This is the second supplement to the Journal of Perinatology entitled “Recommended Standards for NICU design.” The first issue (December 1999) presented the current evidence recommended by the Fourth Consensus Committee with a detailed interpretation of each standard. The 2002 supplement reflects the opinions of the Fifth Consensus Committee, which met in January 2002 under the auspices of the Physical and Developmental Environment of the High-Risk Infant Project.

During the last 2 years, there has been an abundance of newly designed and redesigned Neonatal Intensive Care Units (NICUs). As technology proliferates and the neonates are of lower gestational age and weights, the need for more family interaction increases. The physical environment changes as we learn more about physiology and make adaptations to our patients. There are constraints that must be considered. Is there a limit to what we can do as health care providers to the micropreemie? Can we afford to spend so much of a shrinking health dollar on these tiny babies? Providing a better environment can only lessen our constraints and improve long-term outcome.

In addition, we also present a commentary by Robert White, the Chairman of the Consensus Committee, dealing with the evolving concept of Individual Rooms in the NICU.