Caring for your baby

You are your baby’s most important caregiver.

There are many important ways you can care for your baby while they are in the neonatal unit and they all help you and your baby.

It can be very overwhelming seeing your baby connected to medical equipment and monitors. You might feel afraid of touching or holding your baby at first. These feelings are normal and we are here to help you.

Skin to skin cuddles or kangaroo care has shown to have many benefits for both babies and their parents. These include:

  • Your baby’s observations (heart rate, how fast they are breathing, oxygen levels) can stabilise.
  • If your baby is cold a cuddle can increase their temperature and keep them warm.
  • It allows longer periods of restful sleep which is great for your baby’s growth.
  • Allows your baby to self-regulate. This means your baby is learning to calm or settle themselves.
  • If you are expressing breast milk or planning to breastfeed kangaroo care has shown to increase breastfeeding success. This means you may express more milk and your baby may be able to successfully breastfeed for a longer amount of time.
  • Skin to skin cuddles are a great way for both mums and dads to connect and bond with your baby. Babies recognise their parents and they know they are loved.

    "Just love your hugs with your baby as we love them so much." - Lewis, 27 weeker, 2016

Even if your baby is on a ventilator, they may still be able to have a cuddle with you. Please speak to your nurse to discuss this including when would be the best time.

Once your baby is comfortable and settled on you, they often fall into a deep sleep and this can be a good time for you to relax too. For this reason, it is best to have at least an hour together so make sure you have been to the bathroom and had something to eat and drink.

You will be able to get to know your baby’s individual responses, likes and dislikes. There are many ways you can look after your baby and the type of care that can be done will depend on how well your baby is.

This care may include:

  • hand hugs in the incubator
  • taking your baby’s temperature
  • changing your baby’s nappy
  • providing mouth care with a cotton tip
  • washing or bathing your baby
  • looking after your baby's skin
  • applying coconut oil to your baby’s skin
  • changing the oxygen saturation probe and ECG leads
  • changing the cot sheets
  • weighing your baby
  • holding your baby’s feeding tube
  • feeding your baby
  • talking, singing, reading to your baby
  • choosing your baby’s clothes
  • assisting with CPAP hat releases and head massages

There is no timeframe or pressure to do these activities. It can take a little time to feel close to your baby, and this is okay. Initially, you may be comfortable sitting by your baby’s bedside or talking to your baby. We are here for when you are ready and can help you develop your own goals for you and your baby.

We have clothing for your baby which you can choose from daily or you are welcome to bring your own. Please check with your baby’s nurse what clothes are suitable – some clothes may not be appropriate for your baby’s condition due the equipment and monitoring your baby is attached to. Please label all your baby’s own clothing, sheets and wraps. Ask your nurse to place a sign on your baby’s cot or incubator so we know it’s yours.

Your baby’s doctors will conduct a ward round each day generally between 8:30am and 11am to discuss your baby’s individualised care plan.

Specialist doctors and/or surgeons may be involved in the care of your baby. They will review your baby at varying times of the day in consultation with the NICU medical team.

Ward rounds are a great time for you to meet your baby’s team and to join in the discussion about your baby’s care.

We encourage you to introduce your baby to the team and let them know your thoughts about how they are doing. You know your baby and the medical team will listen to you as you plan next steps.

We encourage you to ask questions and discuss concerns so we can make a plan with you.

If you are not here for the ward round the medical team are happy to update you at any time.

Your baby will have a communication board at their bedside called “All About Me in the NICU” where their goals and plans for the day are written by you and your baby’s nurses.

You can use this to keep staff updated about your plans to come in, timing of feeds you will be in for and skin to skin cuddles.

You can tell us your baby’s likes and dislikes and share any messages with the team, for when you aren’t able to be here.

Every baby is individual and has their own needs. Being involved in your baby’s care and daily routine makes their journey through the neonatal unit as positive as possible as you learn about their needs and abilities.

Your baby will have their care 'clustered' so they can have longer periods of sleep with noise, lights and handling by the nursing and medical teams is kept to a minimum. Sleep is very important for preterm babies as it helps with brain development and allows babies to preserve their energy and catch up on growth.

Preterm babies must learn to move against gravity, rather than in the womb, so care is taken to position your baby to support their joints whilst helping them build up their muscle strength and movement control. Your baby is communicating with you, just through body movements, facial expressions and their observations (like heart rate, respiratory rate and oxygen level) rather than words.

Getting to know your baby using senses, both yours and your baby's is a great way to learn more about each other. As your baby is growing and developing there are many things that you as parents can do to support your baby's development.

 

Typical development

What you can do

  
 

Touch

Touch is the first sensory system to develop.

The skin can be extremely fragile, thin and sensitive.

Touch your baby with warm, clean hands.

A firm, gentle touch is more reassuring than light, stroking or tickling movements that can irritate your baby.

Skin to skin cuddles with your baby.

 

 Smell

Sense of smell develops at about 22 weeks gestation.

Your baby will be able to recognise your smell.

They will be sensitive to strong smells.

Avoid strong perfumes, cigarette smoke.

Scent clothes are small pieces of fabric that can provide the familiar scent of you to your baby. They are infused with your scent from having them close to you, for example wearing them in your top. Leave them with your baby for when you are not there. Take the used one home to assist when you're expressing as it will have your baby's smell.

