A Neonatal Intensive Care Unit, commonly referred to as a NICU, is a specialised hospital unit dedicated to providing care for newborn babies with specific needs. This care is especially crucial for infants born prematurely or with an illness requiring immediate attention. The team of experts who provide care in the NICU includes neonatologists, neonatal nurse practitioners, respiratory therapists, and dieticians, all with extensive training in caring for newborns. However, the cost of neonatal intensive care in India is a significant concern for many parents whose babies require this treatment.
Factors Affecting the NICU Cost in India
Since the babies receive extra attention and intensive care, neonatal intensive care costs are often much higher than that of standard newborn care. Nevertheless, certain factors affect the cost of NICUs in India. They are:
Why the baby was transferred to NICU matters a lot when determining the cost of NICU. For instance, the cost of NICU for a premature baby would be much lower than an infant who might have been born with breathing difficulty, sepsis, or a kidney or heart condition.
Length of Stay
How long a baby has to stay is another factor that will affect the cost of NICU. The longer the baby needs to stay in the NICU, the higher the cost. A premature baby might have to stay for about 15 to 20 days. In comparison, a baby with a congenital condition might need to stay in the NICU for a longer period.
Level of Care Provided
The level of care provided in the NICU depends on the facilities and resources available at the hospital. The lesser the facilities and resources, the lower the level of care provided. The cost of NICU would also be lower in such hospitals. NICUs with more advanced equipment and resources can provide a higher level of care and hence charge a higher amount per day.
Hospital Type and Location
Private hospitals usually have a higher cost of NICU than public or government-aided hospitals. However, the quality of care and facilities available at most government hospitals would be limited. Private hospitals can afford to invest in advanced equipment and more resources. Also, if the hospital is in a major city, the cost of NICU would be much higher because of higher staff salaries and overhead costs.
Conditions Where NICU Is Required
As a specialised unit of hospitals, the Neonatal Intensive Care Unit or NICU provides intensive care for babies born with severe health issues. While most such babies are born early, there would be many with infections, congenital heart/kidney/lung conditions, or other health problems. Here is a list of requirements when babies might require NICU admissions:
Babies born before 37 gestational weeks are generally termed premature babies. They need specialised care since they might be at risk of developing severe health issues, due to low birth weight. NICUs of most reputed hospitals are well-equipped to provide 24/7 care for premature babies. They continuously monitor their vital signs, provide oxygen as needed, and administer timely medications for faster recovery.
Any functional or structural anomalies that might occur during intrauterine life are termed congenital disorders or birth defects. Most such conditions can be identified at or even before birth. They include heart defects, down syndrome, neural tube defects, hernias, clubfoot, and cleft lip & palate. Babies with such conditions can thrive if provided specialised care at NICU. They require specialised monitoring with therapies and treatments.
Some babies might experience breathing difficulties during or after birth. With immediate treatment and assistance from the NICU team, these babies can be resuscitated and put on the road to recovery. Depending on their condition, they would require respiratory support, oxygen therapy, and various other treatments.
Certain newborns tend to develop infections in the womb or shortly after birth. NICU teams are usually well-equipped to identify such infections in their early stages and provide the required treatments. This will make it easier and faster for these babies to fight infections and recover.
Low Birth Weight
Premature babies are often born with low birth weight. In some cases, even full-term babies can be born with a birth weight of less than 2 kg. NICU teams offer appropriate support and nutrition to help these babies gain weight and thrive.
Levels of NICU
Different hospitals provide different levels of NICU care depending on their facilities, resources, and capabilities. Broadly, NICUs can be classified into four different levels:
A NICU of Level 1 can be expected to provide a basic level of care. The newborns admitted here would be generally healthy but would need some extra care and monitoring for a short period. Babies with jaundice, moderately low birth weight, or those that might have difficulty feeding would be treated here.
Level 2 NICUs would be slightly more advanced than Level 1 NICUs. They are equipped to treat babies with more severe issues, such as infections, heart defects, and even respiratory problems. Their teams would include neonatologists, neonatal nurses, and other specialists. The babies admitted here might need close monitoring, oxygen for breathing, and IV fluids.
