Like all babies, premature babies need their parents' love and support to grow and thrive. They also need a little more time to get comfortable with the outside world and may not yet be able to process their surroundings in the same way full-term babies can. When you take your baby home for the first time, you'll want to learn as much as you can about the unique qualities of preemie development. Although you should always rely on your doctors, who are experts and know your baby’s situation very well, this information might provide you with a little extra assistance to help you support your preemie now that he’s home.
Why Your Premature Baby Needs Lots of Down-Time
Your preemie’s brain has had less time to grow, and he’s quickly trying to make up for lost time. As your premature baby grows, brain development is one of the top priorities. You may find that your preemie finds it difficult to stay awake, take in sights and sounds, regulate his breathing, and respond positively to touch. That’s because his brain is still maturing and is just now learning to make vital connections with other parts of the nervous system, in order to begin to perform these normal functions independently.
It's worth knowing that your baby may be using a lot of energy eating, growing, and blocking out intense light and sounds. As you might expect, all of this growing and learning can be exhausting, and your baby might not have much energy left for social interaction. You may find that exposure to certain noises, light, or even your touch can be difficult for your preemie to process, especially after undergoing a variety of NICU tests.
Reading Your Preemie Baby’s Signs
Babies are able to communicate their needs through their movements, their ability to become alert or go to sleep, and their physiological reactions, such as changes in breathing or skin color. Your baby will let you know if he’s beginning to feel a little overwhelmed. To support your preemie’s development, watch for these signs of stress, so you know when to give him a little space. If you see any of the following, it’s probably time to slow down and let your baby rest and save his strength:
- Faster breathing or pauses in breathing
- Bearing down (as if having a bowel movement)
- Growing pale or red in skin color
- Yawning or hiccupping
- Changing body tension (extending legs or arms or going limp)
- Sudden jerky movements or twitches
- Getting fussy and staying that way for a long time.
On the other hand, you can also watch for the following signs that show he’s ready to engage:
- Steady breathing rate
- Stable skin color
- Gentle movements of arms and legs
- Quiet alertness and holding a steady gaze
- Grasping and holding on to objects
- Putting his hands on his face or in his mouth
- Sucking on a pacifier or finger.
Celebrate and support these displays of development — your baby is working hard and growing stronger every day. You’ll be the first to understand how your baby communicates, and you can use this knowledge to support his development. Remember, if you have any questions or concerns about any signs your baby is showing, be sure to consult with your doctors, who are available to provide you expert guidance and advice.
How to Help Your Premature Baby Grow
You might feel like there’s not much you can do to help your preemie, but there are some great ways you can support your baby’s early growth and development:
- Support your baby’s efforts. As babies grow, they learn how to do things for themselves, for example how to comfort themselves, and they feel the pleasure of success. These rewards boost confidence and set the stage for even more tries. Try helping your baby’s efforts; if sucking his fingers calms him, then place your arm so he can brace his foot to feel more stable while sucking, or gently guide his hand to his mouth.
- Handle with care. When he’s awake, move him gently and slowly. He’s still learning and working hard to control his arms and legs. Holding your child close so he feels support and warmth or swaddling him in a blanket will help until his movements are more purposeful and controlled.
- Provide continuity and predictability. Just like most adults, babies need to know what to expect next to reduce their anxiety and help them perform better. By providing a set daily routine (with the same caregiver and bedtime rituals, for example), you are creating an organized and predictable world for him. When he feels safe and relaxed in this routine, he will learn new skills more easily.
- Provide a soothing environment. As you already noticed, your baby may be sensitive to light, sound, or new experiences. Be especially careful when he is tired or trying to concentrate on difficult skills, such as feeding or listening to your voice. Be aware of places and situations that tend to be overwhelming for him, and try to avoid them. For example, taking a fragile infant to a grocery store may be too much sensory input; he may need more time and maturity to be able to handle all the stimulation a trip like this creates. By providing a relaxed environment and consistent affection, you will help strengthen your relationship with your baby, and help foster his physical and emotional development.
- Let your baby be your guide to interaction. Periods of play and wide-eyed alertness may be limited at first. Preemies need to conserve their energy by resting and sleeping. At first, your baby may not be ready to look, listen, and move all at the same time. If that's the case, limit your interaction to letting your baby just look at your face. Later you can use a soft voice to encourage him to follow the movement of your head. Feeding is an especially difficult time for many fragile infants, because it takes so much effort to eat, look, and listen. Being quiet during this time might be the best strategy. Your baby will signal when he can handle more stimulation.
- Keep him comfortable. To ensure his skin is more comfortable, use a preemie diaper that is super absorbent, as this will help reduce diaper rash and help maintain the skin’s pH. Sensitive wipes are also helpful to care for easily irritated preemie skin. For more tips on how to help keep him comfortable, read our guide to preemie clothing and diapers.
- Kangaroo care. Skin-to-skin contact is important for all newborns, and preemies also benefit from being held against mom or dad’s bare chest. Read more about kangaroo care for preemies to find out how you can practice skin-to-skin contact at home – it has great benefits for both baby and parents.
For a first-hand look at how parents of preemies support their baby’s development, watch Lauren and Aaron talk about learning to monitor and help Addyson’s breathing during those early, post-NICU days:
Why Preemie Development Milestones Are Different
As you know, there are different levels of prematurity. Your doctors will be able to tell you more about the level and type of care your preemie may need in the future based on his personal medical background and whether he was extremely premature, very premature, or moderate to late premature.
Although you’ll no doubt be anxious to see your baby hitting early developmental milestones, it’s important to remember that there’s no definitive guide to premature baby development week by week, and, like each baby, your preemie is unique.
For preemies, when certain milestones should be reached is calculated based on due date, not birth date. It may help you to calculate your preemie’s “adjusted age,” which takes into account how early he was born to estimate when he might hit certain milestones. Count the number of months between his due date and his actual birth date, and subtract this number from his current age. For example, if your baby was two months premature, then he may reach development milestones two months later than expected for his age. Above all, keep in mind, your pediatrician and other specialists are the true experts who can give you the best guidance and advice.
Caring for Your Own Needs
Don’t forget to take care of yourself, to pay attention to your own needs, and to enjoy those wonderful moments with your baby during these early days. The birth of a baby is a challenging time for the whole family, and for mom in particular, as caring for a preterm baby often adds extra tension.
Exhaustion may be inevitable, but try to set aside some me-time to keep from feeling overwhelmed. You may benefit from a walk around your neighborhood, a yoga session, or talking to close friends. For more strategies, check out our article on coping with worry. Taking care of yourself may seem counterintuitive, but it’s extremely important, as your ability to provide the best care for your baby depends on you being healthy and as rested as possible.
