Emergency & essential care is needed during critical conditions of a Neonate.

1. LEVELS OF NICU Pg. No 1
LEVELS OF NICU
Level - 1 Care:
 About 80 to 90 percent of neonates require minimal care which can be provided by
their mothers with support from family members and under supervision of basic health
professionals.
 The neonates weighing above 2000 g or having gestational age of 37 weeks or more
belong to this category.
 This care can be given at home, sub center and primary health centers.
 Essential perinatal care should be provided as basic care at birth, provision of warmth,
maintenance of asepsis and promotion of breastfeeding.
Level - II Care:
 Only 10 to 15 percent of all neonates require this care.
 Neonates weighing between 1500 to 2000 g or having gestational age of 32 to 36
weeks need specialized neonatal care supervised by trained nursing staff and
pediatricians.
 This intermediate neonatal care should be provided by the equipped district hospitals,
teaching institutions and nursing homes.
 There should be arrangement of resuscitation procedures, maintenance of
thermoneutral environment, intravenous infusion, gavage feeding, phototherapy and
exchange blood transfusions.
 It should be available at all hospitals where 1000 to 1500 deliveries take place per
year.
Level - III Care:
 Only 3 to 5 per cent of all newborn babies need this care.
 Neonates weighing less than 1500 g or born before 32 weeks of gestation require
intensive neonatal care.
 Skilled nurses and neonatologists especially trained in neonatal intensive care.

2. LEVELS OF NICU Pg. No 2
 Apex institutions or regional perinatal centers equipped with centralized oxygen and
suction facilities, incubators, ventilators, monitors and infusion pump, etc. are best
suited to provide intensive neonatal care.
 High - risk pregnancies which are associated with birth of high risk neonates must be
identified during pregnancy and referred to an appropriate center for skilled
management and better outcome.
 At birth, detection of high risk neonates should be done at all levels of health care
delivery system and appropriate referral is essential to different level of neonatal care
for prevention and reduction of neonatal mortality and morbidity.