The Penn State Health Children’s Hospital Approach to Neonatal Intensive Care
Parents expect their babies will be born healthy. Yet, sometimes newborns need to be hospitalized. The 56-bed neonatal intensive care unit (NICU) at Penn State Health Children’s Hospital is led by a compassionate team of neonatologists (doctors who care for sick and premature newborns), neonatal-perinatal medicine fellows, neonatal advanced practice providers, pediatric residents, bedside neonatal nurses and other neonatal healthcare professionals.
As a Level IV NICU (the highest level NICU) and the only one between Philadelphia and Pittsburgh, our team provides complete and comprehensive, lifesaving care to the most complex and critically ill newborns and serves as a regional referral center. Our first NICU opened in 1972. Our new NICU is on the 8th floor of Penn State Health Children’s Hospital, and opened in November 2020. Our NICU is the only one in central Pennsylvania to offer a full range of services - including the ability to perform surgery on-site 24 hours a day, seven days a week. Our team cares for nearly 800 babies each year, with about 30% admitted from outside hospitals.
The new NICU uses a hybrid room model. This means we can adapt to your family, as parents can visit at any time of the night or day. The family-centered environment features 27 single-family rooms, four twin rooms, one triplet room and three six-bedded open bay rooms. The private rooms, when available, allow parents to room-in with their infant during the entire hospitalization, where they will be actively engaged in the care of their baby and grow comfortable with the specialized care their newborn needs. We are also fortunate to have AngelEye video technology, bedside cameras that allow parents to see their child virtually when they cannot be at the bedside.
Babies are admitted to our NICU because they were born too early (up to 17 weeks before their due date), have lung or heart problems, need surgical intervention for birth defects, require consultative care from our pediatric subspecialists or have other life-threatening conditions. The integrated Neonatal-Perinatal Medicine team at Penn State Health Children’s Hospital develops special individualized treatment plans for every ill baby in our care. If you have a high-risk pregnancy, choosing Milton S. Hershey Medical Center for your delivery gives you access to a dedicated team for resuscitating the smallest and sickest babies born.
At Penn State Health Children’s Hospital, we also have an active transport team that brings sick infants to our NICU who are unable to be fully cared for in community hospitals. We also provide outreach education and training to nearby hospitals.
Our Experts in Care
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Why Choose Penn State Health Children’s Hospital for NICU Care
Penn State Health Children’s Hospital has a steadfast commitment to quality, safety and using the most up-to-date treatments and technology to provide the best care. As a member of several national multicenter organizations focused on safety, our dedicated team is involved with ongoing initiatives to improve outcomes. We are a member of the Vermont Oxford Network, a collaboration of NICUs around the world with the shared goal of improving outcomes for sick newborns. Additionally, many neonatologists and members of the Division of Neonatal-Perinatal Medicine are researchers. We have expertise in research about neonatal abstinence syndrome (babies addicted to drugs while in the womb), neonatal hypoglycemia, neonatal brain injury, neonatal lung disease, necrotizing enterocolitis (a condition where infants have impaired gastrointestinal function) and assessment of the risk of developing poor long-term outcomes.
U.S. News & World Report has recognized Penn State Health Children’s Hospital specialties with top rankings, including neonatology, pediatric cardiology, pediatric cancer, pediatric nephrology and pediatric pulmonology and lung surgery. You can see all of our awards and recognitions here.
Comprehensive NICU Team
NICU doctors and advanced practice providers are on faculty at the Penn State College of Medicine at the Milton S. Hershey Medical Center, the only academic medical center in central Pennsylvania. The environment that babies grow in is very important. The entire NICU staff is dedicated to providing the very best care for babies. One of the many aspects of the care we provide includes promoting a developmentally supportive care environment.
Each area represents organized and holistic care of the family infant dyad. By following the Universe of Developmental Care Model, babies are placed at the center of all care and interventions provided. Each area of focus is implemented in every interaction with babies to promote the best neurodevelopmental outcome, promote rest and prevent pain and stress.
The team of providers caring for your baby will include:
- NICU nurses - Our NICU is staffed by the region’s most highly skilled registered nurses with a national neonatal certification specializing in our unique patient population. Our Clinical Practice Nurse Leader and a Quality Nurse Specialist focus on improving patient outcomes and implementing new and innovative evidence-based nursing practices. Our NICU nurses partner with parents for an integrated family model. Each nurse typically cares for one to three infants at a time depending on the baby’s needs.
- NICU child life specialist - Our certified child life specialists are specially trained in child development and helping patients and families understand and cope with their hospitalization. They support the whole family by providing supportive play, support during procedures, positive touch, and celebrate special occasions. They can also help siblings or other family members prepare for a NICU visit, teach them how to bond with the baby, and show parents how to support older children.
