[2] The first American newborn intensive care unit, designed by Louis Gluck, was opened in October 1960 at Yale New Haven Hospital.

[6] Some institutions may accept newly graduated RNs having passed the NCLEX exam; others may require additional experience working in adult-health or medical/surgical nursing.

[6] The National Association of Neonatal Nurses recommends two years' experience working in a NICU before taking graduate classes.

Their competencies include the administration of high-risk medications, management of high-acuity patients requiring ventilator support, surgical care, resuscitation, advanced interventions such as extracorporeal membrane oxygenation or hypothermia therapy for neonatal encephalopathy procedures, as well as chronic-care management or lower acuity cares associated with premature infants such as feeding intolerance, phototherapy, or administering antibiotics.

[8][9][10] It was not until 1922, however, that hospitals started grouping the newborn infants into one area, now called the neonatal intensive care unit (NICU).

[11] Before the Industrial Revolution, premature and ill infants were born and cared for at home and either lived or died without medical intervention.

[13] Stephane Tarnier is generally considered to be the father of the incubator (or isolette as it is now known), having developed it in 1880 to attempt to keep premature infants in a Paris maternity ward warm.

[12] After Tarnier retired, Pierre Budin, followed in his footsteps, noting the limitations of infants in incubators and the importance of breastmilk and the mother's attachment to the child.

[14] Budin is known as the father of modern perinatology, and his seminal work The Nursling (Le Nourisson in French) became the first major publication to deal with the care of the neonate.

[15] The incubator was improved in 1890 in Marseilles by Alexandre Lion, who founded in 1891 the Œuvre Maternelle des Couveuses d'Enfants in Nice and in January 1896 in Paris.

[16][17][18] Another factor that contributed to the development of modern neonatology was Martin Couney and his permanent installment of premature babies in incubators at Coney Island.

A more controversial figure, he studied under Budin and brought attention to premature babies and their plight through his display of infants as sideshow attractions at Coney Island and the World's Fair in New York and Chicago in 1933 and 1939, respectively.

At Southmead Hospital, Bristol, initial opposition from obstetricians lessened after quadruplets born there in 1948 were successfully cared for in the new unit.

Strict nursing routines involved staff wearing gowns and masks, constant hand-washing and minimal handling of babies.

The tubes were originally made of rubber, but these had the potential to cause irritation to sensitive newborn tracheas: Barrie switched to plastic.

In Britain, some early units ran community programmes, sending experienced nurses to help care for premature babies at home.

Cuddling and skin-to-skin contact, also known as "kangaroo care", are seen as beneficial for all but the frailest (very tiny babies are exhausted by the stimulus of being handled; or larger critically ill infants).

Rhesus incompatibility (a difference in blood groups) between mother and baby is largely preventable, and was the most common cause for exchange transfusion in the past.

However, breathing difficulties, intraventricular hemorrhage, necrotizing enterocolitis and infections still claim many infant lives and are the focus of many new and current research projects.

From the early years, it was reported that a higher proportion than normal grew up with disabilities, including cerebral palsy and learning difficulties.

Besides prematurity and extreme low birth-weight, common diseases cared for in a NICU include perinatal asphyxia, major birth defects, sepsis, neonatal jaundice, and infant respiratory distress syndrome due to immaturity of the lungs.

Stressors for the infants can include continual light, a high level of noise, separation from their mothers, reduced physical contact, painful procedures, and interference with the opportunity to breastfeed.

A special aspect of NICU stress for both parents and staff is that infants may survive, but with damage to the brain, lungs, or eyes.

This tour includes information on the different types of equipment used in the NICU, such as incubators, monitors, and ventilators, and how they help to support the health and well-being of the babies.

It usually has a miniature ventilator, cardio-respiratory monitor, IV pump, pulse oximeter, and oxygen supply built into its frame.

Other simple things that can help ease pain include: allowing the infant to suck on a gloved finger, gently binding the limbs in a flexed position, and creating a quiet and comfortable environment.

Also known as 'Local Neonatal Units', these can look after babies who need more advanced support such as parenteral nutrition and continuous positive airway pressure (CPAP).

Babies who will need longer-term or more elaborate intensive care, for example extremely preterm infants, are usually transferred to a Level 3 unit.

Some babies being cared for in Level 3 units will require less intensive treatment and will be looked after in HDU or SCBU nurseries on the same site.

Neonates weighing 1200-1800 grams or having gestational maturity of 30–34 weeks are categorized under level II care and are looked after by trained nurses and pediatricians.