Hand to Hold's Official Blog: Written by Parents for Parents

What are Level I and Level II NICUs?

Have you ever wondered what it means to be in a Level I NICU vs a Level IV NICU?  I had no idea what the differences were between NICUs, so I decided to find out.

A Level I NICU, or Level I Nursery is defined by two different sources as follows:

1.  “Level 1 nurseries care for healthy, full-term babies. They are able to stabilize babies born near term to get them ready to transfer to facilities that offer special care.” http://preemies.about.com/od/allaboutthenicu/a/NICUPart1.htm

2. “Level I (basic) [NICU]: a hospital nursery organized with the personnel and equipment to perform neonatal resuscitation, evaluate and provide postnatal care of healthy newborn infants, stabilize and provide care for infants born at 35 to 37 weeks’ gestation who remain physiologically stable, and stabilize newborn infants born at less than 35 weeks’ gestational age or ill until transfer to a facility that can provide the appropriate level of neonatal care.” http://allnurses.com/nicu-nursing-forum/what-level-nicu-156806.html

So basically, a Level I NICU can’t do anything for premature babies but get them prepped for transfer to a better equipped unit.  Now, let’s take a look at a Level II NICU:

1.  “Level II: Specialty Newborn Care: These nurseries can care for babies born at greater than 32 weeks gestation or who are recovering from more serious conditions.

  • Level IIA: These nurseries do not provide assisted ventilation.
  • Level IIB: These nurseries can provide assisted ventilation for less than 24 hours, and can also provide continuous positive airway pressure (CPAP).” http://preemies.about.com/od/allaboutthenicu/a/NICUPart1.htm

2. Level II (specialty) [NICU]: a hospital special care nursery organized with the personnel and equipment to provide care to infants born at more than 32 weeks’ gestation and weighing more than 1500 g who have physiologic immaturity such as apnea of prematurity, inability to maintain body temperature, or inability to take oral feedings; who are moderately ill with problems that are expected to resolve rapidly and are not anticipated to need subspecialty services on an urgent basis; or who are convalescing from intensive care. Level II care is subdivided into 2 categories that are differentiated by those that do not (level IIA) or do (level IIB) have the capability to provide mechanical ventilation for brief durations (less than 24 hours) or continuous positive airway pressure. http://allnurses.com/nicu-nursing-forum/what-level-nicu-156806.html

Were any of your preemies stationed in a Level I or Level II NICU?  What types of facilities did your NICU have for the parents, and how long did your preemie stay in the NICU?

My next post will describe Level III and Level IV NICUs.

Afton Mower About Afton Mower

After Mower (UT) lost her firstborn son at 21 weeks.  Her daughter was born a year and a half later at 27 weeks.  The NICU was overwhelming and isolating and it was through those two experiences she was led to found this social hub for parents to find the support they needed. Afton also gave birth to another daughter, born two days overdue after four months of strict bedrest. She believes it is a tender experience to hold a special baby in your arms when his spirit returns to his heavenly home, a miracle to watch tiny babies survive the risks of prematurity and a blessing to hold a healthy full-term baby after months of difficulty and sacrifices.


  1. Level I (basic) [NICU] ~ 161 days ~ NOTHING was available for the parents! We lived 2 1/2 hrs away & we had to stay at a hotel next dooe for $100 a night when we needed to stay – it was tough!

  2. I live in Rochester, MN so the mayo clinic is right here so we could be w/ our preemie whenever. We could come at 3am if we wanted! One of the first things they asked us when I went into labor was if we needed Ronald McDonald house to be contacted. Luckily we didn’t but for other parents it is free and has a shuttle back and forth incase you don’t have a car!

  3. Stefanie says:

    We are currently at a Level 3 NICU and have been there for a month. Options for us is the Ronald McDonald house and also apartments in the hospital that they offer to doctors as well as parents who have children who will be there a while.

  4. My baby was in a level II NICU. She was there for a month and one day. It wasn’t so bad for us because the hospital was only 15 minutes away but it was sad to see the parents who lived far away, struggling to balance life and being with their baby. I do know that right across the street, there was a Ronald Mcdonald house where parents were able to stay.

  5. We were in a Level 3 NICU for 170 days. We lived only 20 minutes from the Hospital where he was born. We then visited 2 other hospitals for surgery. Thank goodness we were close to all 3 hospitals, but it was a long time in the NICU! The hospital where my son was born was the best hospital we have been in and they are a little hospital. Littleton Adventist Hospital and their staff are amazing!

  6. Our daughter was at the St. Paul Children’s NICU which is a level II/IIIc Nicu. Each child had their own room that included a couch that was also a bed. There was a family lounge and kitchen. Breast feeding mothers could receive food vouchers, as well. We lived 10 minutes away, so the only thing we ever used was the bed during the times when someone needed to be there. Our daughter was born at 28 weeks and stayed in the NICU for 10 weeks.

  7. We spent 10 days in level II and the hospital kept me as a “boarder mom” in a regular delivery room on the same floor and provided space for my family to stay as well when they wanted, and 3 meals a day off the menu. McKee in Loveland CO was superb!

  8. Bay Area Women’s Center in Corpus Christi, Texas. Level III and Level II.
    They pack in as many babies into small cubicles, mixing different levels to make it easier on nurses. So don’t be surprised when your baby is struggling on a vent and their roommate is a 36 weeker with tons of loud cellphone talking visitors and 2 year old brother that … See Moreplays with all the buttons and too bad the nurse is in the wash room arguing on her cellphone with her boyfriend. Most of the Nurses are great. But a few of the nurses were substandard, unfortunately I learned you can request NOT to have one in the last week. But when your babies life is in their hands, I didn’t like how lazy some nurses were and how they were never disciplined or corrected and continued working.

    Our hospital didn’t offer the parents anything, even though we lived over an hour away. I felt even as though I was a burden on the Drs and some staff becuase I wanted to be around all the time, “in the way”. Parents are kicked out for Dr rounds and if you want to speak with one good luck, you might find one. And some nurses acted like My sons Dr always called him a girl, you think he’d notice that a penis when he examined him…. We slept in the lobby and ate out of the vending machine at night. We didn’t qualify for McDonald house, but it was full anyways. In 6 weeks, we spent around $12,000 total in gas, hotels, food and I have no clue on what…

    So on our last day nurse Sonya shooed us out saying “you got to go”, because they “already have a baby for his place”. Which surprised me that she wasn’t even our nurse for the day.

    Bay Area is a good NICU if the baby is an older preemie with no issues. Otherwise I’d transfer to the Children’s Hospital they are much more parent friendly. That where we wound up when my son went home at 35 weeks, then stopped breathing on his 2nd day home. I luckily revived him with CPR and we were admitted to the Children’s Hospital.

  9. We were in a level 2b NICU for seventeen days with my 34 weeker. They had parent “rooms”, more like a closet, with a twin bed and there was a shower available. Thankfully we lived 20 minutes away (why I chose the hospital), so I stayed everyday from 630a-5p and then slept at home. Nurses were fantastic, docs were all from Boston Children’s, we are so blessed to have such good care so close to home!

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