The physical environment of the NICU has an important impact on the growth and development of the newborn infants who live there, as well as their families and caregivers. Optimising the infant’s environment requires first an understanding of its sensory and caregiving needs, then designing an environment that will best support those needs. It is now clear that newborns benefit from extended intimate human contact, especially with their mothers, and that this can be facilitated by providing sufficient space, privacy, and empowerment for parents. Benefits and hazards of the trend towards use of single-family rooms to achieve this goal will be discussed, as well as a brief reflection on the impact of this design strategy on families and caregivers.