While neonatal intensive care units are common in hospitals, level four NICUs – which provide the most complex care for the tiniest and sickest babies – are designated by region. (Children's Mercy Hospital)

 By Kevin Patrick Allen, Contact

September 13, 2017

KANSAS CITY, Mo. – It's only been five years since the American Academy of Pediatrics created the level four designation of neonatal intensive care units.

Known as NICUs, they are facilities that treat the smallest and most critically ill babies.

Neonatology has only been recognized as a profession since 1960. But Children's Mercy Hospital in Kansas City – the only level four NICU in the region – is demonstrating how much can be accomplished when a band of specialists with a passion for treating newborns is brought together.

Children's Mercy Director of Neonatology, Dr. Howard Kilbride, says premature birth was, for many years, the single biggest threat to babies.

"That, no longer, is the primary cause of death in babies that we're seeing,” he states. It's close, but congenital anomalies or birth differences make up probably the leading cause of neonatal deaths now for us. "

Research shows a 2.2-pound baby born in 1960 had a mortality risk of 95 percent. Today the probability of survival for that same 1 kilogram newborn is 95 percent.

Kilbride says his hospital’s NICU has 80 beds and 300 bedside nurses who are specialized in caring for infants.

In his five-plus decades of work as a neonatologist, Kilbride acknowledges he's experienced lots of emotional highs and lows with his patients and their families.

"I am just always in awe at the resilience of the families that we deal with and the ability to be able to cope," he states.

The creation of a regionalized approach to the most specialized NICUs occurred in the 1970s.

Kilbride says the nearly 50-year-old strategy has worked extremely well because it puts a vast array of resources under one roof to deal with problems that, while rare, have to be taken very seriously.

Kilbride notes that the psychosocial focus of level four NICUs is also vital. A team of social workers and counselors is always available to help families cope while their newborn is in the hospital's care.

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