Level 3 NICUs are equipped with ventilators and provide continuous life support to babies who are critically ill. The medical team of level 3 NICUs would be capable of performing minor surgical procedures to repair specific acquired or congenital conditions. Apart from neonatologists and neonatal nurses, Level 3 NICU staff would also include respiratory therapists, pediatric medical specialists, physical therapists, occupational therapists, imaging technologists, and even lactational consultants and social workers who offer support to the families of newborns.
Level 4 NICUs provide the highest and the most advanced level of care. They will have multidisciplinary teams capable of performing complex surgeries and providing specialised care and long-term treatments to babies with life-threatening conditions and multiple medical issues. They also treat babies who are born before 29 gestational weeks. They offer family-centred support by including parents as core members of the NICU team.
Importance of NICU In India
Considering the high infant mortality rate, every hospital in India should have a NICU to provide specialised care for newborn babies. Also, there are too many premature babies and low birth-weight babies born every year in the country. Here are a few more facts that can establish the significance of NICUs in India:
The highest number of births and neonatal deaths in the world happen in India.
The death rate in the first month has risen from 24 to 40 per cent. Providing quality neonatal care can prevent 70 per cent of these deaths.
An infant born in a poor country like India is fourteen times more likely to die in the first 28 days of its life when compared to an infant that is born in a developed country.
60 to 80 per cent of neonatal deaths happen due to low birth weight, which could be due to intrauterine growth restriction or pre-term birth. Most such deaths are unrecorded as they occur at homes.
Fully equipped NICUs with advanced technology equipment and specialised staff can provide an intensive, supportive, and safe environment for fragile infants who are critically ill. Ventilators, cardiac monitors, incubators, and phototherapy machines are a few of the life-saving equipment they need to invest in.
Apart from providing specialised care to babies with congenital disabilities, NICUs in hospitals in India will also be able to offer support to the families of these babies. All babies deserve the best chances of survival, irrespective of their complications. Only well-established NICUs will be able to make this possible.
Top 10 Neonatal Hospitals In India
Despite the high infant mortality rate, many neonatal hospitals are in India. Most of these are equipped with advanced technology equipment and highly skilled team members who can provide intensive and specialised care to newborns with multiple health problems. Here are the 10 best neonatal hospitals in India:
1. KEM Hospital, Mumbai
King Edward Memorial Hospital in Mumbai has a NICU with 42 beds. They provide specialised care and closely monitor babies who require advanced ventilatory care. They have a Kangaroo Mother Care Center for newborn babies with low birth weight. They provide regular follow-up care for low birth weight babies discharged from NICU. They also have a human milk bank for the optimal nutrition of babies in the NICU.
2. Apollo Hospitals, Chennai
The NICU at Apollo Hospitals in Chennai provides specialised care to babies born as early as 24 gestational weeks. Newborns with complex surgical as well as cardiac problems are treated here. Treatments provided include high-frequency ventilation, nitric oxide, and Tecotherm. They also offer ROP (Retinopathy of Prematurity) screening, OAE screening or hearing, follow-up care and neurodevelopmental assessment.
3. Surya Child Care Centre, New Delhi
NICU at Surya Hospitals provides the finest care to newborns who are sick or born prematurely. Backed by equipment of the latest technology, they have an excellent team of experts experienced in diagnosing, treating, and managing complex neonatal conditions. With advanced imaging modalities, bed warmers, cribs, and incubators, the NICU can handle all kinds of emergencies.
4. Narayana Health, Bengaluru
Narayana Health Hospitals in Bengaluru have advanced NICU and PICU units to provide specialised care for babies who are critically ill, premature babies born with low birth weight, congenital disabilities, jaundice, and respiratory distress syndrome. Their highly trained team includes expert neonatologists, nurse practitioners, and other medical professionals.
