Texas Children's Hospital designated as Level IV NICU, the highest level of care available for preterm and critically-ill newborns


HOUSTON - (Nov. 8, 2012) - The American Academy of Pediatrics (AAP) has issued a new policy statement indicating a change in the Levels of Neonatal Care, by updating the levels of care from Level I to Level IV, with Level IV offering the highest level of care available and treating the tiniest and most critically-ill babies. With the announcement of this new policy, theneonatal intensive care unit (NICU) at Texas Children's Hospital has now been designated as a Level IV NICU, where it will continue to provide care for infants with complex interdisciplinary issues including complex surgical disease that is not available in a level III NICU. To learn more about Texas Children's Newborn Center please visit www.texaschildrens.org/newborn.

"A crucial part of a patient's outcome is that they have access to the highest level of care available, especially the most fragile infants, who can face numerous challenges," said

Dr. Stephen Welty, chief of neonatology in the Division of Neonatology, Department of Pediatrics at Baylor College of Medicine and section chief for the Newborn Center at Texas Children's Hospital. "Babies who are born prematurely or who are critically ill have the highest demands for specialized resources and require around-the-clock, multidisciplinary care, and the designations are critical for proper regionalization of neonatal care and optimal outcomes."

Previously, Texas Children's was designated as a Level IIIC NICU, the highest level prior to the new standards which were published in the September 2012 edition of Pediatrics.

The AAP's updated NICU classifications consist of basic care (level I), specialty care (level II) and subspecialty intensive care (level III, level IV). Subspecialty neonatal intensive care involves providing life support, the ability to care for infants born earlier than 32 weeks gestation and weighing less than 1500 grams, performing advanced imaging including MRI and echocardiography, and providing a full range of respiratory support, among many other criteria.

NICUs with a Level IV designation must meet all Level III capabilities, plus:

  • Be located within an institution with the capability to provide surgical repair of complex congenital or acquired conditions
  • Maintain a full range of pediatric medical subspecialists, pediatric surgical subspecialists, and pediatric anesthesiologists at the site
  • Facilitate transport and provide outreach education

"It's important for women experiencing high risk pregnancies, as well as normal pregnancies, to understand that there are differences in the NICU care offered at different facilities," said

Dr. Stephanie Martin, service chief of Obstetrics and Maternal Fetal Medicine at Texas Children's Pavilion for Women. "If you're anticipating a complication, talk to your doctor about whether or not the hospital you plan on delivering in is equipped to handle the level of care your baby may need."

Taking care of the tiniest of newborns

Ashlee Haefs was having a healthy and uneventful pregnancy when suddenly, at 23 weeks and five days into her pregnancy, she gave birth to her daughter Madilynn, who weighed just 1 pound 5 ounces at birth. Madilynn was cared for at Texas Children's Newborn Center, where she experienced numerous complications related to prematurity including chronic lung disease and retinopathy of prematurity and she needed intensive care for an extended period of time. Madilynn also had to undergo surgery at Texas Children's including the placement of a reservoir and a shunt to alleviate hydrocephalus that occurred after a she sustained a large intracranial hemorrhage. Madilynn spent 119 days in the NICU where she was cared for by a multi-disciplinary team of subspecialists. Now 2 years old, Madilynn is a true miracle baby and her parents believe that because they had a plan and were near a hospital with an equipped NICU, Madilynn's life was saved.

"I never expected that I would give birth to Madilynn so early and though it was a very difficult experience to go through, we knew Madilynn was getting the best care available and that she had access to all of the subspecialty care she needed, including surgery, all in one facility," said Ashlee Haefs.

Texas Children's is nationally recognized as a leader in neonatology, ranking #2 in the nation for neonatology among pediatric hospitals in U.S.News World Report's 2012-13 edition of Best Children's Hospitals. Texas Children's Newborn Center and the hospital's new Pavilion for Women together house 173 NICU beds, making the hospital the largest NICU in the nation. Texas Children's Newborn Center cares for nearly 2,500 babies each year and offers the most complete and complex level of care available, with 24/7 access to neonatologists and pediatric subspecialists. Babies are often transported to Texas Children's Newborn Center from other medical facilities because they require a higher level of care.

About Texas Children’s Hospital

Texas Children’s Hospital, a not-for-profit health care organization, is committed to creating a healthier future for children and women throughout the global community by leading in patient care, education and research. Consistently ranked as the best children’s hospital in Texas, and among the top in the nation, Texas Children’s has garnered widespread recognition for its expertise and breakthroughs in pediatric and women’s health. The hospital includes the Jan and Dan Duncan Neurological Research Institute; the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital planned to open in 2017. The organization also created the nation’s first HMO for children, has the largest pediatric primary care network in the country and a global health program that’s channeling care to children and women all over the world. Texas Children’s Hospital is affiliated with Baylor College of Medicine. For more information, go to www.texaschildrens.org. Get the latest news by visiting the online newsroom and Twitter at twitter.com/texaschildrens.