November is National Prematurity Awareness Month. If you have a premature baby, you know firsthand how stressful it can be. A potential NICU stay, dozens of appointments, concern for your baby’s growth and development, as so much more. I have worked as a physical therapist with babies both in the NICU and after they have gone home. Many parents have told me they feel lost when it comes to supporting their baby’s development. Here are the 5 things I would tell all premature babies’ parents to try at home.
Babies normally stay curled up tight in their mother’s womb until about 40 weeks. When a baby is born prematurely, they don’t spend as much time surrounded by the warm, comforting uterine wall. Being held in a flexed position gives them lots of important sensory information. Babies develop a sense of body awareness, muscle strength, and emotional regulation from pushing against a snug, firm boundary. Swaddling is a great way to try and replicate that experience for newborn babies, especially if they are premature. With any baby, make sure that you always leave the swaddle loose around their hips and stop swaddling your baby when they are able to roll over (around 4 months of age). If your baby has medical concerns, talk to your doctor about any special precautions before swaddling.
Similar to swaddling, babywearing with a wrap, carrier, or sling provides a comforting sensory experience for your baby. They are held close to your body where they can hear your voice and sway with you as you walk. Babywearing can also be a good opportunity for skin to skin. Premature babies often have to spend extended time in an incubator or hospital crib where they might miss out on soothing sensory experiences like rocking, cuddling, and being held while they sleep. Babywearing is a great way to give them positive exposure to combined touch, sound, smell, and movement experiences, which helps their nervous system develop in a healthy way and builds a stronger attachment with you.
Premature babies have a greater likelihood of developing sensory processing differences as they grow older. Often, this is related to the overwhelming sights, sounds, and feelings of being in the NICU. Sometimes, there is a very valid concern that your premature baby could catch germs from interactions with new people and places, limiting their exposure to new sensory experiences. One way you can help them to develop a healthy nervous system is by giving them safe opportunities to “play messy” at home. Let them rub their food all over themselves, play with bubbles in the bath, squish baby-safe paint, and pull toys out of rice or bean bins. Babies learn about the world around them by activating their senses. Their ability to stay calm and regulated when they get older is directly related to the early sensory experiences they have as babies.
Things like walkers, bouncers, and jumpers are on nearly every expecting parent’s baby registry. While these devices are far from ideal for promoting any baby’s development, they can be especially unhelpful for premature babies. Preemies can struggle with coordination, motor delays, and walking on tiptoes. The best way for them to develop strong, coordinated muscles is to play on the floor as often as possible. And if necessary, receive individualized physical therapy.
I don’t think preemie parents get told this enough. You are the expert on your child. You are their biggest comfort, advocate, and safe space. Your parenting journey may have started with a slew of medical professionals telling you exactly what to do, but you are the one who took all that and made it work for your baby. The doctors, nurses, and therapists on your team want to know your priorities. Follow your instincts, and take time to really get to know your baby. You are doing a great job!