Few things are as stressful for new parents as hearing that their baby needs to go to the nursery or neonatal intensive care unit (NICU). It's natural to feel worried, even frightened. Understanding what these units do — and why babies are admitted — can help make the experience less overwhelming.
Newborn Nursery vs. NICU
Hospitals generally have a few different levels of newborn care:
- Well-baby nursery: for healthy newborns who don't need special medical care — typically rooming-in with mother, routine checks, feeding support.
- Special care nursery / Level 2: for babies who need closer monitoring or minor interventions — for example, monitoring blood sugar, treating jaundice with phototherapy, or short-term feeding support — but who are otherwise stable.
- Neonatal Intensive Care Unit (NICU) / Level 3: for babies who need intensive monitoring and treatment — such as breathing support, IV fluids/medications, or care for significant prematurity or medical conditions.
Why Babies Are Admitted
Common reasons for admission to special care or the NICU include:
- Prematurity — babies born before 37 weeks often need support with breathing, temperature, and feeding (see our guide on low birth weight newborns)
- Breathing difficulties — including transient breathing problems after birth, or more significant respiratory conditions
- Low blood sugar (hypoglycemia) — common in premature babies, babies of diabetic mothers, and small-for-gestational-age babies
- Significant jaundice — requiring phototherapy to reduce bilirubin levels
- Infection or suspected infection — requiring monitoring and sometimes antibiotics
- Feeding difficulties — needing tube feeding or close feeding support
- Birth complications — such as a difficult delivery requiring monitoring
Importantly, NICU admission doesn't always mean a long-term problem — many babies, including full-term babies, are admitted briefly for monitoring or a specific treatment and go home within days.
What Happens in the NICU
NICU care is highly individualised, but commonly includes:
- Continuous monitoring of heart rate, breathing, oxygen levels, and temperature
- Incubators or radiant warmers to maintain a stable temperature
- Breathing support — ranging from a small amount of extra oxygen to more intensive respiratory support, depending on need
- IV fluids and/or medications if needed
- Feeding support — tube feeding, fortified breast milk, or specialised formula as appropriate
- Phototherapy for jaundice — special lights that help the body break down bilirubin
- Regular assessments by a neonatal team, with a care plan updated as the baby progresses
Parent Involvement & Kangaroo Care
Even in intensive care, parental involvement matters — and most units actively encourage it. Skin-to-skin contact (kangaroo care) has well-documented benefits for stabilising heart rate, breathing, and temperature, supporting breastfeeding, and reducing parental stress. Ask the team how you can be involved — whether through skin-to-skin time, participating in feeds and care routines, or simply being present and talking to your baby. These interactions are valuable for your baby's development, not just emotionally important for you.
Have a baby in special care, or preparing for a high-risk delivery? Dr. Yasser Masood provides neonatal care and follow-up at Shifa International Hospital, Islamabad, and is available to discuss your baby's care plan with you. Book an appointment or call 051-8464646.
Discharge & Going Home
Babies are generally ready for discharge once they can: maintain their body temperature in an open cot, feed effectively by breast or bottle, and show steady weight gain — rather than reaching a specific target weight. Before discharge, the team will typically arrange:
- A follow-up appointment for growth and development monitoring
- Guidance on feeding, especially if fortified milk or special formula was used
- Information on any ongoing medications or treatments
- A vaccination plan — see our vaccination schedule guide
- Information on warning signs to watch for at home, and when to seek help (see our guide on when to see a pediatrician)
The transition home after a NICU stay can feel daunting, but the same team that cared for your baby in hospital is usually available for follow-up — don't hesitate to reach out with questions, even ones that feel small.
