In the NICU, Environment Matters

In the NICU, Environment Matters

Each year, approximately 3,600 precious and fragile patients pass through the doors of the Newborn Intensive Care Unit (NICU) at Brigham and Women’s Hospital (BWH). As New England’s largest facility of its type, the NICU is staffed with nationally and internationally renowned clinicians in neonatal health who provide each patient and family with unparalleled, even heroic, care every hour of every day.

Newborn intensive care units like BWH’s did not exist before the 1960s. It was the death of President Kennedy’s son, Patrick, at 34 weeks that sparked the birth of modern neonatology.

Steven Ringer, MD, PhD, senior attending neonatologist in the Department of Pediatric Newborn Medicine and program director of the Better Birth Project in the Ariadne Labs, recalls the excitement around the survival of a two-pound baby in the early 1980s. At that time, the survival rate for a baby that size was 10 percent. With advanced technology, new drugs, and better knowledge, the survival rate has increased to greater than 90 percent today.

Since BWH’s NICU opened in 1992, “we’ve become quite good at saving their lives,” says Robert Insoft, MD, the medical director of the NICU. “Now we’re working on improving the quality of that life. We’ve come to recognize that the environment matters and is important for optimal brain development.”

The next step in the evolution of neonatology at BWH is to make the current open ward more family centered, with private rooms where parents can comfortably stay overnight. Research shows that a private room NICU has the potential to improve a baby’s long-term health outcomes and brain development, reduce infections, and increase family involvement and privacy.

The new NICU is being designed to maximize the use of natural light and include individual room controls for light, as well as better temperature and humidity control. Fragile preemies need diminished stimulation and individualized care to promote brain development and mimic the womb environment.

The new space will be structured more like a village of neighborhoods. Each neighborhood will include a nurses’ station, private and semi-private patient rooms, and a family area. This set up will increase comfort while preserving family privacy, and provide families with the opportunity to interact, share information, and form a network of support and understanding. 

What happens in the NICU isn’t just about helping a baby be well enough to go home. “We’re investing now to improve the entire lifespan of the babies we care for,” says Ringer. “Babies who are born far too early can go on to have a successful life, and we can help prevent disabilities down the road by offering a more ideal environment.”