Neonatology

What to Look For in a NICU

When considering NICU care, you'll want to know the following:

1. Volume and outcomes: Research shows that babies treated at newborn centers who see a lot of babies have better outcomes. For example, Texas Children’s treats more than 2,000 babies a year, making us one of the nation’s largest and most experienced NICUs.
2. Around-the-clock care: Be aware of how the NICU is staffed. Having a dedicated neonatologist and nursing staff on-site 24 hours a day, 7 days a week, is essential, but having additional medical staff, such as respiratory therapy and neonatal nurse practitioners, readily available is important as well. The top-level NICUs have onsite neonatal and pediatric surgeons and anesthesiologists, dedicated to around-the-clock care, who have experience with critically ill and premature infants.
3. Environmental controls: Exemplary hospitals ensure minimal activity at bedside, soft lights and low noise levels, which reduce stimulation and allow babies to rest.
4. Nutritional care: Breast milk is the best food for babies, and baby-centered NICUs will make it as easy as possible for you to breastfeed and offer human donor milk as needed to your baby. Interventions for babies who are unable to eat normally, such as feeding tubes and IV fluids, should also be available.
5. Respiratory care: Premature and ill infants may require advanced respiratory support with very little warning, and the best NICUs will have respiratory therapists who specialize in newborn care and are available 24/7.
6. Parental support: Get a sense for how involved parents are in the care of babies in the NICU. If a hospital offers visits anytime 24/7, overnight facilities for parents and support services for families in place, you can be assured that you will be as able to bond with your newborn as their medical condition will allow.
7. Team approach: In addition to neonatologists and specialized nursing care, premature and sick newborns may need physical therapists, respiratory specialists, developmental specialists and dietitians. Input from this wide variety of specialists helps your baby receive care targeted to their individual needs. Facilities like Texas Children’s provide access to these kinds of experts.
8. Transition home: As important as it is to know if your baby will be able to get advanced care at a moment’s notice, it’s also important to understand how the neonatal team will de-escalate care and prepare you to safely care for your baby at home. In some cases, babies may go home with stitches or feeding tubes, and it’s beneficial to understand what kind of support you’ll have from home.
9. Ongoing research: Academic medical centers, like Texas Children’s, make advances in patient care, train the next generation of doctors and scientists and make medical breakthroughs that bring more options and more hope to patients and their families. This means you have access to the most updated treatments available.
10. Evidence-based care: When possible, it can be helpful to understand if the neonatology team is dedicated to staying current with advances in neonatal medicine. Efforts to minimize interventions and allow for as much parent contact as possible reflect current best practices. Texas Children’s staff provides evidence-based care developed from research that has shown what is best for newborn babies who need specialized care.