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First Years Lesson: Vol. 1, No. 8

"Comfort and Care Strategies"

September 8, 2020


Comfort and Care Strategies
No matter how much of a rock star you are, living in the NICU and then transitioning home with your new baby, is tough on a momma (and a daddy!). It’s even more difficult when your little one is fussy, and you’re struggling to comfort them. Luckily in the NICU, you have a team of baby whisperers at your disposal to give you all kinds of pointers. Once you get home, it’s a bit of a different story. Here are a few expert tested tricks that are preemie specific. Note: If you haven’t gotten the all clear to head home yet, consult with your care team if any of these are new to you and your baby.
Your Baby’s Special Language:
Before you can know what to do for your baby, you first have to know what they need! Your baby may not be able to communicate with you verbally, but they are giving you plenty of signals about how they are feeling and what they want. Here are a few of those signals, decoded for you!
  • Turning away from you after being engaged for a length of time – this is a signal that your baby may be overstimulated and need a break. This is a good time to lower your voice, turn off any lights or music you may have playing, and just hold or rock your baby so they can comfortably disengage.
  • Repeatedly stretching their legs straight out and arching their back, and / or kicking their legs and bringing them to their chest – this is often a pretty clear indicator of gas, and it can be as painful for mommy as it is for baby. Bicycle kicks, or helping your baby get their knees up to their tummy can often help push some of the gas out. Infant massage on their belly can also be helpful. If your baby has been cleared for massage watch this video to learn a basic infant massage technique to alleviate a gassy baby. **Important note** ALWAYS check with your care team or pediatrician before using any oils or lotions on your baby’s skin!
  • Relaxed arms and facial expressions, sucking on fingers and hands, and focused gaze (even for a short time) – these are all indicators that your baby wants to interact with you. Even though this is a calm time for your baby, these are important to note, because if they are craving interaction and do not receive it, they can become distressed. Skin-to-skin (Kangaroo Care), breastfeeding, talking, or singing to your baby are all welcome at this time.
The 5 S’s:
We talked about these a few issues back. See issue #5 for a refresher, but these tried and true techniques were developed by Dr. Harvey Karp, a pediatrician, child development specialist, and Assistant Professor of Pediatrics at USC. You can learn more about the 5 S’s in Issue 5 of First Years E-Newsletter or the visit the happiest baby website to learn more!
Touch:
One thing that is true of almost all preemies is that their nervous system is underdeveloped, which means that they are very sensitive to stimuli, especially as it relates to their skin (it’s the largest organ of the body, after all).
  • Believe it or not, when it comes to touch, preemies do not always know the difference between painful and pleasurable stimuli. Our first instinct when we see a teeny tiny baby, is to stroke them with a feather-light touch. In the case of a preemie, this may actually be perceived as painful to their immature nerves. The best way to touch your preemie is what I call “with intent”. By not being too delicate, they will know that you’re there, and not be confused by what they are feeling. You can stroke your baby’s skin with the same amount of pressure you would anyone else. Be sure to watch their response, so they can signal if your touch should be adjusted.
  • Swaddle Bathing is another important comfort measure for your preemie when it comes to touch, and is actually a great tool for all newborns. Beyla’s first several baths were done in a swaddle, and now the bathtub is the happiest place on earth for her! It’s exactly like it sounds! If you’re in the NICU, the nurses can help you. If you’re at home, get the bathroom nice and warm, and watch this video to see how it’s done.
  • Get a swaddle blanket (like the ones they use in the hospital, not those gigantic fancy things that you need 4 people just to fold), and loosely wrap the baby so you will have easy access to all of their limbs once they are in the tub.
  • Put your swaddled baby in the tub, getting the blanket completely wet with the warm water. Unwrap one limb at a time to wash, then wrap it back up, and proceed to the next. Wash their head last (right before you take them out of the tub), since this is where they lose the most heat.
  • Remember to NEVER leave your baby unattended in the tub.
Check for Stress:
One of the most important cues to be mindful of, as I mentioned above, is when your baby is overstimulated. The reason this one is so important, is because it can cause a domino effect of distress. The longer your baby is overstimulated, the longer it could potentially take to calm them down. Additionally, if your baby is fussy and crying, they could be sucking in a lot of air, which can contribute to gas. Always be mindful of loud noises, bright lights, and any strong fragrances. Be careful with scratchy clothing or blankets as well. If you start to notice your baby giving you their stress signals – change in breathing pattern, coloring, wide spreading of the fingers, frowning, hiccuping, or frantic movements – it’s time to disengage. Do your best to minimize the stressors so your baby can relax. Taking a few deep breaths yourself will also help soothe your baby, signaling to them that everything is okay.
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Related posts:

First Years Lesson: “Quarantine Cuisine” First Years Lesson: ” Picking Yourself Back Up” First Years Lesson: “Shhh, It’ll Be Ok!” First Years Lesson: The “Miracles” of Motherhood
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