Everything You Need to Know About Three Stages of NICU

Having a child requires you to make many decisions. Among the numerous concerns on your mind are sleeping arrangements, feeding, car seats, nursery and pediatricians. What happens, though, if you have to schedule your child's stay in a neonatal intensive care unit (NICU)? You may also be researching NICUs if you have a prenatal diagnosis or wish to make a plan for your baby's care in case they require more advanced medical attention. In addition, you ought to be aware of the kind of NICU that would be best for your child in case they require one.

The American Academy of Paediatrics (AAP) divides NICUs into levels according to their capabilities. The highest level of distinction is Level IV and the lowest is Level I. These levels can help direct you to the right facility to ensure the best care for your family, based on your baby's needs or condition. You should talk to your doctor about the right NICU stage for the medical needs of both you and your infant. These care tiers line in levels according to the treatments and offerings. Establishments that provide neonatal critical care must obtain federal or state licensing or certification in order to comply with health standards.

An overview of each NICU level's definition and features are discussed in this article.

What is NICU?

The neonatal intensive care unit (NICU) is a dedicated section of hospitals where newborns in need of critical care are typically provided essential care. The NICU is equipped with cutting-edge medical equipment and skilled medical personnel to provide specialized care for the little patients. 

Babies who are not as sick but still require specialized nursing care may also be taken care of in NICUs. Babies are referred to another hospital because certain hospitals lack the personnel necessary to operate a NICU. If a newborn is delivered in hospital with a NICU, their chances of survival are higher than if they are transferred after birth.

The four levels of NICU are:

• Level I: Proper newborn nursery
• Level II: Special care nursery
• Level III: Neonatal intensive care unit (NICU)
• Level IV: Regional neonatal intensive-care unit (regional NICU)

Three stages of NICU

Level 1 NICU:

Level I NICUs, also referred to as newborn nurseries, offer preterm infants (babies born before 37 weeks of pregnancy) basic care. Regular care is given to healthy preterm babies in these NICUs. A Level I NICU in a hospital is capable of providing care for:

• Healthy preterm infants born between 35 and 37 weeks of pregnancy
• Newborns whose health is stable and who are able to breathe on their own, and regulate their body temperature
• Preterm infants under 35 weeks old can, if necessary, be stabilized in Level I NICUs before being moved to a higher level NICU for more advanced care.

Level 2 NICU:

All of the features of a Level I nursery are present in Level II units, which are also referred to as special care nurseries. In addition to Level I healthcare professionals, these facilities also employ neonatologists, and neonatal nurse practitioners.
Units at Level II are capable of:

• Providing care for infants with physiologic immaturity or moderate illness that is expected to improve quickly and does not require immediate subspecialty services, if they are born at 32 weeks gestation or later and weigh more than or equal to 1,500 gms.
• Taking care of infants who are taking feed and getting stronger or who are recuperating from critical care.
• Giving mechanical ventilation or constant positive airway pressure for a brief duration 
• Certain specialized tools, such as a blood gas analyzer and a portable X-ray machine is present in the facility
• Medical professionals with specific training in neonatal (newborn) care who are always on call for ongoing care as well as emergencies
• 24 hours after birth, babies who are not able to breathe on their own should be moved to a higher level of care.

Level 3 NICU

For infants born before 32 weeks of pregnancy or those with certain medical conditions requiring surgery or other specialized pediatric care, level III NICUs offer vital care.

A Level III NICU in a hospital is capable of providing care for:

• Premature babies who are born before 32 weeks of pregnancy or who are under 1,500 grammes (3.3 pounds) at birth
• Infants, regardless of age, who have medical or surgical conditions

A Level III Neonatal Intensive Care Unit needs to:

• Possess substantial clinical experience, as evidenced by the volume of patients and complexity of their care.
• Provide prompt, round-the-clock access to pediatric and neonatal subspecialists 
• Possess the ability to provide life support long as necessary
• Have easy access to advanced breathing support, advanced surgery, specialized monitoring equipment, nutrition, pharmacy, and imaging services for newborns.

Level IV NICU

The best medical care is provided to premature infants and newborns in Level IV NICUs. Regardless of the baby's gestational age at birth, these facilities are capable of caring for the most fragile and small infants as well as the infants with the most complicated neonatal conditions. These facilities have all the features of a Level III NICU, plus they have more experienced staff members and round-the-clock access to child specialists (medical and surgical specialists). Along with offering the same services as a Level III NICU, Level IV NICUs also provide:

• Constant, on-site care from children's heart, brain, and breathing specialists (pediatric medical and surgery subspecialists).
• Surgery for congenital conditions, or complicated birth defects, such as heart defects, anorectal malformations, and craniofacial syndromes

Additionally, in order to provide the safest and most comfortable surgery possible, they typically collaborate with pediatric anesthesiologists. Lastly, within their respective regions, Level IV NICUs usually coordinate for neonatal transport and education.

Conclusion

Understanding the three stages of the Neonatal Intensive Care Unit (NICU) is crucial for parents and caregivers of premature or critically ill infants. The NICU journey typically begins with intensive care, where newborns receive life-saving treatments and continuous monitoring. As babies stabilize, they move to the intermediate care stage, focusing on growth and development while still receiving necessary medical support. Finally, the transition stage prepares infants for discharge, emphasizing parental involvement and readiness for home care. Awareness of these stages helps families navigate the emotional and physical challenges, ensuring they are informed and prepared for their baby’s progression toward health and home.

If you want best neonatal care for your newborn, then choose Surya Hospital. Book your consultation now!

Frequently Asked Questions (FAQs)

Q1: Can my infant stay with me in the NICU?

A: You might find it difficult to spend as much time with your child as you would like. Ask the staff about free or inexpensive hotels in the area for parents of NICU patients if you don't live close to the NICU. Parents can also sleep in certain NICU rooms. Regarding your baby's condition, what do you tell people?

Q2: How NICU differs from ICU?

A: Critically ill patients are treated in both the NICU and ICU; however, the ICU is meant for adult patients, while the NICU is meant for newborns. Because adult patients can verbally express their discomfort, while newborns cannot, this leads to differences in beds, equipment, and supervision.