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Preterm baby—parenting

We encourage you to participate in caring for your baby. During care watch how your baby moves and responds so that you can learn when they appear secure and calm and the times when your baby appears to need rest.

Preterm babies need specific care and their condition will vary on how preterm they are. This brochure is broken into five sections, each focusing on a different type of preterm baby.

Less than 26 weeks gestation

Touching and holding

  • Hold your baby’s hand, or other parts of their body, with gentle pressure. At this age your baby will not like being rubbed, poked or lightly stroked.
  • Cradle your baby by placing your hands around your baby’s head and bottom or feet.
  • Place your finger in your baby’s hand to invite them to hold onto you.
  • Kangaroo care—holding your baby next to your chest skin to skin—may be possible. Your baby’s nurse will advise when this becomes possible.

Feeding

  • Observe your baby sucking on tubes in the mouth.
  • You should begin expressing breast milk for your baby as soon as possible.

Sleeping

  • When your baby is asleep, try not to wake them when touching.
  • Support periods of rest; this promotes growth.

Positioning

  • Your baby should generally have their hands close to their face and legs curled up as if still in your uterus.
  • Have boundaries around your baby help to maintain a snuggled position and facilitate emerging development of extension and flexion of arms and legs.

Looking, listening and smelling

  • Open the isolette cover slowly so that light changes are gradual.
  • Shield your baby’s eyes from bright or direct light.
  • Avoid loud sounds around your baby.
  • Provide one input at a time, such as only touching or talking softly—but not both at the same time.
  • Protect your baby from strong odours such as perfume, aftershave or scented lotions.

Nappy changing

  • Provide boundaries around your baby during nappy changes to keep this care from being stressful.
  • Move slowly and gently while changing nappies.

Bathing

  • May be performed by nurses and parents together.
  • Will only receive "spot" baths, not "tub" baths, and should only be bathed as needed.
  • Provide containment to your baby’s arms and legs during a bath to keep your baby calm.

26 to 28 weeks gestation

Touching and holding

  • Prepare your baby for touch by speaking in a soft voice.
  • When touching, do so slowly, gently and deliberately, without making sudden movements.
  • When touching your baby do not stroke or rub but rather provide continuous gentle pressure.
  • Cradle your baby by placing your hands around your baby’s head and bottom or feet.
  • Place your finger in your baby’s hand to invite them to hold onto you.
  • When moving your hands away from your baby, do so gently and slowly without abrupt movements.
  • Kangaroo care—holding your baby next to your chest skin to skin—is recommended at this age. Your baby’s nurse will advise when this becomes possible.

Feeding

  • Your baby may suck a pacifier (if consented to) for very short periods—a few sucks at a time.
  • You should begin expressing breast milk for your baby as soon as possible.
  • Consider placing a pad scented with your breast milk in your baby’s bed during tube feedings.

Sleeping

  • When your baby is asleep, try not to wake them when touching.
  • Support periods of rest, so that your baby may conserve energy.
  • Before care giving procedures, wake your baby slowly by gently placing your hands on them.

Positioning

  • When sleeping your baby should generally have their hands close to their face and legs curled up as if still in your womb.
  • Repositioning and any caregiving should be performed with slow gentle movements and without sudden changes.
  • Have boundaries around your baby to maintain a snuggled position and facilitate emerging development of extension and flexion of legs.

Looking, listening and smelling

  • Shield your baby’s eyes from bright or direct light.
  • Avoid loud sounds around your baby’s space.
  • Use a soft and quiet voice when talking to your baby.
  • Protect your baby from strong odours such as perfume, aftershave or scented lotions.

Nappy changing

  • Provide boundaries around your baby during nappy changes to keep this from being stressful.
  • Move slowly and gently while changing nappies.

Bathing

  • May be performed by nurses and parents together.
  • Your baby should receive full body baths and/or spot cleaning of soiled areas, only as needed.
  • Provide containment to your baby’s arms and legs during a bath to keep your baby calm.

