What do NICU levels mean?

Many hospitals have neonatal intensive care units (NICUs), but not all NICUs are the same. The American Academy of Pediatrics differentiates between NICUs by defining levels of care the NICU is able to treat. These levels are based on the complexity of medical conditions. Here’s a guide to what to a NICU is, what each NICU level means and what conditions a NICU treats to provide babies with the specialized care they need.
NICU stands for neonatal intensive care unit. A NICU is a specialized hospital unit that provides intensive medical care for newborns who are premature, have low birth weight or have health conditions requiring close monitoring and specialized treatment. The NICU provides around-the-clock care from a team of expert providers, including neonatologists, NICU nurses, respiratory therapists and other specialists trained in newborn care.
The NICU typically begins caring for a newborn right after birth. How long a baby will receive NICU care depends on the reason why they need care and how they’re progressing — some babies go home within a few days and some babies need care for several months or more. If your baby needs NICU care, rest assured that the NICU nurses and staff will guide you every step of the way and encourage you to bond with your baby and participate in as much of his or her care as possible.
NICU level | What it means | Care provided |
---|---|---|
Level I | Well care | Regular nursery care available at most hospitals that deliver babies |
Level II | Special care | Intensive care for sick and premature infants. Babies cared for in this level have conditions that are expected to resolve quickly and not expected to need subspecialty care urgently |
Level III | Neonatal intensive care | Comprehensive care for more seriously ill newborns. Babies cared for in this level may have mild to complex critical conditions or medical problems that require life support, assistance with blood circulation or ventilation |
Level IV | Advanced neonatal intensive care | The highest level of neonatal care. Level IV units include the capabilities of level III with additional capabilities and considerable experience in the care of the most complex and critically ill infants. A level IV NICU will have pediatric medical and surgical specialty consultants continuously available 24 hours a day. Babies may need major surgery, surgical repair for congenital conditions and anomalies that require life support |
According to the March of Dimes, about 1 in 10 babies are born prematurely and may need NICU care. The NICU environment is equipped with advanced medical technology, including incubators, ventilators and monitoring systems, to support fragile infants until they’re healthy enough to go home. The NICU provides care for a wide range of conditions, including:
Prematurity and low birth weight
Respiratory conditions
Infections and sepsis
Heart conditions
Birth defects and congenital abnormalities
Neurological conditions
Tumors and malignancies
Jaundice and metabolic disorders
At Texas Children’s, a NICU nurse is assigned to each baby to provide consistent, compassionate care throughout their stay. In addition to caring for babies, nurses in the NICU are also an incredible resource to parents, helping you to connect and bond with your baby and teaching you how to care for baby both in the NICU and at home. A NICU nurse provides specialized care to newborns with health problems.
At Texas Children’s, NICU nurses are highly experienced in caring for the most critically ill infants and have specialized NICU training, including neonatal resuscitation and life support.
If your baby needs additional care after birth, he or she may be admitted to a NICU. A doctor decides whether your baby needs a level II, III or IV NICU, but you choose the hospital. How long your baby will be in the NICU is dependent on his or her medical needs.
If your baby is admitted to a Texas Children’s NICU, our team will support your family every step of the way, letting you know what you can expect and how to best participate in your baby’s care. With one of the largest NICUs in the nation, we treat more than 2,000 babies a year in our NICU and are ranked No. 3 in the U.S. for Neonatology by U.S. News & World Report.
See some of our resources for NICU parents navigating your NICU journey:
Amenities at each of our locations
Our NICUs provide specialized care for newborns requiring intensive medical attention. With state-of-the-art facilities and expert neonatal teams, we offer advanced treatment and support for premature and critically ill infants. NICU services are available at our conveniently located hospitals in Houston and North Austin, ensuring families receive compassionate care close to home.
We offer 3 NICU locations in Texas: Texas Children’s West Tower, Texas Children’s Hospital The Woodlands and Texas Children’s Hospital North Austin.
Texas Children’s Newborn Center® was the first hospital in Texas to be designated a level IV NICU.