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What is a Level 3 NICU?

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Updated April 09, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

A Level III NICU can care for the smallest and sickest babies.

A Level III NICU can care for the smallest and sickest babies.

Image courtesy Getty Images / Alvis Upitis

A level 3 NICU, or level III NICU, is a neonatal intensive care unit that is capable of caring for the smallest and sickest of newborn babies. Level 3 NICUs have a wide variety of staff on site, including neonatologists, neonatal nurses, and respiratory therapists who are available 24 hours a day. They may also be called subspecialty care centers or subspecialty NICUs.

Because taking care of premature and sick babies is complex, level 3 NICUs are further broken down into sublevels. These definitions may vary by state or by hospital system, but provide a good idea of what should be available at different levels of care:

  • Level IIIA: A level IIIA NICU, or level 3A NICU, can care for babies born at 28 weeks or older and who weigh 1,000 grams or more. They can provide mechanical ventilation and minor surgical procedures, such as umbilical vessel catheterization.
  • Level IIIB: A level IIIB NICU, or level 3B NICU, can care for babies born at any viable gestational age, including micropreemies. They can provide mechanical ventilation and high-frequency mechanical ventilation. They have pediatric surgical centers on site or close by to complete major surgeries, including PDA ligation and bowel surgery to treat NEC.
  • Level IIIC: A level IIIC NICU, or level 3C NICU, has all of the capabilities of a level IIIB NICU and more. This is the highest level of NICU care, and level IIIC NICUs can provide ECMO and can complete complicated surgeries that require cardiopulmunary bypass.

Sources:

American Academy of Pediatrics Committee on Fetus and the Newborn. "Policy Statement: Levels of Neonatal Care." Pediatrics Nov. 2004. 114: 1341-1346.

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