Picking an NICU

There is not always time to pick a hospital. In some cases though, early delivery is predictable. In others, it is not and hospital choice is done by the universe BUT you always have the option to change the hospital if you are not happy with it for some reason.

During our NICU journey, at one point, we had to consider switching hospitals. I made research on other hospitals and even visited one of them. Changing hospitals when your baby is in such a vulnerable situation is not ideal or comfortable at all. It makes you feel agitated and it is very difficult to come to terms with. I am grateful that we did not have to change our current setting then. However, if I did have time to pick a hospital before delivery or if I had to change hospitals, here is what I would look at.

1- NICU level

NICU level indicates the level of care your baby can get from that NICU.

Level 1 NICU: Well newborn nursery that accommodates 35 to 37 week old preemies who are stable and expected to be discharged rapidly.

Level 2 NICU: Special care nursery that accommodates >32 week old or >1500 gr preemies whose issues are expected to resolve rather quick and with no major illness.

Level 3 NICU: Neonatal intensive care unit that accommodates <28 week old preemies. If your baby is very premature meaning born less than 32 weeks, NICU needs to be at least level 3. Level 3 NICU means it has the capability of caring for very small or very sick newborn babies. Level 3 NICU has neonatologists, neonatal nurses, and respiratory therapists and they are available 24 hours a day. Our hospital was level 3 and it was enough for our needs. It had all the respiratory supporting tools and advance imaging tools. Ours had agreements with pediatric surgeons either in-house or external. If a baby needs a surgery it is performed in the hospital.

Level 4 NICU: Regional NICU is the highest level that accommodates cases that require more complex surgeries and treatments.

2- Hospital night stay

I would go after this one big time if I had the chance. In the region where I gave birth it is not common practice, however, I have come to know that it is indeed an option in some countries. Click to read more about night stay

3- Insurance

NICU STAY IS VERY COSTLY. Every procedure (not just major procedures also the minor ones get added up) that comes on top makes it even more costly. If you worry about your financials, you need to get familiar with the coverage structure your insurance offers. Click if to read more on our experience with insurance

4- Breastfeeding / Skin to Skin

This is not something one can foresee in advance. Our hospital by chance was very supportive of skin to skin contact and we held our baby as soon as she was stable enough to spend time outside the incubator.

However, on the breastfeeding front, I feel we were a bit late to start out with nursing and I felt that support from the lactation consultants was a bit superficial. In my opinion, support should have been more consistent, structured and detailed considering they have an entire team of lactation consultants.

IF YOU ARE INTO BREASTFEEDING, I suggest you find a very experienced, super supportive lactation consultant and stick with her. Sometimes nurses avoid giving specific consultant names but they always know the best one so keep asking each nurse to get that name. Once you find the one, keep making regular appointments during your stay as this is your right as a preemie mother.