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Calming your Premmie

Handling of the preterm baby must be based on two critical components: individualisation of care and timing.  Stress can be minimised for your baby if the caregiver is able to identify individual stress signals and respond appropriately, time interventions to allow for undisturbed rest periods, and provide "time-out" for your baby to re-organise during stressful procedures.  Your baby can be helped to re-organise by following the steps of positive touch, such as still touch, containment hold and skin-to-skin care.

Stroking is a natural and instinctive action for parents, but for a fragile baby it might be too much to tolerate, as the premature baby may experience stroking as painful.  Instead of stroking you can rest a hand on your baby. This is known as still or positive touch.
Containment hold is when you cup the premmie's head and one other body area with a steady hand giving positive gentle pressure.  Movement should always be gentle, firm and rhythmical started on a body part the baby seems to like being touched.  E.g. hold your baby firmly against your chest and rock her body slowly.  This is only started when baby is physiological stable and seems to tolerate the touch.
Massage in premature babies should be done with extreme care, since it may have negative effects.  This should only be done with babies that are stable and seems to tolerate touch well.  Massage should preferably not be started before the baby is in the reciprocity stage.
You can also implement the following to prevent over stimulation:

  • Avoid more than one stimulus at a time - only talk or touch.
  • Prevent visual over-stimulation by using busy toys, eye contact, bright lights and colours.
  • Handle your premmie slow and gentle and keep her in a flexed position, with hands and feet in midline and while keeping the whole body contained.
  • Provide time-out when she seems stress while you are caring for her.  This can be done by stopping what you’re doing and providing still touch or containment hold untill she calms down.  You can continue with what you were busy with after she calmed down.

More ways to help calm your baby

  • Hold your baby firmly but gently in a curled (fetus) position.  Place your hand on your baby's feet and on head or shoulders to help your baby curl up and relax.
  • Swaddle your baby in a blanket.  Bend the legs up and bring the arms to the middle of the body.  Leave your baby's hands free to find the mouth.

The sensible art of swaddling video

Swaddle bath can also be used as a tool to calm baby during bath time.  Dr Welma Lubbe explains why and how in the following video

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Swaddle Bath video

 

Other ways to calm your baby

  • Help your baby bring one hand up to the mouth.  Let your baby suck on a fist, thumb, or fingers.  Try a pacifier, too.
  • Give your baby your finger or a small washcloth roll to hold.
  • Place your baby on her side and surround her with blanket rolls.  These blanket boundaries will keep your baby in a curled position and provide a feeling of security.  This is called "nesting".  
  • Check with the nurse looking after your baby before trying these suggestions and ask her to show you how to best perform these calming activities with your baby.
   
Imitate Fetal position
Flex hands and feet onto
the body
Imitate pressure and
closeness of womb
Use still touch and resting hands
   
Support hands in midline-
close to face & mouth
Provide sucking & grasping
opportunities
 Avoid light stroking -
over-stimulating
Hold hands cupped aroundhead and back / feet Provide one stimulation at a time (talk / touch) Relax and Enjoy your Baby

 

Dr Welma Lubbe also gives further tips and techniques on how to calm your baby in this video

 

Prematurity - Adjusting your Dream is full of ideas on how to interact with you baby depending on her developmental stage.

 

Chapter five of Prematurity - Adjusting your Dream is full of ideas on how to interact with you baby depending on her developmental stage.

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