Updated April 2014, next review April 2017

Your premature baby's time in hospital

Caring for your baby - your role

The healthcare team will cater for your baby's medical needs, but she needs you too. As you get to know your premature baby, you will begin to work out what she needs.

As a first-time parent, one of the most daunting aspects of caring for a baby is feeling that she cannot tell you what she needs, or whether something is wrong. There's no right or wrong way to behave when your baby is born prematurely. Everyone responds differently but no matter how fearful you feel, somehow you will cope.

There are many ways in which you can contribute to your baby's well-being and development. You can:

  • work with the team to give your views, raise questions and make decisions about your baby's care
  • be a presence in your baby's life, to provide love, affection and reassurance as well as warmth, nutrition and care (see below)
  • express your milk so it can be given to your baby, as this is the best milk for your premature baby.

Reading the signs to learn what your baby needs

In her own way, your baby is communicating all the time – for example:

  • if she turns away from you she may be over-stimulated and need some quiet time
  • if she is extremely active and fussing she may be hungry or agitated and need help calming down
  • if her face or body tenses up she may be in discomfort
  • if her face is relaxed and her eyes open she is probably content.

Over time you will develop your own sense of how your baby reacts to different situations. For example, some babies might not like having their nappy changed, while others might enjoy the sense of freedom. Use the long hours on the baby unit to become an expert on your baby's likes and dislikes. With time, you will begin to know that, for example, he doesn't like it when the lid of the wastepaper bin slams shut, but that he loves it if you stroke his hand while he holds the edge of your soft jumper.

Making your baby comfortable

The healthcare team should be watching out for these signs too and adapting their care accordingly. They may try to respond to your baby's needs in different ways – for example:

  • giving him treatments and tests together so that her rest time is not repeatedly interrupted
  • finding ways of soothing her – for example, by swaddling or encouraging sucking
  • carrying out tests, such as blood tests, in ways that cause the least possible distress or pain
  • limiting the number of visitors so that he is not overwhelmed, or avoiding using noisy heating systems.

If you notice anything about your baby's likes and dislikes, jot down your observations and pass them on to other family members and the healthcare team.

Washing your premature baby  

Frequent washing can do more harm than good. Preterm babies have such fragile skin that some products, especially soaps and lotions, may be harmful.

Your baby's delicate skin is highly absorbent. Any soaps, creams and other products you use on her may be absorbed and may also upset the balance of the important oils that nourish the skin. Some products may even change the way the skin fights infection. In the early days it is best to use warm water alone, and your baby’s nurse will guide you in how to do this. 

Caring for your baby's skin

Top and tail: When you wash your baby, use only water. It is usually enough just to 'top and tail' – using cotton-wool balls soaked with tepid water to wash her bottom, face and neck.

Snuggle her dry: When your baby's skin is wet she will become cold very easily. Each time she becomes damp and dries off, she loses some body heat. Always wash her in a warm, draught-free place, and have a towel close by to wrap her in and dry her afterwards.

Bonding with your premature baby

Some parents feel a sense of detachment. Others dare not let themselves love a baby who may die. Some mums and dads feel a deep sense of grief at not being able to be closer to their baby. For other parents, the situation can produce a deadening depression and inertia from being in a situation that they feel powerless to control. If your baby was premature, you might not be able to cuddle her as much as you'd like at first, but there are lots of other ways to bond.

Ways to communicate with your baby

  • Holding: Even if you are not able to pick your baby up, she may find it comforting to hold your finger.
  • Stroking: This can be reassuring for your baby. Do it smoothly and very gently, but firmly enough not to tickle.
  • Using your voice: This is especially important for mums. She could hear your voice inside the womb, so its familiarity will be music to her ears. Gently sing songs to your baby, talk to her or make cooing or kissing noises.
  • Making eye contact: This is crucial for bonding. Look into your baby's eyes and play with her by showing different expressions, such as smiling or looking surprised.
  • Using objects: Show your baby simple black-and-white striped objects or toys.
  • Massaging: Using gently warmed vegetable oil, apply gentle but firm strokes, watching carefully to see where she likes being touched.

Never use any oil other than pure vegetable cooking oil when massaging your baby – not even branded baby oil – as her sensitive skin could absorb it too quickly.

Kangaroo care is a great way of bonding with your premature baby. Read more about kangaroo care here.

Gently does it

The activities listed in the box above may not seem stimulating to you as an adult, but even just a minute or two may be enough to exhaust your premature baby. So watch carefully to see how she responds, and if she starts fussing, stop. She probably needs some peace and quiet. Noisy toys such as rattles will probably be too stimulating at this stage.

Take heart: bonding with a preterm baby can take time

If you haven't connected with your baby in the way you'd imagined it would happen, don't despair. Having your baby early will have disrupted your passage into motherhood, and many women find that this gets them off to a shaky start.

Both you and your baby may need time to recover from the shock of your experiences and to relax before you can start to enjoy a feeling of closeness. Be aware that this could take time, but don't suffer in silence if it's upsetting you. Talk to someone you trust in your healthcare team, as there are many things that could help.

To be able to look after your baby, you need to look after yourself too. Eating and drinking healthy foods and getting sleep will help you keep energy levels up and help with the flow of breastmilk if you are expressing or breastfeeding.


In this section


Your baby's time in hospital:

You can also read about

The following organisations can give you more information about the topics covered in this section.


Sources

Macdonald S and Magill-Cuerden J (2012) Mayes’ Midwifery, Fourteenth Edition, Edinburgh: Bailliere Tindall Elsevier

Cambridge University Hospitals NHS Foundation Trust, (accessed March 2014) Supporting and Comforting Your Baby, http://www.cuh.org.uk/rosie/services/neonatal/nicu/developmental_care/support_comforting_baby.html#positioning.

Tiffany Field, Miguel Diego, and Maria Hernandez-Reif (2010) 'Preterm Infant Massage Therapy Research: A Review', Infant Behavior & Development 33, no. 2

 

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Reading the signs to learn what your baby needs

Washing your premature baby

Bonding with your premature baby



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Feedback on health information

'The healthcare team said: "Don't look at the machines – look at the baby." But the machines are interpretive; mesmerising. You're guided by the machines, and you become a pseudo scientist. You can't help but look. One day, the battery on the monitor stopped working and the nurse said to me: "Look at her face – she's pink and fine." And I looked, and saw that she was. Learning to trust yourself as a mum is very difficult – especially if you've gone through the urgent, trying stuff because your baby nearly died. But developing your intuition and ownership is really important.'

DEBBIE

'Gradually, the nurses show you the ropes of being a mother. They teach you how to change their nappies, how to clean their eyes and their mouth, so they involve you bit by bit, so you're learning all the time. They were lovely, and we'd have a bit of a laugh together too.'

AMINA

'It took a long time to bond. At first I wasn't aware that I wasn't bonding because the neonatal unit was such an alien environment, and when she first came home she was still on oxygen. I loved her, cleaned her and cared for her, but it was only the first time she became really ill, at just over 1 year old, that I realised I'd properly bonded with her.'

DIANE

'I think I'd made a decision on bonding – I'd had 24 hours' notice before the caesarean and it was really good to have that warning. I'd made a conscious decision to bond with him, because I thought that if I didn't and he died, I would feel really terrible for not having loved him enough. This way, if he did die, I couldn't say it was because I didn't love him enough. I think the best way to approach life is to be positive and determined. I think having that outlook has made a difference.'

JESSICA