MUMBAI, Aug. 11 -- The BMC's plan to double the capacity of the Neonatal Intensive Care Units (NICU) at its four major civic hospitals has stalled, not for want of space or beds but due to a critical shortage of nurses. A decision to double the NICU capacity was taken at a special meeting chaired by Harish Bandirge, chairperson of the civic health committee, on June 11. The meeting was attended by the deans of all four major civic hospitals. . "Only specialised, trained nursing staff can handle the care of newborn babies in the NICU. Regular nurses cannot be assigned these duties," Bandirge told HT. "So, now we have sent a proposal to the BMC commissioner to hire more nursing staff for this purpose. NICU capacity can be expanded only after the dedicated nursing staff is brought in," he said. Mumbai has only 154 NICU beds, including 46 in Sion Hospital, 25 in Nair Hospital, 20 in Cooper Hospital and 63 in KEM Hospital. These are manned by a team of 87 nurses. Dr Shailesh Mohite, director of medical education and of major BMC hospitals, said demand for NICU beds in Mumbai has far exceeded capacity. "There are times when we adjust more babies within the NICU by creating additional temporary facilities like cradles to manage the additional load," he said. The shortfall in NICUs is not just due to the rise in population but various other factors. Mumbai's civic hospitals receive cases of complications in neonatal babies, premature deliveries and other complex cases not just from the BMC's own peripheral hospitals but also from hospitals in the entire Mumbai Metropolitan Region (MMR). "This is because Mumbai's peripheral hospitals lack the necessary infrastructure and care structure needed to handle complicated cases in newborn babies," Dr Mohite told HT. Besides, the NICUs in major hospitals also receive cases from private nursing homes. "NICU facilities in private hospitals are expensive. So, when bills exceed the parents' paying capacity, often such children are shifted from private hospitals to BMC NICUs," he said. In addition, newborns tend to stay longer in the NICU, until the baby is strong enough to be shifted out, he added, Dr Rahul Verma, neonatologist and director of paediatrics at the Sir HN Reliance Foundation Hospital, said the number of newborns requiring intensive care has climbed steeply. "Where roughly one in 10 deliveries once required neonatal admission, it is closer to one in five today," said Verma, who trained and worked in municipal hospitals before moving to the private sector. "Some of this is accounted for by a genuine rise in high-risk pregnancies, particularly after infertility treatment, alongside rising caesarean rates." He added, "Also, we now save babies we could not save before. Twenty years ago we were resuscitating at 32 weeks. Today, we resuscitate at 26 and 27 weeks, at birth weights well under a kilogram. And when a foetus stops growing in utero, the calculation has changed: it is now often safer to deliver and let the baby grow under supervision in the NICU than to leave it where it is. Every one of those decisions creates an intensive care admission that would not have existed a decade ago." According to Verma, the pressure is heaviest in the public healthcare system, where mothers arrive with anaemia and undernutrition, untreated infections and little antenatal contact. These conditions produce preterm and growth-restricted babies. "The gap is not just beds. It is competent beds, trained nurses, working ventilators, someone who can put in a line at three in the morning. A cot without that is just a cot," he said....