Recommendations for Level of Facility Care for the 3 Categories of Newborns
| Well Newborns | At-Risk Newborns | Small and Sick Newborns | |
|---|---|---|---|
| Location/placement | Postnatal ward/postpartum unit (wards or single rooms) | Roomed-in with mothers in a designated areaAttached to/in the postnatal ward/postpartum unitAttached to SNCU/NICUaKangaroo mother care units | Special neonatal care unit/neonatal intensive care unitMother-baby unit b |
| Health care provider | Midwives/nurses well trained in the basic care of both the mother and baby, preparation for discharge, and monitoring for and identification of danger signsIdeally and where feasible, coupled with daily rounding by trained physician assistants, nurse practitioners, physicians, pediatricians, and/or neonatologists | Midwives/nurses trained additionally in the monitoring and care of the at-risk babiesDaily rounding by trained physician assistants, physicians, pediatricians, and/or neonatologists with additional visits as required (more frequent than for well babies) | Nurses trained to provide level II, III, and IV carecPediatricians, neonatologists, and/or midlevel providers trained to provide level II, III, and IV care |
↵a Typically, special neonatal care units/neonatal intensive care units do not support rooming-in care for the postpartum mother.
↵b Neonatal units, often level II, where small and sick newborns are kept with their mothers, separate from the general postnatal wards/postpartum units (as in some sub-Saharan countries).
↵c Level 1 care: resuscitation at delivery and postnatal care to stable term and late preterm infants (35–<37 weeks of gestation) and stabilization and transport to all others; level II care: >32 weeks of gestation and >1500 g, or moderately ill with conditions expected to resolve rapidly; level III/IV: provide sustained life support and comprehensive care including access to pediatric subspecialists (American Academy of Pediatrics Committee of Fetus and Newborn).26