28 to 30 weeks gestation

Touching and holding

  • Begin talking to your baby quietly, then add touching, slowly, if tolerated by your baby.
  • Prepare your baby for touch by speaking in a soft and soothing voice.
  • Touch your baby using continuous gentle pressure on their legs, upper body or head and avoid stroking, rubbing or poking.
  • With help from your nurse your baby can be moved gently from the isolette to your arms.
  • When holding your baby, wrap them in a blanket and keep their legs and arms close to their body.
  • Hold your baby still, rather than rocking, as your baby cannot tolerate a rocking motion at this age.
  • When moving your hands away from your baby, do so gently and slowly without abrupt movements.
  • Kangaroo care—holding your baby next to your chest skin to skin—is recommended at this age. Your baby’s nurse will advise when this is possible.

Feeding

  • Offer a pacifier (if consented to) during tube feeds—your baby may need help holding it in their mouth.
  • Hold your baby during tube feeds.
  • You should begin expressing breast milk for your baby as soon as possible.
  • Consider placing a pad scented with your breast milk in your baby’s bed during tube feeds.

Sleeping

  • When your baby is asleep, try not to wake them when touching.
  • Support periods of rest so that your baby may conserve energy.
  • Before care giving procedures, wake your baby slowly by gently placing your hands on them.

Positioning

  • Your baby should generally have their hands close to their face and legs tucked close to their body.
  • Repositioning should be performed with slow gentle movements and without sudden changes.
  • Have boundaries around your baby to maintain a snuggled position and facilitate emerging development of extension and flexion of legs.

Looking, listening and smelling

  • Shield your baby’s eyes from bright or direct light.
  • Avoid loud sounds around your baby’s space.
  • Avoid encouraging your baby to look at toys or pictures.
  • Use a soft and quiet voice when talking to your baby.
  • Consider placing an item in your baby’s bed that has your skin smell i.e. handkerchief.
  • Protect your baby from strong odours such as perfume, aftershave or scented lotions.

Nappy changing

  • Provide boundaries around your baby during nappy changes to keep this from being stressful.
  • Move slowly and gently while changing nappies.

Bathing

  • May be performed by nurses and parents together.
  • Your baby should receive full body baths and/or spot cleaning of soiled areas, only as needed.
  • Provide containment to your baby’s arms and legs during a bath to keep your baby calm.

30 to 32 weeks gestation

Touching and holding

  • Prepare your baby for touch with a soft voice.
  • Touch your baby using continuous gentle pressure on their legs, upper body or head and avoid stroking, rubbing or poking.
  • When holding your baby, wrap them in a blanket and keep their legs and arms close to their body.
  • Hold your baby still, rather than rocking, as your baby cannot tolerate a rocking motion at this age.
  • When holding your baby while they are in a light sleep, talk to them in a soft voice.
  • When moving your hands away from your baby, do so gently and slowly without abrupt movements.
  • Kangaroo care—holding your baby next to your chest skin to skin—is recommended at this age. Your baby’s nurse will advise when this becomes possible.

Feeding

  • Offer a pacifier (if consented to) during tube feeds, as tolerated.
  • Provide an opportunity for your baby to smell milk before beginning breastfeeds.
  • Reduce care giving for your baby just prior to feeds, such as nappy changing, bathing etc, to avoid tiring your baby before feeds.
  • The environment around your baby should be calm and quiet as possible during feeds.
  • Sucking at your breast may be used to prepare your baby for later breastfeeding.

Sleeping

  • When your baby is asleep, try not to wake them when touching.
  • Support periods of rest so that your baby may conserve energy.
  • Provide boundaries for your baby’s arms, legs, head and feet while sleeping.
  • Before care giving procedures, wake your baby slowly by gently placing your hands on them.

Positioning

  • Your baby should generally have their hands close to their face and arms and legs tucked close to their body.
  • Your baby will stretch often and may need repositioning frequently.
  • Repositioning should be performed with slow gentle movements and without sudden changes.
  • Have boundaries around your baby to maintain a snuggled position and facilitate emerging development of extension and flexion of legs.

