilities is available in this unit, like infusion pumps, oxygen masks, suction facilities, incubators, ventilators, TC monitors, vital stats monitors, etc. The unit comes with a full-time availability of nurses too.

Level IV

This is the highest standard of neonatal care, consisting of pediatric specialists, along with all the expert care providers and the specialised services of a Level III NICU. It also offers facilities like extra corporeal membrane oxygenation and transport services from hospital to home. Usually, a level IV NICU is a part of a large hospital with expertise in surgical repair of serious congenital or acquired conditions.

The different levels of a NICU come well-equipped to handle any problems and issues that may arise post-delivery. Knowing the offerings of the above levels can help you better decide the hospital for delivering your baby. Enquire with the top hospitals near you to ensure that your baby will be in the right hands after the delivery.