In recent years, neonatal care has undergone major transformations, moving toward a philosophy of Infant and Family Centered Developmental Care (IFCDC). This shift includes promoting parental involvement and adapting neonatal unit architecture accordingly. In France, the GREEN of the French Neonatal Society has issued recommendations to support this evolution, but little data exist on their implementation.

A nationwide survey was conducted from February to May 2025 across all 60 level III maternity hospitals in mainland France. A 25-question online form was distributed to neonatal intensive care units (NICUs). The objective was to assess NICU architecture and the implementation of the IFCDC guidelines in France.

A total of 35 centers responded (58% response rate), including 80% of university hospitals. On average, individual rooms represented 69% of NICUs, 65% of neonatal intermediate care units, and 71% of standard neonatal care units, while family individual rooms accounted for only 8%, 7%, and 21%, respectively. When available, their mean surface area was 17.4 m² ± 4.80 m². Unrestricted sibling visits were allowed in 71.4% of centers, and unrestricted extended family or friend visits in 51.4%. Family-centered rounds (FCR) were implemented in 34.3% of units. Nearly all centers (97.1%) had windows with blinds or shutters, and 48.6% reported that all rooms had external windows. Ambient light cycling was practiced in 54.3% of units. Most centers provided parental amenities such as communal living spaces, counseling rooms, and lactation rooms with milk storage facilities.

This study provides a nationwide overview of the architectural design of the NICUs and the implementation of the IFCDC guidelines in France. It highlights thoroughgoing improvements but also underlines existing structural and organizational limitations.