Looking, listening and smelling

  • Talking, interacting and care should be done when your baby is awake or in a light sleep.
  • Let your baby remain sleeping when possible.
  • Shield your baby’s eyes from bright or direct light.
  • Shading your baby’s eyes will make it easier for them to look at you.
  • Remain still when your baby’s eyes are open, as they are not ready to look at moving objects.
  • When your baby is awake, occasionally expose them to short periods of soft rhythmic sounds, such as singing songs softly.
  • Avoid loud sounds around your baby’s space.
  • Avoid encouraging your baby to look at toys or pictures.
  • Consider placing an item in your baby’s bed that has your skin smell i.e. handkerchief.
  • Consider opportunities for your baby to suck a pacifier which may help to calm them.
  • Protect your baby from strong odours such as perfume, aftershave or scented lotions.

Nappy changing

Provide boundaries around your baby during nappy changes to keep this from being stressful. Move slowly and gently while changing nappies.

Bathing

  • May be performed by nurses and parents together.
  • Bathing your baby should be carefully considered and performed only when it provides obvious benefits.
  • Provide containment to your baby’s arms and legs during a bath to keep your baby calm.

32 to 36 weeks gestation

Touching and holding

  • Prepare your baby for touch by speaking in a soft and soothing voice.
  • Touch your baby using continuous gentle pressure on their legs, upper body or head and avoid stroking, rubbing or poking.
  • When holding your baby, wrap them in a blanket and keep their legs and arms close to their body.
  • Hold your baby still, rather than rocking, so they can gradually become accustomed to position changes.
  • When holding your baby while they are in a light sleep, talk to them in a soft voice.
  • When moving your hands away from your baby, do so gently and slowly without abrupt movements.
  • Kangaroo care—holding your baby next to your chest skin to skin—is recommended at this age. Your baby’s nurse will advise when this is possible and arrange a time suitable for both you and your baby.

Feeding

  • Offer a pacifier (if consented to) during tube feeds as tolerated.
  • Provide an opportunity for your baby to smell milk before beginning breastfeeds.
  • Reduce care giving for your baby just prior to feeds, such as nappy changing, bathing etc, to avoid tiring your baby before feeds.
  • The environment around your baby should be calm and quiet as possible during feeds.
  • Sucking at your breast may be used to prepare your baby for later breastfeeding.
  • Pause to burp your baby. Do so gently without excessive patting on the back.

Sleeping

  • When your baby is asleep, try not to wake them when touching.
  • Support periods of rest so that your baby may conserve energy.
  • Provide boundaries for your baby’s arms, legs, head and feet while sleeping.
  • Before caregiving procedures, wake your baby slowly by gently placing your hands on them.

Positioning

  • Your baby should generally have their hands close to their face and arms and legs tucked close to their body.
  • Repositioning should be performed with slow gentle movements and without sudden changes.
  • Have boundaries around your baby to maintain a snuggled position and facilitate emerging development of extension and flexion of arms and legs.

Looking, listening and smelling

  • Interact with your baby when they are awake.
  • Let your baby remain sleeping when possible.
  • Shield your baby’s eyes from bright or direct light.
  • Shading your baby’s eyes will make it easier for them to look at you.
  • Provide opportunities for your baby to look at your face.
  • Develop a regular pattern of care eg feed, nappy change, interaction and sleep.
  • When your baby is awake, occasionally expose them to short periods of soft rhythmic sounds, such as singing songs softly.
  • Avoid loud sounds around your baby’s space.
  • Protect your baby from strong odours such as perfume, aftershave or scented lotions.

Nappy changing

  • Provide boundaries around your baby during nappy changes to keep this from being stressful.
  • Move slowly and gently while changing nappies.

Bathing

  • May be performed by nurses and parents together.
  • Amount of time away from a heat source should be minimal.
  • Bathing your baby should be carefully considered and performed only when it provides obvious benefits.
  • If your baby has a tub bath, you may assist or complete bathing independently.
  • Provide containment to your baby’s arms and legs during a bath to keep your baby calm.

36 to 40 weeks gestation

Touching and holding

  • Prepare your baby for touch with a soft voice.
  • Hold your baby in such a way that supports their arms and legs tucked close to their body and hands close to their face.
  • You can touch your baby in a variety of ways, including gentle steady pressure, rhythmicstroking or patting.
  • When holding your baby while they are in a light sleep, talk or sing to them in a soft voice.
  • When moving your hands away from your baby, do so gently and slowly without abrupt movements.
  • Kangaroo care—holding your baby next to your chest skin to skin—is recommended at this age. Your baby’s nurse will assist you with this.

