What is the neonatal intensive care unit?

Posted by Manipal Hospital
July 27, 2017

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Neonatal intensive care unit (NICU) is an intensive care unit that specializes in the care of ill and premature newborn infants. The term neonatal comes from the word neo – meaning “new,” and natal – “pertaining to birth.” It is also known as the intensive care nursery (ICN). Sometimes newborn babies need intensive medical attention and are often admitted into this special unit to address their medical needs.


 How did  NICU originate –


The very first Neonatal intensive care unit was opened in the year 1960 at Yale – New Haven Hospital in the city of New Haven, Connecticut. It was designed by American neonatologist Louis Gluck ( 1924 – 1997 ) , who made several important contributions in the field of care for newborns and is considered as “the father of neonatology.” He developed protocols that helped to reduce the spread of serious bacterial infections in newborns. He also developed a laboratory test called the L/S ratio that could predict the chance of a newborn developing an infant respiratory distress syndrome, a disease caused by structural immaturity in the lungs. Louis had also received several awards for his exemplary achievements. In total he had received 35 national and international awards for his work.


Who looks after the babies in the NICU –


The NICU combines the service of trained health care professionals along with advanced technology. It is directed by one or more neonatologists who are assisted by nurses, nurse practitioners, pharmacists, resident physicians, respiratory therapists and dietitians. The members of the NICU team coordinate with the parents to develop a plan that takes care of the high – risk newborns. There are NICU parent support groups in some hospitals which encourage parental involvement in taking care of the newborns.


Which kind of babies need to be admitted into a NICU –


Most babies that are admitted into the NICU are premature, those that have been born before the 37 weeks of gestational period. The premature babies are also known as preemies. Some babies that are admitted have a birth weight less of than 5.5 pounds or have a medical condition that requires special care. Twins, triplets and other multiples are often admitted to NICU. This is because they are generally born earlier and are smaller than single birth babies. Some are born with infections, heart problems and other birth defects. They are also admitted into NICU and are administered special care.


Levels of of NICU


The American Academy of Pediatrics has laid down guidelines in accordance with which there are four levels of NICU care that have been prescribed


 Level 1 – Well newborn nurseries that provide care to babies that are born at 35 to 37 weeks of gestation period.

Level 2 – Special care nursery that provide care to babies born of more than 32 week gestation period and weighing more than 1500 g.

Level 3 – Provide sustained life support to neonates that weigh less than 1500 g and have a gestation period of less than 32 weeks.

Level 4 – Regional NICU is the highest level of NICU that have pediatric surgical sub specialists in addition to care providers necessary in the above three levels.




What Types of Treatment Do Pediatric Pulmonologists Provide?


Children with breathing problems or any lung related problems are treated by a pediatric pulmonologist. A pediatric pulmonologist has the necessary experience and qualifications to treat the breathing or respiratory problems that develop in children. They are trained to treat, diagnose and manage children having breathing or lung related diseases from birth up to 21 years of age. Some of the qualifications of a pediatric pulmonologist are –


At least 4 years of medical school

3 years residency training in pediatrics

At least 3 years of fellowship training in pediatric pulmonology.

Certification from the necessary board of pediatrics in both pediatrics and the sub

speciality of pediatric.


A pediatric pulmonologist offers treatment to the following conditions in the children –


Chronic cough

A cough that lasts for more than four weeks is defined as chronic cough. It can be annoying for the children and also put a strain on their body. Constant coughing can lead to interrupted sleep, headache, dizziness and in some cases vomiting and rib fractures.


Recurring pneumonia

Pneumonia is the lung infections caused by the inflammation of air sacs. Repeated incidence of pneumonia in children is known as recurring pneumonia.  It generally starts after the child has caught cough, flu or an upper respiratory infection. Usually the pneumonia clears up in 2 or 3 weeks but in certain severe cases the child may even require hospitalisation. The main causes of pneumonia are to bacteria, virus or fungi related infections.


Cystic fibrosis

It is a genetic disease which leads to the mucus in the body becoming thick and sticky. The glue like mucus builds up and cause problems in the lungs. Children those who have cystic fibrosis can have serious breathing problems and lung diseases. In some cases they may even develop digestion, nutrition and growth related problems.


Noisy breathing

It is very common among children, some may have very gentle while some may require urgent treatment. Noisy breathing is usually caused by partial blockage or narrowing of the respiratory tract. It can occur in the nose, mouth, throat, in the voice box (larynx) or in the trachea (breathing tube). Noisy breathing may cause the surrounding tissues to collapse. Some symptoms which will help a parent to determine if a child has noisy breathing are pulling of skin in the collar bone, poor feeding, flaring of the nose or poor weight gain or weight loss.



Apnea is a disease that results in prolonged pause between breaths. Brief pauses during sleep is normal but if the breathing stops for a longer period during sleep it is known as sleep apnea. It is generally caused by something obstructing or blocking the upper airway. It is a serious condition which may lead to the child missing out on a healthy sleep. Sleep apnea can also lead to heart problems, learning, behaviour or growth related problems.



It is one of the most common respiratory problems among the children and even in adults. Every 5 in 100 children suffer from this disease. It is caused by the chronic inflammation of the airways. Symptoms of asthma include frequent coughing spells and attacks of breathlessness, tight chest and wheezing.

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