After your baby is born, doctors will assess their health and decide what type of care they will need for the remainder of their hospital stay. There are four levels of newborn care. Babies who are stable and doing well may spend time in a traditional newborn nursery. Babies who need additional support or treatment for medical concerns may be cared for in more specialized nurseries or in the neonatal intensive care unit (NICU).

Babies can move between levels of care depending on how they are doing — to a higher level if they need more support, or to a lower level if they are improving and require less medical intervention.


Level I: Well Newborn Nursery

  • For babies born full-term (around 40 weeks) who are stable.

  • For some babies born slightly early (35–37 weeks) who are stable and do not need breathing or feeding support.

  • May be a temporary stop for babies waiting to transfer to a higher level of care if medical needs change.

Level II: Special Care Nursery

  • For babies born after 32 weeks and weighing more than 3.3 pounds, who may have minor health concerns.
  • For babies who have improved and are transitioning down from the NICU.
  • May care for babies who need short-term breathing support (typically 24 hours or less) before transitioning to Level I or Level III/IV if more care is needed.

Level III: NICU (Neonatal Intensive Care Unit)

  • For babies born before 32 weeks or who weigh less than 3.3 pounds.
  • For babies of any gestational age who are critically ill.
  • For babies who require breathing support, advanced monitoring, or intensive medical treatment.

Level IV: Regional NICU

  • Provides the highest level of newborn care.
  • For babies with complex, critical medical needs.
  • For babies who require specialized surgeries for birth defects or other serious medical conditions.

*When possible, doctors aim to identify babies who may require higher-level care before birth so delivery can take place in a hospital equipped with an appropriate NICU.

**A NICU is staffed with specialists, including neonatologists, respiratory therapists, and nurses trained in caring for medically fragile newborns.

Source: March of Dimes