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Being involved in your baby's care

Touch / Skin-to-Skin

Some babies are too sick to be taken out of their incubator but it is still possible for you to touch them by placing your hand through the porthole and cupping their head or their feet.  Stroking can be too stimulating for them at this stage as they need to rest.

Once the doctors and nurses feel baby is ready, you may be encouraged to hold your baby ‘skin-to-skin’.  This is when you hold baby (who is just wearing a nappy) next to your bare chest and either one of the parents can hold baby in this way.  Skin-to-skin helps with bonding, attachment, parental anxiety and mother’s milk supply.  Skin-to-ski n is also good for baby as it promotes sleep and weight gain and it helps to regulate baby’s temperature, breathing and heart rate.  It also provides a positive sensory experience for baby as they get to smell and feel your skin.  When your baby is ready for skin-to-skin it may be useful if you wear loose clothing or a top that opens down the front as this will make it easier to position your baby.  You may also like to bring a hand held mirror so you can see your baby’s face during skin-to-skin.

Kangaroo care involves holding your baby on your chest while dressed and it can last for as long as both you and your baby are comfortable.  At least an hour is beneficial as this gives you both time to relax and enjoy being together.  Some units use wraps, slings or stretchy bands like ‘boob tubes’ to help keep baby positioned with their back straight and their chin slightly tilted to help them breathe although you may prefer to bring your own shawl or blanket.

Once baby is well enough, skin-to-skin or kangaroo care can be practised throughout the remainder of their stay on the neonatal unit and can be continued once discharged home.  For more information watch the Small Wonders film on 'Preparing to hold your baby' and read the bliss booklet ‘Skin-to-Skin with your premature baby’ 

Developmental Care

A family centred developmental approach has better outcomes for babies in neonatal care as it means less stress for babies, shorter hospital stays and better long terms outcomes.  Consideration is given to baby’s posture and sensory development as well as looking at their behaviour and trying to understand their cues.  It also looks at ways of developing the relationship between parents and their baby.  Many neonatal units now practise these principles and parents feel more involved in the care of their babies and relationships between hospital staff and parents are strengthened.

However, premature babies make take longer than babies born at full term to reach the normal developmental milestones as they are, in fact, younger.  To determine their development progress babies will be assessed according to their ‘corrected age’ which is the age they are from the date they were due.  As your baby grows, they will be regularly assessed and monitored by healthcare professionals who could include support from a physiotherapist or occupational therapist.  This ongoing support should reassure you that your baby is doing well and if you have any concerns about your baby’s development, then you should discuss this with your healthcare professional.

Mouth care, Nappy Changing and Bathing

Cleaning you baby’s mouth gives you an opportunity to get to know your baby and their way of responding to you.  It is carried out while baby is awake and uses sterile water, expressed breast milk and a cotton bud.  The cotton bud is dipped into the sterile water and gently rolled along baby’s lips, along the gum line and over their tongue.  Once their mouth is clean, the cotton bud is dipped into the expressed milk and wiped round their mouth again - they may even suck on the cotton bud.  Expressed breast milk gives baby something nice to taste and this method of mouth care should continue until baby is able to take feeds by mouth.

Nappy changing is another way you can be involved in your baby’s care and is better done by two people as one keeps baby settled and comfortable while the other changes their nappy.  Keeping baby settled can be done by resting a cupped hand on their head and on their feet or by offering a finger to grasp or something to suck.  If you are changing the nappy on your own, wrap a blanket around baby’s arms and shoulders to help to keep them calm and, if your baby becomes active or uncomfortable during their nappy change, think about pausing for a while until they are relaxed again.

Babies on the neonatal unit are often too small to have a bath but, once they are stable enough, you can gently clean their face with soft gauze pads and warm water.  When your baby is able to maintain their own temperature they will be able to have their first bath which is a very important event so have a camera ready so you can take lots of photographs.  As you put your baby into the bath speak to them as this will help to reassure them.  Small babies can find bathing a tiring experience and a technique called wrap bathing may be used.  This is where baby is wrapped in a sheet or muslin square, gradually placed into a warm bath and one part of the body is exposed, washed and then re-wrapped.   The nurses on the neonatal unit will support you throughout this time and will continue to do so until you feel comfortable bathing baby on your own.