5 Reasons Children's Hospitals Are Larger Than Adult Hospitals

Nash Keen is nothing short of a miracle. Born at 21 weeks, he is the world’s most premature baby, according to the Guiness Book of World Records.

Nash weighed 10 ounces — less than a can of soda — when he was born in July 2024.

With the help of experts at the University of Iowa Healthcare Stead Family Children’s Hospital, Nash defied the odds. He went home from the hospital in January 2025 after a 189-day stay.

Children’s hospitals across the country are well equipped to care for micro-preemies like Nash. They also stand ready to care for patients on the opposite end of the spectrum.

Take Braelyn Hines. The 21-year-old has been a patient at St. Joseph’s Children’s Hospital since he contracted bacterial meningitis at 5 months old. The illness caused him to have strokes, seizures, and hydrocephalus. As a young adult, Braelyn continues to receive care at a specialty clinic inside the hospital.

Caring for all sizes

Caring for tiny babies as well as adult-sized kids means children’s hospitals must be equipped — and staff must be trained — to respond to a wide range of conditions, body sizes, and developmental needs.

That translates into the need for more physical space for patients and families. Much more space.

According to a 2024 report, adult hospitals average 354,000 square feet, while the average children’s hospital comes in at 861,000 square feet.

The need for more space isn’t arbitrary. It’s necessary for children’s hospitals to provide patients and families the care and support they need.

Here are five reasons children’s hospitals must be bigger than adult hospitals.

1. Care delivery

Pediatric demographics vary widely. A children’s hospital must be prepared to treat infants, toddlers, adolescents, and young adults. This creates a need for distinct units based on age as well as the severity or type of illness.

Pediatric-specific needs also require more space for radiology, rehabilitation, and treatment areas. For example, young children can’t undergo an MRI without sedation, necessitating space for anesthesia support in the imaging department. For treatments when an adult may need only a local anesthetic, a child may need general anesthesia, requiring a much more complex care delivery process.

2. Patient room size

Patient rooms at children’s hospitals must be larger to house medical equipment and give family members space to sit, sleep, perform personal hygiene, and store personal belongings.

According to Guidelines for Design and Construction of Hospitals by the Facility Guidelines Institute, pediatric hospitals rooms should exceed the 120 square feet of space recommended for standard medical-surgical patient rooms in adult hospitals.

3. Family support

During a hospitalization or medical procedure, children need parents or guardians present to provide practical and emotional support.

Kids are legally dependent, less self-sufficient, and often cannot communicate or advocate for themselves. That’s why children’s hospitals must ensure adequate space to support families and legal guardians.

Pediatric hospitals need more room for visitors in emergency department bays, treatment areas, and waiting areas. Hallways are larger to accommodate a higher volume of visitors as well as wheelchairs and strollers.

Many hospitals dedicate space for extended stay family lodging, such as a Ronald McDonald House or similar facilities. They also incorporate lounges and respite areas, kitchens, libraries and resource centers, laundry facilities, sibling play areas, and more.

4. Space for specialists

Because of the varying needs of the patient population, children’s hospitals have a broad range of staff members who require space for activity and work areas, storage and locker rooms, offices, and parking.

For example, child life specialists use art, toys, and games to help kids of all ages cope with medical experiences. Music therapists use instruments to sooth and engage children and help them feel safe in an unfamiliar environment. Pharmacists need room to manage and store additional weight-based doses for children. And security guards monitor access to patient care areas. Some hospitals incorporate classrooms where patients needing extended stays can continue learning and engaging with peers.

5. Patient experience

Hospitals are especially stressful for children. Unfamiliar sights, sounds, smells, and sensations cause anxiety and uncertainty.

Many hospitals attempt to ward off young patients’ feelings of fear with positive distractions, comfortable furniture, soothing colors, and soft lighting.

Hospitals are creating immersive environments to engage children in new ways during inpatient and outpatient visits. From interactive coloring walls to 3D projections to virtual reality-equipped treatment rooms, hospitals are easing the care process for children and their families.

Beyond the building: learn why it costs more to care for kids.