Distinct support space shall be provided for all clinical
services that are routinely performed in the NICU.
Space for preparation and storage of formula and additives to
human milk and formula shall be provided within the unit or other
location that is away from the bedside7. When a separate room for
infant feeding preparation is not merited due to infrequency of
need, commercial preparation off premises or other reasons, a
separate area in the food services area or in the patient unit shall
be designated for infant feeding preparation. Hospital food
preparation design guidelines shall be followed.
When the functional program requires a separate room, the room
shall include the following areas that can be separated in
individual rooms or combined:
(a) Ante area
(c) Storage space for supplies, formula, and both
refrigerated and frozen breast milk.
(d) Clean-up area
To minimize contamination, the ventilation system should have a
minimum filtration of 90% based on the American Society of Heating,
Ventilation and Air Conditioning Engineers standards or have a HEPA
forced air filtration system.
Provisions shall be included for human milk storage. Human milk
may be stored in a designated space in the infant feeding
preparation room, and in designated spaces on the patient unit.
Interpretation: Ancillary services such as (but
not necessarily limited to) respiratory therapy, laboratory,
pharmacy, radiology, developmental therapy, and specialized feeding
preparation are common in the NICU. Distance, size, and access are
important considerations when designing space for each of these
functions. Satellite facilities may be required to provide these
services in a timely manner.
Unless performed elsewhere in the hospital, a specialized
feedings preparation area or room should be provided in the NICU,
away from the bedside, to permit mixing of additives to breast milk
or formula. The cleanliness of the floor surface, walls and ceilings
should be easily maintained. Floor drains are not recommended unless
required by local code. Adequate sinks, electrical outlets and
storage should be provided based on the individual hospital facility
needs. The use of a laminar flow hood is a decision that each
hospital should make. Pharmacies are not required to use laminar
flow hoods to prepare oral medications. Powdered formulas are not
sterile, and preparing them under a laminar flow hood does not
improve the sterility of the product. All water supplied for feeding
preparation should meet Federal Standards for drinking water and be
commercially sterile. Commercially sterile water is preferred
because it has eliminated pathogenic and other organisms, that if
present, could grow in the product and produce spoilage under normal
conditions of handling and