Contact us

Choosing your baby's NICU

By Tamyra Hoff, RN, MS, NE-BC

Your doctor informs you that your baby will need to go to a different hospital for specialized care. You nod and agree to the hospital recommended because you know that your doctor wants what’s best for your baby. But the reality is that you have a choice about where your baby will go. If you know in advance that your baby will need specialized care, or if you are expecting your baby to be born before 34 weeks’ gestation, you can take steps ahead of time to make sure you have a voice in selecting the neonatal intensive care unit (NICU) where your baby will be treated.

The first steps in choosing a NICU involves determining which hospitals in your area have a NICU and which of these facilities are covered under your health insurance plan. Once you’ve found NICUs that your insurance will cover, you can request a tour of each one. It’s important to note that not all neonatal care is the same. Neonatal care units are designated as either Level I, II, III, or IV. Each level up is equipped to care for sicker babies. If your baby is born extremely premature or requires a high level of care, they may only be eligible to go to a Level III or IV NICU, so your choice may be limited to those units.

You may also want to consider a number of other factors when choosing a NICU: If you want your baby to go to a specific NICU, let your doctor know. Many times, a doctor will be happy to transfer a baby to a hospital of the parents’ choice. Even if you do not expect to need a NICU, do some shopping and find a hospital and a NICU that will provide the environment and care that would make you most comfortable, should the need arise. The hope is that your baby will never need to spend time in a NICU, but if you do need that help, you will know which NICU seems right for you and your baby. *

  • Distance from your home: Depending on how early your baby is born or how sick they are, they may be in the NICU for as long as 3 or 4 months, so you may want to find a NICU close to home to minimize your travel time.
  • Privacy: Some NICUs offer single rooms, while others have an open floor plan. While a single room may offer you more privacy during this stressful time, you may find it a bit isolating. Open floor plans can give you an opportunity to meet and connect with other parents in the NICU. Ultimately, however, which setting is best for you and your family is a personal preference.
  • Donor milk: Human breastmilk is highly recommended for premature babies. In case you cannot produce milk or your milk supply is low when your baby is born, you may want to choose a NICU that offers donor milk so you can ensure that your baby gets the benefits of human milk.
  • Fortifier type: Premature infants often need a fortifier to give them extra calories, proteins, and minerals. While all fortifiers in the NICU are referred to as “human milk fortifiers,” or “HMFs,” most of them are made from cow milk. Prolacta offers the only fortifier made from 100% human milk. Studies show that when used as part of a 100% human milk diet, Prolact+ H2MF fortifier is clinically proven to improve health outcomes for critically ill, extremely premature infants in the NICU weighing between 500 and 1250 g at birth, as compared to cow milk-based fortifier or preterm formula. *,1,2,3 Knowing this, you may want to ask what type of fortifier a NICU uses.

Outcome measures were statistically based on average weight data.

References:

  1. Abrams SA, Schanler RJ, Lee ML, Rechtman DJ. Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products. Breastfeed Med. 2014;9(6):281-285. doi: 10.1089/bfm.2014.0024.
  2. Cristofalo EA, Schanler RJ, Blanco CL, et al. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. J Pediatr. 2013;163(6). doi:10.1016/j.jpeds.2013.07.011.
  3. Sullivan S, Schanler RJ, Kim JH, et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr. 2010;156(4):562-567. doi: 10.1016/j.jpeds.2009.10.040.