Feeding

  • Breastfeeding is encouraged as soon as oral feedings begin.
  • Offer a pacifier during tube feeds as tolerated (if consented to).
  • Provide an opportunity for your baby to smell milk before beginning breastfeeds.
  • Reduce care procedures and activity around your baby prior to and during breastfeeds.
  • The environment around your baby should be calm and quiet as possible during feeds.
  • During feeding, your baby may want to suck for a while, then look and listen for a period of time.
  • Burp your baby as needed, doing so gently without vigorous patting on their back.
  • If your baby is fed by a tube, provide a pacifier during feeds, as tolerated.

Sleeping

  • Your baby should sleep on their back.
  • Wake your baby before care giving procedures by gently placing your hands around them.
  • Provide care giving and social interaction when your baby is awake.

Positioning

  • Support your baby’s position with their arms, hands and legs close to their body.
  • Repositioning should be performed with slow gentle movements and without sudden changes.
  • Have boundaries around your baby to maintain a snuggled position and facilitate emerging development of extension and flexion of legs.

Looking, listening and smelling

  • Talk and sing to your baby.
  • Shield your baby’s eyes from bright or direct light.
  • Shading your baby’s eyes will make it easier for them to look.
  • Provide opportunities for your baby to look at your face and their environment.
  • Develop a regular pattern of care eg feeding, nappy change, interaction, sleep.

Nappy changing

Provide support around your baby during nappy changes.

Bathing

  • May be performed by nurses and parents together.
  • Amount of time away from a heat source should be minimal.
  • Bathing your baby should be carefully considered and performed only when it provides obvious benefits.
  • Provide containment to your baby’s arms and legs during a bath to keep your baby calm.
  • If your baby has a tub bath, you may assist or complete bathing independently.

36 to 40 weeks gestation

We encourage you to participate in caring for your baby. During care watch how your baby moves and acts so that you can learn when they appear secure and calm and the times when your baby appears to need rest.

Touching and holding

  • Prepare your baby for touch with a soft voice.
  • Hold your baby in such a way that supports their arms and legs tucked close to their body and hands close to their face.
  • You can touch your baby in a variety of ways, including gentle steady pressure, rhythmic stroking or patting.
  • When holding your baby while they are in a light sleep, talk or sing to them in a soft voice.
  • When moving your hands away from your baby, do so gently and slowly without abrupt movements.
  • Kangaroo care—holding your baby next to your chest skin to skin—is recommended at this age. Your baby’s nurse will assist you with this.

Feeding

  • Breastfeeding is encouraged as soon as oral feedings begin.
  • Offer a pacifier during tube feeds as tolerated (if consented to).
  • Provide an opportunity for your baby to smell milk before beginning breastfeeds.
  • Reduce care procedures and activity around your baby prior to and during breastfeeds.
  • The environment around your baby should be calm and quiet as possible during feeds.
  • During feeding, your baby may want to suck for a while, then look and listen for a period of time.
  • Burp your baby as needed, doing so gently without vigorous patting on their back.
  • If your baby is fed by a tube, provide a pacifier during feeds, as tolerated.

Sleeping

  • Your baby should sleep on their back.
  • Wake your baby before care giving procedures by gently placing your hands around them.
  • Provide care giving and social interaction when your baby is awake.

Positioning

  • Support your baby’s position with their arms, hands and legs close to their body.
  • Repositioning should be performed with slow gentle movements and without sudden changes.
  • Have boundaries around your baby to maintain a snuggled position and facilitate emerging development of extension and flexion of legs.

Reference

Daniels T.H, Phillips S, Browning F.J, Prehn J, White C.B Henderson R, Stewart K.D. Parenting Based on the Developmental Progression of Preterm Infants. Murrysville: Respironics Children's Medical Ventures, 2006.

© 2010 Mater Misericordiae Ltd. ACN 096 708 922.

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-430037
Last modified 09/8/2017.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 28/2/2014
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