Supporting Your Preemie's Development

Babies are able to communicate their needs through their movements, their ability to become alert or go to sleep, and their physiologic reactions such as changes in breathing and skin color. Infants born early may be more sensitive than full-term infants and react to even slight changes in their environment and handling.

"I'm overwhelmed." Signals that a preemie might need to slow down or take a break include:

"I'm ready." Signals that a baby is more organized and able to handle incoming information include:

"I'm helping myself."Babies also have their own strategies for becoming more organized. These include:

Each baby organizes himself differently, which helps him take in new sensations in his own way. You'll soon be familiar with your own baby's special ways of communicating and be able provide the support he needs to interact with the world. This emerging relationship with your baby is the most important foundation for his physical and emotional development.

For more on understanding your preemie's signals, click here.

Understanding how your baby communicates is the first step to a nurturing relationship. The next one is supporting your preterm infant's emerging organization. The following strategies will help.

Provide a soothing environment. As you already noticed, your baby may be sensitive to light, sound, or new experiences. Be especially careful when she 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 to her, and try to avoid them. Just taking a fragile infant to a grocery store may be too much sensory input; she may need more time and maturity to be able to handle all the stimulation a trip like this creates.

Be aware of pacing and timing. Preterm babies are working on organizing their sleep-wake schedules as well as coping with caregiving from different people. Their sleep may sometimes be interrupted, or they may be rushed through a diaper change. Be sensitive to your baby's need to wake on her own. Look for signals that she is ready for play. Match your handling of her or your social interaction to what her signals tell you. Be sure to give your baby pauses when she needs to recover or take a nap.

Offer continuity and predictability. Just like most adults, babies need to know what to expect next. It reduces anxiety and helps them perform better. Providing a set daily schedule, using the same caregiver, and putting the baby to sleep in the same bed are examples of how we can create an organized and predictable world for them. This helps them feel safe so they relax and learn new skills more easily.

Supplement your baby's efforts to help herself. As they grow, babies learn to do things for themselves, and they feel the pleasure of success. However small, attempts to calm themselves—sucking on a hand, for example—are rewarding and set the stage for more tries. A fragile baby may need additional help. One way is to support her shoulder so she can move her hand to her mouth to suck on it more easily. Another is using your arm to let her brace her foot so she feels more stable. These small supports have a big impact on your baby's achievements. And they just may help put off a fussy period.

Handle and position her carefully. By now you know about the importance of putting your baby to sleep on her back. When your baby is awake, it is important to move her gently and slowly. Babies who have been born early are still working hard to move smoothly and to keep their arms and legs from dangling or extending. Holding your child close so she feels support and warmth from your body or swaddling her in a blanket will be necessary until her movements are more purposeful and controlled. Preterm babies sometimes have difficulty with fast movements, and you're likely to see "I'm overwhelmed" signals when they are moved quickly or without a blanket or body support.