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NIDCAP: Specialized Care for Babies & Families in NICUs

Dr. James Perciaccante & his daughter practicing kangaroo care
Above: Dr. James Perciaccante & his daughter (now 17) practice kangaroo care.

*This blog post was written in collaboration with Jim Helm, with contributions from Dr. James Perciaccante.

Parents and caregivers recognize the importance and the positive impact that developmental care can have on the health and development of premature babies.

The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) is an approach to providing developmentally supportive care to infants and families in Neonatal Intensive Care Units (NICUs).


NIDCAP was developed at Harvard Medical School more than twenty-five years ago. The program was (and continues to be) based on careful observation and sensitive care with close parent involvement.

Dr. James Perciaccante, a  board-certified neonatologist and Medical Director of the WakeMed North Special Care Nursery points out the importance of NIDCAP and how it sets WakeMed apart:

NIDCAP brings the home nursery atmosphere into the intensive care setting.

We are still very much an intensive care unit, but we are an intensive care unit that focuses on the best way to help a baby grow and heal is to reduce stress on the baby and keep the environment as close to nature intended as possible.

This means keeping the premature babies swaddled so they feel the squeeze of their mother’s womb. It means keeping the lights low when bright lights are not needed and keeping unnecessary noise to a minimum. Most importantly it means putting the family back in the center. NICU stays disrupt the normal newborn process of parents holding their baby for the first time. NIDCAP emphasizes the critical importance of that parent-baby relationship.

Why NIDCAP matters to parents and caregivers

NIDCAP is a systematic approach to providing highly specialized, developmental care that is sensitive to the cues of a premature baby while providing all of the medical care that the baby needs.

From the gentle way that premature babies are bathed to the custom quilts that adorn some of the incubators – research shows that this type of care and support makes a true difference in how comfortable premature  babies are as well as how they will do further down the road.

NIDCAP practices lead to shorter hospital stays, better long term outcomes, and changes in brain structure and function that can be seen on MRI and EEG.

Premature babies are still growing their brains and the environment in which that happens matters. The brain will grow a 100 billion neurons and each neuron will make thousands of connections with other neurons in our brain. Most of that usually occurs in utero.

When a baby is born prematurely it is important that we do everything we can not to disrupt that process through unnecessary stress and stimulation.

NIDCAP Eligibility, Certification, & Requirements

for Individuals

Individuals can be certified as reliable in the NIDCAP approach. Training to be a potential Certified NIDCAP Professional is quite comprehensive with a minimum of 120-150 hours of work, and it typically takes between 12 – 18 months to complete all of the training.

for Nurseries

Nurseries can be certified as a “NIDCAP Certified Nursery”. The NIDCAP Federation International (NFI) is the organization that maintains the training and standards. It is also the organization that certifies nurseries.

For a nursery to be awarded NIDCAP certification, it needs to have a Certified NIDCAP Professional on staff. The nursery must also be part of an accredited hospital with a strong developmental program integrated throughout all aspects of care. You can read more about the application and baseline requirements here.

Did You Know?

There are 22 NIDCAP training centers worldwide!

  • 9 in the United States
  • 12 in Europe
  • 1 in South America
  • and 4 in development

There are 7 NIDCAP Certified Nurseries (and several in process).

How WakeMed is Different

Developmentally supportive care is when care is provided in a way that supports the efforts of babies to manage the challenge of care; that supports the normal growth and development of each baby as best we can when babies are born early or needing intensive care for other reasons.

Babies’ behaviors “tell” us how each experience is for them and how they are managing. If we listen, we can make each moment easier, and we can support the developing competencies of the baby. When one doesn’t listen, babies struggle much more. The NIDCAP approach is the “Voice of the Newborn”. Research shows positive short-term and long-term outcomes for babies cared for from this approach.

happy baby and happy father

High Level of Family-Centered Care

WakeMed is  1 of only 9 NIDCAP Training Centers in the United States (since 1989), and 1 of only 3 NIDCAP Certified Nurseries in the United States.

Currently, there are only seven NIDCAP Certified Nurseries in the world. We were the 4th to be certified.

This signifies that we have a high level of developmentally supportive, family-centered care from admission through discharge.

No other North Carolina nurseries have this approach integrated into their care. While some hospital nurseries may provide some level of developmentally supportive and family-centered care, none offer a program as comprehensive as ours.

NIDCAP: Not Like Other Nurseries

A “NIDCAP Certified Nursery” is a nursery that has been evaluated by the NFI and designated as having a high level of NIDCAP-based developmentally supportive, family-centered care integrated throughout a family’s experience from the time of admission through the time the baby is discharged.

You can take a look at the NIDCAP Nursery Assessment Manual to see all the aspects of care that are considered within 4 main categories that characterize a nursery: Environment, Care of Infant, Care of Family, and Care of Staff.  As a result, there is a different culture, and a different expectation from staff – and it translates to a different experience for babies and families.

[NIDCAP] matters as a parent. When your baby is born and things do not go as you planned because the baby is sick or premature, it’s a very helpless feeling. You feel that your place as a parent is with that baby protecting them, but their condition makes that seem hard or impossible for you to do, so you rely on others to do that for you.

NIDCAP’s relationship-based, family-centered approach helps put the parents back in control by making them an integral part of their baby’s care by encouraging their presence in the NICU anytime and encouraging skin-to-skin kangaroo care.

About Jim Helm, PhD

Jim Helm is Director of the Carolina NIDCAP Training Center at WakeMed. He is also the Vice President of Administration on the NFI’s Board of Directors. Having first arrived at WakeMed as a consultant in 1984, James was hired full time in Neonatology in 1988. He is a certified NIDCAP trainer with certification on the Brazelton Neonatal Behavioral Assessment Scale (NBAS).

Jim’s current clinical and research interests include: infant-family development, infant behavior and communication, and ways to best provide individualized, developmentally supportive, family-centered care in NICUs.

About James Perciaccante, MD

Dr. Perciaccante is a board-certified neonatologist and Medical Director of the WakeMed North Special Care Nursery. He is also a member of the Perinatal Section of the American Academy of Pediatrics, the North Carolina Neonatologist Association and the North Carolina Medical Society.