25. Levels of Neonatal Care
Level I-basic neonatal care
Function of the unit
Care of neonates with uncomplicated conditions,
availability of emergency measures, and plan for transfers
to Levels II and III
Risk assessment
Plan for well child post-discharge care
Parent education and discharge planning
Continuing education
26. Criteria for admission
Normal, stable, full term neonate with a body weight ≥2,500
gm
No risk factors
Physical facility
Space allocation: rooming-in with the mother at the post-
delivery room.
The number of bassinets (cribs) should be at least equal to
the number of obstetric beds.
The room temperature should be maintained at 24º-26ºC.
27. Equipment, supplies, and medications
Resuscitation box with equipment, supplies and
medications necessary for neonatal resuscitation .
Neonatal stethoscope
Newborn scale
Neonatal thermometer
Alcohol 70%
Antibiotic eye drops
Personnel
Nurses and physicians must be trained in basic neonatal
care and resuscitation
Staffing requirements should reflect a nurse-infant ratio of
1:6-8
28. Level II-special neonatal care units
Function of the unit
Management of moderately ill newborns expected to
improve rapidly
Management of extremely ill newborns requiring
stabilization and transfer to Level III
Management of recovering neonates transferred back
from Level III or Level IV centers
Risk assessment
Continuing education
29. Criteria for admission of neonates at level II
units
Preterm infant 32 weeks' gestation
Low Birth Weight (LBW) infant
Infant of a diabetic mother (IDM)
Affected infant born to high risk pregnancy and delivery
Respiratory distress not needing assisted ventilation
Hyperbilirubinemia, needing phototherapy
Neonatal sepsis
Hypothermia
Personnel
Nurse-infant ratio of 1:4 during each shift Resident trained in
neonatology available 24 hrs/day
Pediatrician with special neonatal training available 24 hrs/day
30. Level III-neonatal intensive care units
Function of the unit
Care of moderately ill and extremely ill newborns
Transport system
Regional and in-house continuing education
Assist region in assessing unmet needs in perinatal health
Evaluation and research
31. Criteria for admission of neonates at level III
units :
Any infant whose clinical condition is such that they
cannot be appropriately cared for in Level II:
Infant with hemodynamic compromise (shock)
Moderate or severe respiratory distress, needing short-term
mechanical ventilation for less than 7 days
Very low birth weight (VLBW) infant
Personnel
Nurse-infant ratio of 1:1-2
Nurse specialized in NICU
Resident available 24 hrs/day
Consultant available 24 hrs/day