- NICU nurse care coordinator - Our care coordinator will work with your family and the medical team to plan for your baby’s discharge from the hospital. They will help set-up all care you will need after discharge and work with your insurance provider.
- NICU social workers - Our social workers are dedicated to the NICU. They will connect you with available resources and community supports and act as an advocate for families as they navigate the NICU environment. They can help you with everything from emotional support, insurance coverage and supplies, to lodging and transportation.
Our NICU team also includes
- Clinical pharmacists specializing in neonatology pharmaceuticals
- Dieticians specializing in infant nutritional needs
- Occupational therapists and physical therapists
- Respiratory therapists to manage ventilators
- Speech therapists
Every newborn and infant who comes to our NICU receives the highest quality of care. We use the most effective forms of life support to help babies breathe, get the oxygen they need and maintain a stable body temperature. Common diagnosis in the NICU include:
- Acute kidney injury
- Bronchopulmonary dysplasia
- Cleft palate and lip
- Complex congenital heart disease
- Congenital diaphragmatic hernia
- Congenital anomalies and chromosomal abnormalities
- Hypoxic ischemic encephalopathy
- Intraventricular hemorrhage
- Metabolic disorders/Inborn errors of metabolism
- Necrotizing enterocolitis
- Neonatal abstinence syndrome
- Neonatal hypoglycemia
- Neonatal platelet disorders
- Neurodevelopmental disorders
- Newborn resuscitation
- Patent ductus arteriosus
- Periventricular leukomalacia
- Pulmonary hypertension
- Respiratory distress syndrome
- Respiratory syncytial virus
- Retinopathy of prematurity
- Transient tachypnea of the newborn
- Urinary tract infection
Learn More about the NICU
Small Baby Unit
Penn State Health Children's Hospital Small Baby Unit was established in January, 2021 for the coordinated and consistent care of newborns born at 23 to 28 weeks’ gestation (12 to 17 weeks before their due date).
The purpose of the Small Baby Unit within the NICU is to provide the best possible care to our most premature newborns. We combine an evidence-based team approach to care using our experienced and interested caregivers to reduce mortality and morbidity in our smallest patients.
Very premature infants will initially be admitted into quiet, private rooms, anywhere in the NICU, to limit stimulation that can be overwhelming. Then, once medically stable and off ventilators, and if parents are unable to stay with their infants, they will be moved to one of the open bay rooms where they will experience human voice and other stimulation. If parents are able to stay, the infant and parents will be able to remain in the private rooms. Research shows that most premature infants can experience significant developmental delays without regular exposure to a human voice. Our hybrid room model assures that your baby will have the best neurodevelopmental outcomes.
The guidelines and recommendations for care in the Small Baby Unit were developed by Penn State neonatologists, NICU nurses, the Chief of NICU clinical research, advanced practice providers, neonatal-perinatal medicine fellows, respiratory therapists, NICU dieticians and pharmacists, radiology technicians, NICU lactation specialist, the NICU Clinical Practice Nurse Leader and Nursing Quality Specialist.
Bringing Milk to the Milk Lab
The NICU Milk Lab is located immediately outside the NICU entrance, on the eighth floor of the Children’s Hospital. Parents can drop breast milk off at the Milk Lab window, open daily during the following times:
- 7-9 a.m.
- 10 a.m.-noon
- 3-7 p.m.
If the drop-off window is closed, parents can store a small amount of milk in the specialized refrigerator available in every baby’s hospital room until a milk technician can retrieve it for storage in the Milk Lab. If parents have frozen milk or a large volume of milk, they should inform their nurse of their storage needs.
For security reasons, when milk is dropped off at the Milk Lab window or retrieved from a baby’s room by a milk technician, two people will check that the correct label is on the container before it is placed in baby-specific bins in the Milk Lab refrigerator.
Suggested Containers for Milk Storage
The NICU Milk Lab team recommends storing milk in Snappies brand milk containers, available at the drop-off window. All containers must be labeled with special breast milk labels available at the lobby check-in desk or from your nurse.
Types of Feedings
The type of feeding each baby receives is determined by the providers and the care team. When appropriate, the NICU will use parent-provided breast milk first, if available that day by noon. If the Milk Lab runs out of parent-provided breast milk, then the appropriate alternative will be prepared.
Checking on Milk Supply in Storage
Parents can stop by the Milk Lab drop-off window when it is open and ask a milk technician to check how much of their stored milk supply is left.
How to Find Out More
Parents who have questions or need additional information are welcome to ask their bedside nurse to contact the Milk Lab’s team of dietitians, certified milk technicians and nursing leadership.
