If your baby is born early or needs neonatal care

How neonatal care works in Spain's public hospitals if your baby is born early or sick: the three levels of unit, what to expect about being with your baby, and the follow-up and early support after you go home.

Key rules

Levels: Neonatal care has three levels, from basic care with you (I) to intensive care (III), matched to your baby's needs.

Transfer: If your hospital lacks the right level, your baby is moved to a reference hospital by regional neonatal transport.

Parent access: Most public hospitals allow parents in around the clock, but each hospital sets its own rules.

Follow-up: Very premature babies are usually followed until about 6 to 7 years of age.

Early support: Atención temprana is generally free and needs a referral from your paediatrician or the hospital.

Your baby is placed in the unit that matches their needs

Spanish neonatal units are grouped into three levels. The level depends on how early or how ill your baby is, not on your choice. The decision tool below helps you see which level fits.

Level I is basic care for healthy newborns, who stay with you in your room.
Level II is intermediate care for moderately premature or sick babies. It has two sublevels, IIA and IIB, depending on the breathing support available.
Level III is intensive care (NICU) for very premature or critically ill babies. It has three sublevels, IIIA, IIIB and IIIC, depending on the surgery and specialist services offered.

If your hospital does not have the right level

Your baby is moved to a reference hospital. The regional neonatal transport service does this, often with a specialised ambulance team.

If a pregnancy is high risk, doctors try to move you before the birth, so the baby is born in a hospital with the right level. Ask your midwife or obstetrician early whether your hospital can care for a baby born early.

Which hospital is the reference centre depends on your region. Ask your hospital which one covers your area. Transport arrangements also differ by region.

Being with your baby

Most public hospitals now let parents in at any hour, and they encourage skin-to-skin contact (kangaroo care). Siblings and other visitors are more limited. Each hospital sets its own rules, so ask the unit staff on your first day about visiting hours, siblings and where you can rest.

After you leave the hospital

Very premature babies, and babies with risk factors, are usually followed in the hospital's neonatal follow-up programme. It includes regular developmental checks, usually until about 6 to 7 years of age. The hospital normally books these for you. Check that you leave with the first appointment.

Atención temprana is early intervention therapy for children from 0 to 6 who have a developmental delay or are at risk of one. It is run by each region and is generally free. Your paediatrician or the hospital refers you. If nobody mentions it, ask for the referral. The questions below give more detail.

Choosing between options

Which level of neonatal care does your baby need, and where?

Level I: basic care with you: Your newborn is healthy. Your baby stays with you in the room and gets basic care.
Level II: intermediate care: Your baby is moderately preterm or sick. Sublevels IIA and IIB depend on the respiratory support the unit can give.
Level III: intensive care (NICU): Your baby is very preterm or critically ill. Sublevels IIIA, IIIB and IIIC depend on the surgical and specialised services available.
Transfer to a reference hospital: Your local hospital does not have the level your baby needs.

Your baby's needs set the level. If your hospital lacks that level, your baby goes to a hospital that has it.

Frequently asked questions

Can I stay with my baby in the neonatal unit around the clock?

Yes, most public hospitals now let parents stay 24 hours a day, but each hospital sets its own rules. Skin-to-skin contact (kangaroo care) is encouraged. Siblings and other visitors are usually more limited, so ask the unit about their times.

How long are premature babies followed after leaving hospital?

Very preterm babies and those with risk factors are usually followed in a hospital neonatal follow-up programme up to about 6 to 7 years of age. You get regular developmental checks during that time. The unit will tell you when the first appointment is.

What is atención temprana and how do I get it?

Atención temprana is early intervention therapy for children from 0 to 6 with developmental delay or risk of it. It is run by each region and is generally free. Ask your pediatrician or the hospital for a referral.

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