Image of nurse and parent working with baby in NICU small baby unit

The small baby unit within the Comer Children’s Hospital Neonatal Intensive Care Unit (NICU) provides advanced, specialized care for the most premature babies.

Our NICU team has always offered the highest level of care for all premature babies and infants with critical illnesses. But staff realized that the smallest babies required even more specialized care.

A growing body of research has shown that babies born at 30 weeks or less or weighing less than 1250 grams (2.76 pounds) have different developmental and medical needs than other babies, even premature ones just a few weeks older.

The 16-bed Small Baby Unit opened in May 2023 and receives patients as early as 22 weeks of gestation.

Learn more about Small Baby Unit director, Dr. Kelly

Zeroing In on the 'Golden Hour'

Care in our small baby unit focuses on acting quickly to deliver medical interventions during the critical first hour after birth. Research shows that what happens during this “golden hour” has lasting repercussions for outcomes both short and long-term.

For the new unit, staff made changes including:

  • Streamlining delivery room resuscitation teams for faster response.
  • Developing procedures to act quickly to manage the baby’s temperature, initiate respiratory care and administer surfactant replacement -- noninvasively, if possible -- in in the first moments after birth.

Once the baby arrives in the NICU, staff offer streamlined procedures including:

  • Faster delivery of medications and fluids.
  • Placing babies in developmentally appropriate positions.
  • How quickly the top could be closed on the newborn’s isolette.

A Special Environment for the Smallest Babies

Updates for the small baby unit also optimize the environment for these unique patients, including creating a space that remains dark and quiet.

At this early age, minimizing stimulation is key and care is heavily focused on neurodevelopment.

Our small baby units have:

  • Dim lights.
  • Tinted windows.
  • Sound meters on the walls to notify the care team if volume gets too loud.

Care is timed around babies’ sleep schedules as much as possible to avoid waking them unnecessarily. Other areas of care closely followed include:

  • Appropriate developmental positioning.
  • Respiratory support/needs.
  • Nutrition and growth.
  • Promotion of parent-baby bonding.

A specialized multidisciplinary team will round daily on your baby. Babies typically “graduate” out of the small baby unit at around 32 weeks and are moved to another area of the NICU or the hospital’s transitional care unit.

A Commitment to Improvement

While it’s too early to report results for the small baby unit, individual cases have shown promising results. The Small Baby Unit team is also currently conducting research focused on interventions to improve key outcomes of our smallest patients. Some of these outcomes include decreasing bronchopulmonary dysplasia and intraventricular hemorrhage, decreasing length of stay, improving growth, and optimizing long-term developmental outcomes. In addition, our team is investigating how we can better support families and increase their involvement during their baby’s NICU admission.