Commitment to the Most Up-to-Date NICU Technology
We pride ourselves on being at the forefront of neonatal care technology. We use all forms of invasive and non-invasive respiratory support and perform all advanced radiological procedures and cardiac imaging on an emergency basis. In addition to 24/7 in-hospital coverage by board-certified and board-eligible neonatologists, our hospital has all pediatric subspecialists and pediatric surgeons available 24 hours a day. We have the capability for surgical repair of all complex conditions including congenital heart malformations. Pediatric surgeons are also continuously available to place sick infants with severe respiratory failure on extracorporeal membrane oxygenation (ECMO), a form of cardio-respiratory bypass that is lifesaving when medical treatment is not effective.
Our NICU is also equipped with a specialized ventilator called neurally adjusted ventilatory assist (NAVA). It is a device that uses electrical signals generated by the baby’s diaphragm to control breathing.
Other advanced technologies in the Penn State Health Children’s Hospital NICU include:
- Bubble continuous positive airway pressure (CPAP), a non-invasive method of ventilation for premature babies that do not need to be on a ventilator
- High-frequency jet ventilation for extremely immature newborns with respiratory failure
- High-frequency oscillatory ventilation for babies with severe respiratory failure
- Nitric oxide, a special gas that relaxes pulmonary arteries in babies with pulmonary hypertension
- Sophisticated brain assessment through continuous electroencephalogram (EEG) monitoring
- Therapeutic hypothermia, a cooling treatment that may help reduce the risk of brain injury in babies who have been deprived of oxygen
Babies with congenital heart defects have access to Penn State Health Children’s Heart Group, a regional center of excellence in the care of children with heart disease. Newborns with congenital defects of the lungs, intestines, kidneys, and other organs and newborns with surgical problems, have around-the-clock access to Pediatric Surgeons.
Care Extends Beyond the NICU - Neurodevelopmental Clinic
Our commitment to care continues long after your child leaves the NICU at Penn State Health Children’s Hospital. We are one of the few programs in the region with a NICU Neurodevelopmental follow-up clinic that tracks the developmental progress of former high-risk NICU patients. The clinic’s goal is to provide early identification and referral for early intervention to address the neurodevelopmental and neurobehavioral problems associated with a NICU stay.
Babies who receive neonatal intensive care are at risk for developmental delay. Our NICU Neurodevelopmental clinic specializes in identifying neurodevelopmental problems early to provide timely intervention and therapies to reduce long-term developmental issues. We review the growth and progress of:
- Cognitive function
- Fine and gross motor skills
- Language development
- Play skills (cognitive development)
- Social-adaptive behavior
Our team of neonatologists, clinic coordinators (a neonatal nurse practitioner and a neonatal physician assistant), neonatal-perinatal medicine fellows, occupational therapists, pediatricians and a neuropsychologist care for your child as they grow. Care begins in early infancy with evaluations through age two years. Infants are typically seen three times after NICU discharge:
- 4 months after their due date
- 9 months after their due date
- 18-24 months after their due date
All patients are seen by an occupational therapist who assesses motor development and tone. Patients who are 18-24 months are also seen in conjunction with a neuropsychologist who assesses language, cognitive function and social-adaptive behavior. At the end of these assessments, the team will meet to discuss the patient and the care coordinator will help arrange follow up and referrals. The care team will then counsel the family and provide them with a report card summarizing this information. Later, they will compile a letter inclusive of all parties’ assessments and recommendations to send to the primary care physician. Most appointments last 1-2 hours.
As the child grows and develops, the care team provides monitoring and age-appropriate support, follow-up screening, reevaluation and assists with recommended treatments.
The NICU Neurodevelopmental follow-up clinic is located at our Penn State Health Pediatric Specialties.
Patient Education and Resources
We want to make sure patients and families have the resources they need. Whether it is lodging for out of town visitors, post-operative care for the patient, support groups for the family or financial support, we are here as your resource. If you have any questions please call our office at 717-531-8413.
NICU Advisory Council
The NICU Advisory Council is comprised of parents whose children spent time in the NICU and multidisciplinary staff members from both the NICU and Women’s Health units. Together, the group works on projects and initiatives to improve the NICU environment and the relationships among patients, families and staff. The NICU Advisory Council meets quarterly throughout the year at the hospital and meetings are facilitated by elected staff and parent co-chairs. Some projects and initiatives the council has worked on include:
- Created an electronic ”Wall of Hope” within the NICU showing photos of infants while in the NICU alongside a more current photo showing their progress following discharge
- Created milestone cards that can be posted at an infant’s bedside and/or kept by parents to explain a variety of big moments in a patient’s admission (e.g., extubation, weight goals, a feeding tube coming out, coming out of the incubator and first outfit)
- Helped with deciding on the décor (pictures, color schemes, etc.) for the new NICU
- Provided input on NICU processes such as discharge, volunteers and various support services
- Renovated the NICU breast pumping room
If you are interested in learning more about joining NICU Advisory Council, please email NICUFamilyAdvisory@pennstatehealth.psu.edu or complete the application here, specifying your interest in the NICU Family Advisory Council.
