As a first-time parent, one of the most daunting aspects of caring for a baby is feeling that she cannot tell you what they need, 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 wellbeing 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 their own way, your baby is communicating all the time – for example:
- if they turn away from you they may be over-stimulated and need some quiet time
- if they are extremely active and fussing they may be hungry or agitated and need help calming down
- if their face or body tenses up they may be in discomfort
- if their face is relaxed and their eyes open they are 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, they don't like it when the lid of the wastepaper bin slams shut, but that they love it if you stroke their hand while they hold 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 them treatments and tests together so that their rest time is not repeatedly interrupted
- finding ways of soothing them – 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 they are 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 them dry: When your baby's skin is wet they will become cold very easily. Each time they become damp and dry off, they lose some body heat. Always wash them in a warm, draught-free place, and have a towel close by to wrap them in and dry them 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 them 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, they 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. They could hear your voice inside the womb, so its familiarity will be music to their ears. Gently sing songs to your baby, talk to them or make cooing or kissing noises.
- Making eye contact: This is crucial for bonding. Look into your baby's eyes and play with them 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 their 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 they respond, and if they start fussing, stop. They probably need 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.