What are the different levels of neonatal care?

It can be confusing to understand your baby’s level of care. Here, we talk about the different levels of care neonatal units provide.

Why are there different levels of neonatal care?

There are different types of neonatal units in the NHS, and they are named depending on the level of specialist care they offer. Have a look at the section below to find out more about different types of unit.

Babies admitted to a neonatal unit get care according to what they need, and this care may change during the time they spend in hospital.

It is possible that your baby might have to be moved (often called ‘transferred’) to another hospital. You might also have been moved to a different hospital before your baby was born. This might not always be the hospital that is closest to your home, or where your baby was born.

However, staff will be specially trained to look after your baby. Take a look at our page on transfers for more information.

What are the different levels of neonatal care?

I will never forget walking into the unit and seeing her in the incubator, surrounded by machines. I soon learnt what each wire was for, what each monitor did and what the alarms meant. What are the different levels of neonatal care?

Ben, dad to Jemima

Special care baby unit (SCBU, sometimes called low dependency)

This is for babies who do not need intensive care. Often, this will be for babies born after 32 weeks’ gestation.

Care can include:

  • Monitoring their breathing or heart rate
  • Giving them more oxygen
  • Treating low body temperature
  • Treating low blood sugar
  • Helping them feed, sometimes by using a tube
  • Helping babies who become unwell soon after birth

Sometimes, a baby might be admitted to a special care baby unit for phototherapy to treat jaundice. But sometimes, this condition is treated in transitional or postnatal care (see below).

Local neonatal unit (LNU)

Babies who need a higher level of medical and nursing support are cared for here. If your baby was or will be born between 28 and 32 weeks’ gestation you may be transferred to an LNU.

Care on an LNU might include:

  • Breathing support given through their windpipe (called ventilation)
  • Short-term intensive care
  • Care during short periods where they stop breathing (called apnoea)
  • Continuous positive airway pressure (called CPAP) or high flow therapy for breathing support
  • Feeding through a drip in their vein (called parenteral nutrition)
  • Cooling treatment for babies who have had difficult births or are unwell soon after birth (before being transferred to a neonatal intensive care unit – see below)
  • Helping babies who become unwell soon after birth

Neonatal intensive care unit (NICU)

This is the level of care for babies with the highest need for support. Often these babies will have been born before 28 weeks’ gestation, or be very unwell after birth.

You might have been transferred to a different hospital which has a neonatal intensive care unit before your baby was born. This is usually because the staff feel your baby would benefit from this level of care, but that it is safer to transfer your baby before they are born.

Babies are cared for here when they:

  • Need breathing support given through their windpipe (called ventilation)
  • Have severe disease affecting their breathing (called respiratory disease)
  • Need or have just had surgery

At a neonatal intensive care unit, all levels of care may also be given to babies from the local area.

Transitional care

This is where you and your baby stay together in hospital whilst you and the team care for your baby.

It means your baby is well enough to stay with you, either in the postnatal ward or a room on the neonatal unit, with support from the hospital staff. You will be in the hospital for 24 hours a day.

Some babies born between 32 and 37 weeks’ gestation, or babies with mild jaundice or feeding problems, get the care they need in this way.

I'm confused by the different levels of neonatal care

It can be confusing to understand your baby’s level of care.

Sometimes babies might be treated in different types of units because their condition has changed. It might not be clear straight away what type of care your baby is getting.

For example, your baby could be in a neonatal intensive care unit, but getting special care. You can always ask the staff if you want more information about the level of care your baby is getting.

You might hear staff on the unit call the different levels of care by different names than we've used here. Have a look through our neonatal words for some other ways people talk about levels of care.

Want to see inside a neonatal unit?

Watch a series of five videos which will introduce you to life on a neonatal unit.
Read more

The information in this section is due for review May 2021