Neonatal Intensive Care Unit (NICU)

Specialized Care for Newborns at Duke University Hospital and Duke Regional Hospital

Call for an Appointment 855-855-6484

Duke Health provides all levels of neonatal intensive care for babies born prematurely, at very low birth weight, or with serious medical conditions. We value you and your family as our partners. We strive to answer all your questions, keep you informed, and welcome your input regarding your child’s condition and treatments.

Level IV NICU
The sickest and smallest babies receive the highest level of care in the Duke University Hospital Level IV neonatal intensive care unit (NICU). The Level IV designation indicates our NICU is staffed by pediatric medical, surgical, and other subspecialists. We work as a team to provide advanced care to newborns with serious heart, brain, and lung conditions, or abnormalities that are present at birth, such as underdeveloped organs or malformations.

Level II NICU
Duke Regional Hospital’s Special Care Nursery is a Level II NICU for infants who need moderate, less urgent care. Often, babies start their care in Duke University Hospital’s NICU and are transferred to this step-down nursery as they continue their journey toward home.

Our NICUs and Special Infant Care Clinics

Duke NICUs are located at Duke University Hospital and Duke Regional Hospital in Durham. Our special infant care clinics are located in the Duke Children's Health Center in Durham.

Why Your Baby May Require Neonatal Intensive Care

Your doctors may determine that your baby requires intensive care after birth, during your pregnancy or at delivery if:

  • Your baby is born before 37 weeks of gestation.
  • Your baby is diagnosed with a condition during your pregnancy or at birth that requires immediate attention.
  • Your baby needs additional support after delivery, such as respiratory or nutritional support, treatment for infection, or close monitoring.
  • You are carrying multiples (twins, triplets, or more).
  • You have a pre-existing condition during pregnancy that impacts your baby’s health and development after delivery.
  • You are diagnosed with abnormal placement or attachment of the placenta. This can lead to significant complications for your baby during and after delivery. Examples include placenta accreta and placenta previa.
  • You are at high risk for carrying a low birth weight baby.

Prenatal Consultation and Planning for Your Baby’s NICU Care
Our team of neonatologists, maternal-fetal medicine specialists, pediatric subspecialists, and surgeons work together to assess the health of your unborn baby and counsel you as needed. We prepare you and your family for the delivery of your baby and the potential need for intensive care after birth.

Fetal Diagnostics Center
Advanced fetal imaging may be recommended to help doctors detect and monitor issues that can occur as your baby develops.

Delivering Your Baby at Duke University Hospital
We work with your obstetrical team through your pregnancy, labor, and delivery at Duke University Hospital’s Birthing Center. The American College of Obstetrics and Gynecology designates our facility as Level IV, which means we are equipped to provide care for the most complex, critically ill pregnant people and fetuses.

We Are a Referral Center for Other Hospitals
Ten to 20% of the infants who come to Duke’s NICU are transported to us for specialized care after being delivered elsewhere.

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Level IV NICU -- Highest Level of Care

Treatments Available

  • Hypothermia to treat infants with suspected brain injury
  • Nitric oxide to treat pulmonary hypertension
  • Continuous video EEG to diagnose seizure disorders
  • Extracorporeal membrane oxygenation (ECMO) or cardiac bypass
  • Access to investigational protocols and therapies
  • Access to early cardiac intervention

A Team of Specialists
Duke University Hospital’s NICU is staffed with neonatologists, neonatal nurse practitioners, and other providers including pharmacists, respiratory therapists, occupational therapists, social workers, and registered dietitian nutritionists with expertise in caring for newborn infants. We also work closely with pediatric specialists across the spectrum to provide the necessary medical and surgical care.

PT/OT and Speech Therapy
Duke’s occupational, physical, and speech therapists work with families to monitor developmental progress and provide therapies while in the NICU.

Lactation Consultants
Our lactation consultants support new mothers to provide their own milk for their babies while hospitalized; we can provide donor human milk from an HMBANA-certified milk bank when the mother’s milk is not available.

Kangaroo Care
We encourage Kangaroo Care for you and your infant when they are safe to participate. This skin-to-skin contact has proven benefits, including stabilizing your baby’s heart rate and helping to regulate body temperature.

Developing New Approaches to Newborn Intensive Care
The Duke Division of Neonatology participates in the National Institute of Child Health and Human Development (NICHD) Neonatal Research Network, a consortium of the leading neonatal intensive care units in the country that perform collaborative clinical research to improve neonatal care and outcomes. Our participation in this consortium allows us to develop and implement the latest scientifically proven approaches to neonatal care. It may also provide opportunities for your child to participate in clinical trials of new advances in care. 

Take a tour of Duke Children's Intensive Care Nursery, the largest critical care unit at Duke University Hospital.

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Special Care Nursery

Level II NICU
Our Level II NICUs provide some services beyond basic well-baby care for premature or sick newborns. This kind of neonatal intensive care unit is best for babies born early who may be underweight and who need equipment to help them breathe.

Babies Transition as Intensive Care Needs Lessen
Babies transition to either the Duke University Hospital transitional care nursery or special care nursery at Duke University Hospital or Duke Regional Hospital as their needs for intensive care lessen. They continue to grow and develop skills -- such as feeding -- that are needed before they can safely transition to home.

Special Care Nursery at Duke Regional Hospital
Babies in Duke Regional Hospital’s level II NICU receive the same expert care in an environment that may be more convenient and accessible for parents and families.

Learn more about how the staff at Duke Regional's Special Care Nursery care for your child.

Transitional Care After Discharge

Special Infant Care Clinic
Our special infant care clinic provides nutrition, feeding, physical, and occupational therapies, as well as support for your child's development after discharge.

Transitional Medical Home
Infants with complex problems, including those dependent on technologies such as a ventilator or feeding tube, receive comprehensive care and help during the first year after discharge. Our staff also facilitates the coordination required when multiple subspecialists provide care for complex infants.

Transitional Care for Infants with Complex Needs
Once babies with complex needs leave the NICU, they may be followed through a program that provides 24-hour medical support. If your baby is eligible, pediatric specialists walk you through problems that may arise with feeding and mechanical breathing support. This program can prevent the need for babies to be readmitted to the hospital.

Reducing the Risk of Neurodevelopmental Concerns After NICU
Follow-up care during the first few years of life can help identify delays early and provide intervention. Duke’s neurodevelopment team makes feeding recommendations, manages feeding tubes, monitors weight gain, supports neurodevelopment, coordinates with other specialists, and receives outpatient therapies.

Neonatal Quality of Life Program
This family-centered program is for newborns and infants with life-threatening, and potentially life-limiting, conditions. Our quality-of-life team includes doctors, nurse practitioners, spiritual counselors, and social workers who specialize in maximizing comfort and providing pain and symptom relief. They also provide emotional, psychosocial, and spiritual support for your infant and family.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 9 pediatric specialties.

This page was medically reviewed on 05/03/2023 by