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Tiny patients in the Neonatal Intensive Care Unit (NICU) may be dealing with a wide range of medical challenges, but NICU team members at the University of Maryland Children's Hospital (UMCH) are united in improving the neurodevelopmental outcomes of these fragile infants. This overarching goal was the impetus for a completely new NICU that was six years in the making and tripled the square footage devoted to the nationally regarded program. The new NICU will officially open later this summer.

Unveiled in late June, the 37,000-square-foot space provides 52 private, sound- and light-controlled rooms that seek to imitate a baby's experience in the womb. Combined with other targeted efforts to enhance brain development, the bigger, better NICU is building on its current Level IV designation, endorsing its reputation of providing the highest possible level of neonatal care.

Currently 43 babies occupy the NICU at UMCH at any given time, though that number will increase with the additional rooms. Some are low- or extremely low-birth-weight preemies, while others have surgical, genetic or cardiovascular complications. Their stays range from days to months, but it's understood that any NICU experience is traumatic for both babies and parents. Many of the NICU upgrades aim to mitigate that trauma, explains Cynthia Bearer, M.D., Ph.D., head of pediatric neonatology at University of Maryland Children's Hospital and Mary Gray Cobey Professor of Neonatology at University of Maryland School of Medicine.

"Improving the neurodevelopmental outcomes of these babies was, I think, the impetus for the NICU enhancements," Dr. Bearer says. "We also wanted to improve the ways we can assist families in taking care of these babies, both in the short term in the hospital and also having some impact on when they get home."

Books on Tape, Baby-Style

The advanced light- and sound-control systems in the NICU mimic the muted conditions in a mother's womb during pregnancy, helping avoid neural overstimulation in the neonates. Additionally, background lighting in the unit becomes brighter or darker according to natural day-night cycles, helping infants' circadian rhythms adjust to life outside their mothers.

But one of the most notable ways NICU staff members hope to create a unique sound environment for babies is by recording parents as they read children's stories to them — tapes that can be replayed even when parents aren't physically present in the NICU, Dr. Bearer says.

"If babies were in utero, they would be hearing their mothers talking 16 or 18 hours a day, and we want to simulate that in our NICU," she says. "As babies get older, we encourage parents to read to them more and more, and this is one way we can help them get in the habit when they get home."

Private rooms for each NICU patient — which allow parents to stay overnight — embody a model of care that incorporates parents more and more in NICU tasks, which, with many interventions and constant need for monitoring, can seem impersonal, Dr. Bearer says.

"We really hope this setting of having parents in the room encourages more parents to stay," she says.

New NICU Spawns Illuminating Research

Another positive outgrowth of the upgraded NICU is how it will enhance research at UMCH focusing on the impact of these changes on babies' neurodevelopment.

"The new NICU allows us to do the research," Dr. Bearer explains, "but it's not part of the research."

Potential neonatology research projects include studying whether more new moms breastfeed and if they do so longer because of the privacy afforded by the 52 individual NICU patient rooms. Another study could focus on the length of time parents engage in Kangaroo Care, skin-to-skin contact that promotes neurodevelopment, in the upgraded space.

"Our interest in normal neurodevelopment and what we need to do to support that — including regulating noise and lighting — all will improve the outcomes of our babies," Dr. Bearer says. "And that will show up in the databases we belong to. We have a way of collecting data that will show us what the impact of these changes will be. We'll be able to see it."

To reach the division of neonatology at the University of Maryland Children's Hospital, please call 410-328-6003. For an urgent transfer of a baby or simply to talk to a neonatologist, please contact the Maryland Regional Neonate Transport at 1-888-540-6767.