5. K.J. Somaiya Medical College, Mumbai
K.J. Somaiya Medical College in Mumbai has a 20 bedded NICU with state-of-the-art equipment, including various monitors and advanced ventilators. Apart from low-birth weight and prematurity, they also manage neonatal conditions such as jaundice, respiratory distress syndrome, birth asphyxia, neonatal sepsis, anaemia, meconium aspiration syndrome, haemorrhage, polycythemia, apnea, neonatal seizures, metabolic disturbances, fluid and electrolyte imbalances, necrotising enterocolitis, pulmonary hypertension, congenital heart disease, and other congenital anomalies.
6. Fortis La Femme, New Delhi
Fortis La Femme in New Delhi has a Level 3 NICU with a highly skilled team of neonatologists and advanced technology equipment to provide specialised care for pre-term babies and newborns with complex medical problems. The facilities include conventional ventilators, High-Frequency Ventilators, blood gas analysers, transcutaneous carbon dioxide monitors, incubators, open head warmers, isolation rooms, bedside physiological monitors, infusion pumps, nasal CPAP drivers, digital syringes, and specially designed nurseries with special lighting and low ambient noise level.
7. Medanta – The Medicity, Gurugram
Medanta – The Medicity in Gurugram is also equipped with a Neonatal Intensive Care Unit that provides specialised care to premature and critically ill babies and newborns. Treatments are provided for jaundice, respiratory distress syndrome, congenital heart disease, anaemia, hypoglycemia, hypotonia, necrotising enterocolitis, and neural tube defects. The NICU provides the best possible care for newborns, equipped with state-of-the-art technology and a highly-skilled team of doctors, nurses, and support staff.
8. Max Super Speciality Hospital, New Delhi
The NICU at Max Super Specialty Hospital in New Delhi treats premature babies and newborn babies with complex diseases. Besides providing specialised care to these babies, they also provide counselling services to parents so they can carry out their baby-care responsibilities easily. For anaemia, pneumonia, apnea, heart-related issues, feeding difficulties, and neonatal sepsis, treatments are provided.
9. Manipal Hospitals, Bengaluru
The NICU at Manipal Hospitals in Bangalore is equipped with advanced state-of-the-art equipment and a specialised team of neonatologists, respiratory therapists, neonatal nurse practitioners, and resident physicians. They provide specialised care to babies born as early as 24 gestational weeks. Backed with hi-tech apparatus, the NICU team can provide the best chances of survival to babies with undetected congenital disabilities and pre-term babies with underdeveloped body systems. Treatments are provided for anaemia, apnea, bradycardia, bronchopulmonary dysplasia, neonatal sepsis, hydrocephalus, jaundice, patent ductus arteriosus, intraventricular haemorrhage, infant respiratory distress syndrome, necrotising enterocolitis, transient tachypnea of newborn, periventricular leukomalacia, and retinopathy of prematurity.
10. Rainbow Children’s Hospital, Hyderabad
Rainbow Children’s Hospital at Hyderabad has a Level 3 to Level 4 NICU with an attached perinatal centre. They were the first hospital to establish a neonatal transport service in the country. They have expert neonatologists, respiratory therapists, neonatal nurse practitioners, and lactation consultants with round-the-clock availability.
They have decades of experience in treating neonates with respiratory problems, low-birth weight babies, and pre-term babies. They have even treated babies with birth weights less than 1 kg. They have created records by treating a baby weighing 375 grams and a 22-week premature baby weighing 450 grams. They have a human milk bank and a kangaroo mother care service to provide the best nutrition and support to newborns.
Their facilities include ventilators, incubators, open head warmers, physiological monitors, and CPAP and Bubble CPAP monitors. They provide the best laboratory services, vaccination services, and ROP care.
Considering the high mortality rate, neonatal intensive care units are a must in India if the goal is to provide all newborn babies with the best chances of survival. Apart from offering specialised care and advanced treatments to critically ill newborns, NICUs must also be equipped to support the families of these babies and help them handle the stress. Investing in equipment, infrastructure, and staff of NICUs is crucial if the need is to provide quality care to infants.
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