Information about level 2 newborn care | Blog By Dr. Sorabh Goel, Paras Bliss, Panchkula and Mohali

What is Level 2 Newborn Care

What is Level 2 Newborn Care

by: Dr. Sorabh Goel
Consultant - Neonatology-Paras Bliss, Panchkula

With the availability of neonatal intensive care, the outcomes for high-risk infant cases may include preterm newborns, newborns with serious surgical or medical conditions. The upgraded classification of neonatal care consists of basic care (level 1), specialty care (level2), and subspecialty intensive care (level3, level4).

Level 2: Special New Born Care Unit(SNCU)

Any facility with more than 3000 deliveries per year should have an SNCU. NICU Level II is divided into two categories – IIA and IIB (this division is done on the basis of their ability to provide assisted ventilation). Level IIA nurseries don’t have the capabilities to provide the assisted ventilation except on an interim basis until and unless the infant is being transferred to the higher level facility. Level IIB nurseries provide mechanical ventilation for brief durations of up to <24 hours or CPAP.

Its capabilities include level 1 capabilities plus

  • Provide care for infants born≥32wk gestation and weighing≥1500gm who have physiological immaturity or the babies who are moderately ill with problems that are expected to resolve rapidly
  • Provide care for infants convalescing after intensive care
  • Provide mechanical ventilation for brief duration<24hrs or continuous positive airway pressure or both
  • Stabilize infants born before 32wks and weighing less than 1500gm until transfer to a neonatal intensive care facility.

Who should be admitted to Special New Born Care Unit( SNCU)

  • Birth weight<1800gm or gestation <
  • Large baby≥4kg
  • Perinatal asphyxia- moderate birth asphyxia(neonates with APGAR score 4 to 6 at five minutes and/or requiring any form of resuscitation at birth.
  • Respiratory distress (rate≥60 or grunt/retractions) not requiring ventilation
  • Severe jaundice (appears<24hrs/ stains palms and soles/ lasts≥2wks)
  • Hypothermia <4 or hyperthermia ≥37.5 if not stabilized.
  • Central cyanosis
  • Shock (cold periphery with CFT>3sec and weak and fast pulse) requiring inotropes.
  • Coma, convulsions or encephalopathy
  • Abdominal distension, vomiting, bilious aspirate
  • Bleeding diathesis
  • Newborn requiring: incubator care, oxygen therapy, cardiorespiratory monitoring, exchange transfusion, nasal CPAP.

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