Family Care Conferences in the NICU
Our providers and staff believe in family-centered care. This means we partner with our families to make sure they are involved in all aspects of care for their babies at the level they choose.
One way we encourage our families to be involved is having family care conferences at certain points during your baby’s stay. These are opportunities for our families to meet the care team away from the bedside to ask questions and understand the plan of care.
If you would like to schedule a family care conference, please ask your bedside nurse, social worker or care coordinator.
NICU Parent Support Program
The NICU Parent Support Program provides support to families with children that have special needs.
We work with Parent to Parent of Pennsylvania, which connects families who currently have a baby in the NICU with other families who previously have had a baby in the NICU.
When you have a baby in the NICU, it is difficult and overwhelming. Having someone who has been through similar circumstances can help.
All NICU Parent Supporters have received extensive training on a variety of topics including how to be a great mentor. They stand by to support new parents through this challenging time.
If you are interested in being matched to a NICU Parent Supporter, call Parent to Parent of PA at 888-727-2706. When you call, a regional coordinator will ask you questions about your baby and family needs. Based on this information, the coordinator determines which NICU Parent Supporter would be most helpful to you. You should expect a call within 48 hours. It is that simple. Together, you and the NICU Parent Supporter will determine future contacts. Each match is unique and the number of contacts preferred by one caller may be different than that preferred by another caller. Sometimes, lifelong friendships develop.
For Referring Physicians
As part of our integrated neonatal care services, we provide support for referring physicians and their newborn patients:
- Communication - our staff keeps you informed about your patients and care team members will update you on progress, providing consultation and sharing outreach services. We also keep families informed and involved in the family centered care approach
- Consultation - neonatal attending physicians provide telephone consultation (717-531-8941) 24 hours-a-day, seven-days-a-week
- Direct connection - just one call connects you directly with the specialized neonatal services. 24-hour neonatal consultations and transports: 717-531-8941
- Easy access and parking: opportunities to stay at the Ronald McDonald home close by
- Expertise - experienced allied health professionals including nutritionists, occupational therapists, physical therapists, feeding team therapists, respiratory therapists and pharmacists offer advice and support
- Follow-up - high-risk patients are followed after discharge for up to two years
- Neonatal transport - air and ground transport to Penn State Health Children’s Hospital; highly skilled specialized transport teams return infants to “home” hospitals when additional hospitalization is required following discharge from Penn State Health Children’s Hospital
- NICU - 56-bed Level IV neonatal intensive care unit
- Perinatal Program Services - coordinated multidisciplinary prenatal and postnatal services for prospective parents of infants with prenatally identified congenital abnormalities
Regional Referral Center
With the backing of the only academic medical center in central Pennsylvania, the NICU in our Children's Hospital is at the heart of modern academic medicine and the main source of evidence-based and innovative treatments.
When babies are born with more extensive issues than the “home” hospital can accommodate, they should be transported to Penn State Health Children’s Hospital. With the support and resources of Life Lion aeromedical services and Children’s Hospital Mobile Intensive Care Unit (pediatric-specific ambulance), we ensure the safest possible transportation from other neighboring hospitals.
Complex Fetal Care Center
Our Complex Fetal Care Center helps guide parents who are expecting a baby with known fetal abnormalities and anticipating surgical or medical intervention immediately following delivery.
The Complex Fetal Care Center coordinators arrange for parents to meet with the pediatric and neonatal specialists who will be involved in their baby’s care. Ongoing consultation reports and communication with referring physicians and hospitals is facilitated to provide a seamless and effective consultation process for patients, their families and referring physicians.
Management of newborns exposed to mothers with confirmed or suspected COVID-19
Although there is limited information about newborns born to mothers with confirmed or suspected COVID-19, in utero transmission to babies is very rare, or may not occur at all. Particularly in the hospital after delivery, clinicians have refined practices to prevent secondary infection. While guidance from international associations is continuously being updated, all facets of care of neonates born to women with confirmed or suspected COVID-19 are center-specific, given local customs, building infrastructure constraints and availability of protective equipment. Healthy term newborns can stay in private rooms with their mothers, as long as the mother is asymptomatic or has mild symptoms, and breastfeeding can occur with mothers wearing masks, after careful handwashing. Learn more about guidance on the most suitable respiratory support for newborns during the COVID-19 pandemic.
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