Babies Preemies Capabilities of a Special Care Nursery By Cheryl Bird, RN, BSN Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia. Learn about our editorial process Cheryl Bird, RN, BSN Medically reviewed by Medically reviewed by Sarah Rahal, MD on January 04, 2021 linkedin Sarah Rahal, MD is a double board-certified adult and pediatric neurologist and headache medicine specialist. Learn about our Review Board Sarah Rahal, MD on January 04, 2021 Print ERproductions Ltd/Getty Images Babies born in hospital settings are usually cared for in a nursery after birth. Depending on various factors, including health at birth, weight, and number of weeks gestation, a baby may require more advanced care in a different type of nursery. Those nurseries are categorized by the American Academy of Pediatrics into four levels based on the care they are equipped to provide: Level I: Well newborn nurseriesLevel II: Special care nurseryLevel III: Neonatal intensive care unit (NICU)Level IV: Regional neonatal intensive-care unit (regional NICU) Facilities with a neonatal intensive care unit (NICU), which provide the highest levels of care, have demonstrated that they meet healthcare standards through federal/state licensing or certification. who need extra care after birth are usually cared for in the neonatal intensive care unit (NICU). Level II Nurseries Because they are born with fewer weeks of gestation, many premature babies will require care in a higher level nursery. Those born at greater than 32 weeks but less than 35 weeks will most likely require some care in a Special Care, or Level II, nursery. These nurseries have all the capabilities of a Level I nursery as well as pediatric hospitalists, neonatologists and neonatal nurse practitioners on-site. They have the equipment and capabilities to care for babies who are: Born before 32-weeks gestation and weigh less than 1500g until they are transferred to a Level III neonatal intensive care facilityBorn between 32 weeks and 35 weeks gestation or older and weigh 1500g or morePhysiologically immature or moderately ill with problems that are expected to resolve rapidlyNot expected to need subspecialty services on an urgent basisCan't stay warm on their own and need to be placed in an incubator.Aren't strong enough to eat well and need NG or OG feeds.Have mild health problems related to prematurity, such as jaundice or apnea of prematurity.Have spent time in a level 3 NICU and are recovering. Level 2A and 2B NICUs Special care nurseries are further broken down into Level 2A and Level 2B NICUs based on the type of respiratory support they offer: Level 2A NICUs are limited in the type of respiratory support they can provide. They cannot provide CPAP or mechanical ventilation at all.Level 2B NICUs can provide CPAP or mechanical ventilation for short periods of time, usually less than 24 hours. Babies born at less than 32 weeks gestation or who have a critical illness will be cared for in a Level III nursery (NICU). Those who require surgical repair of complex congenital or acquired conditions will be cared for in the highest level NICU, a Level IV. These nurseries are housed in facilities that offer a full range of pediatric medical and surgical subspecialties on site. Was this page helpful? Thanks for your feedback! Track your baby’s most exciting moments with our milestone checklist. Get it free when you sign up for our newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Pediatrics Committee on Fetus and the Newborn. "Policy Statement: Levels of Neonatal Care." Pediatrics Nov. 2004. 114: 1341-1346.