  

 Hearing

Hearing develops early in pregnancy and your baby can recognise and will be comforted by your voice.

Your baby will be sensitive to loud sounds and they may startle to sudden noises.

Speak softly to your baby, open and close the incubator doors carefully and quietly and don’t place objects on top of the incubator. The sound inside can be magnified.

If your baby is startled by a noise use your hands to contain them so they can go back to sleep.

You can also sing, hum or read to your baby or just tell them about your day. It's important your baby is exposed to as much language as possible.

  

 Vision

Vision is the last sensory system to develop.

Your baby can see when they open their eyes, but it is not yet clear, and they can be easily overstimulated by bright lights.

Keep the cover on over the incubator.

Protect eyes from strong light or glare. Ask nurses to turn off overhead lights if appropriate.

As your baby gets older you can let them try and focus and follow your face. Your baby may tire easily. If they look away or shut their eyes this may be a way for them to regulate themselves.

 

 Taste

Your baby may be curious about taste and be able to tell the difference between tastes they like and don’t like.

Smell and taste are closely linked.

It is important to create positive pre-feeding experiences for your baby through oral care and positive touch.

Offering expressed breast milk on cotton tips is a way to clean your baby’s mouth while providing the smell and taste of breastmilk to them. 

Watch your baby’s face and if they frown, gag or cry perhaps they aren’t ready, and you can try again later.

  

Movement and position

Your baby is used to being curled up in the womb. Once born they don't have this support, so their arms and legs are more extended or straight.

Their movement may appear jerky as their muscles are still growing and developing. 

Assist your baby to stay in their 'nest'. This helps them stay in a curled-up position and gives them a boundary to push on like they would have had in the womb.

A 'hand hug' involves placing one hand on their head and one cradling their bottom or feet. This support can often settle your baby.

Encourage their hands near their face or holding your finger.

Check with nurses if you are able to hold your baby in a feeding position while they are having their tube feed.

  

Body Language

Your baby has their own way of telling you how they are feeling. By watching you baby’s body language you can learn to recognise when they are stressed, settled, hungry, content or when they need support from you.

Signs your baby is ready to interact and likes what is happening around them:

  • Relaxed, alert face
  • Sucking
  • Regular breathing
  • Healthy, pink colour
  • Hands together
  • Feet touching
  • Grasping or holding onto a finger or object
  • Moving hands to the face
  • Sucking or rooting (looking to suck)

Signs your baby doesn't like what is happening around them and may need your help to settle:

  • Fingers splayed or 'stop sign' hand
  • Limp or stiff legs
  • Facial grimace
  • Hiccups, sneezing or yawning
  • Looking away from you
  • Breathing faster or pauses in breathing
  • Goes from awake to asleep suddenly
  • Flapping arms or jerky straight legs
  • Colour changes
  • Squirming or crying

Things you can do to help your baby include:

  • Check the environment. Is it too bright? Too noisy?
  • Position your baby so they are comfortable (swaddled with hands to face or in a nest with their legs tucked up and hands together)
  • Gently hold arms together on chest and tuck legs up
  • Slow down your touch to give your baby time to adjust to changes happening
  • Calmly talk or sing to your baby

Sleep

Sleep is important for babies in the neonatal unit. It helps with brain development, growth and allowing babies to preserve their energy.

Looking at your baby and what sleep state they are in is helpful in deciding when to disturb your baby.

You can assist staff in organising your baby’s daily care routine so that sleep times are protected, and cares can be clustered when your baby is awake and alert.

There are six behavioural or sleep states you may observe your baby in.

 Deep sleep

This is a great time for brain development and growth so try to avoid waking your baby.

If you must wake them, rouse gently with your voice.

  

 Active sleep

Active sleep is the main sleep state of your baby until they are closer to term.

This is a lighter sleep and your baby’s breathing may be faster and more irregular. The eyes will be shut however the eyelids may flutter a lot.
You may notice your baby making mouth movements and they may smile or frown.

This is a time your baby in making new connections in their brain so if you need to disturb your baby gently talk to them and slowly wake them up.

  

 Drowsy

Drowsy is when your baby is half awake/half asleep.

Your baby may be moving towards either sleep or waking up. If you aren’t sure if your baby is trying to wake up wait a few minutes and see if they return to sleep or not.

Their eyes may be open or closed or blinking.

Your baby may be moving around, sucking or fussing a little.

Sometimes your baby might need your help to go back to sleep – for example touch (hand hug) or swaddling them.

 

Quiet awake

When your baby is in a quiet alert stage this is a great time to interact with your baby.

Their eyes will be open, face relaxed and look like they are really interested in interacting with you.

  

Active awake

 In the active awake stage your baby will have open eyes, be making active movements and may be making sounds. They could be telling you that something needs to change or stop.  

Crying

Your baby can be crying for a variety of reasons.

They could need a nappy change, be tired, too hot or cold, hungry or uncomfortable and need to be repositioned. Look for changes in their cries for different needs. This will help you when you are home.

Some babies may have a breathing tube in and are therefore unable to make a noise. We wouldn't be able to hear the cry but can tell from their facial expression, tightly closed eyes with arms and legs likely moving about. This is called silent crying.

Whatever their age they will need your help as their parent to settle.

  

Last Updated: 24/05/2024