Born in week 28-31
Keep in mind that each baby develops differently. The level of development can vary depending on whether the baby was born during this period of pregnancy or if the baby was born earlier.
The brain is constantly developing and an insulating myelin sheath is now forming around the neurons, enabling impulses to be sent rapidly between cells. This begins slowly, and then accelerates at the time the baby was due to be born. The pace of development in the brain is irregular, but now starts occurring in cycles when the baby is in REM sleep (REM – Rapid Eye Movement). Dream sleep is important to developing the senses and deep sleep is important to learning ability. The baby is most acutely aware of low-frequency sounds and can distinguish between male and female voices. The eye reflex is immature and unable to fully regulate the amount of light hitting the retina. The baby can distinguish between sweet and sour tastes.
The baby's movement patterns are still expansive and jerky, and frequently occur in repeated patterns that the baby may have difficulty controlling. Attempts are made at self-comforting activities such as bringing its hand closer to its mouth, sucking on a dummy or holding something as the baby is now able to grasp with its fingers and toes. You can discern a pattern of periods of sleep and wakefulness. During sleep, you see rapid eye movements under its eyelids.
During the first weeks of life, some babies will need care in an incubator with warm air and a high level of humidity in order to maintain their body temperature. Normal body temperature is crucial for the baby's well-being, growth and development. As the brain is still immature, care is focused on maintaining a quiet, calm and dark environment. The baby is cared for in a sleeping pod, specially designed to provide support. To minimise any disruptions, care is meticulously planned.
As the lungs are immature, some form of respiratory support is required in order for the baby to breathe efficiently and deeply. Babies are often able to regulate their breathing using a CPAP (Continuous Positive Airway Pressure). The baby may have imbalances in the regulation of heart rate and breathing.
During the first week, some babies may require repeated light therapy due to their immature liver.
The baby's nutrients are primarily supplied through IV nutrition. The baby can often be given a small amount of food using a feeding tube that is inserted through its nose and which goes down to its stomach. When the baby feels well and is awake it can be given small amounts of feed orally. As the baby grows and matures, it can be fed orally and will no longer need IV nutrition.
Due to its thin skin and immature immune system, there is an increased risk of infection.
Depending on the baby's maturity (the week in which the baby was born) it may now be time to move it from the incubator to a heated cot. A heated cot has a temperature-controlled water mattress with a canopy to protect the baby from the light. When the baby lies in a heated cot, it wears a top provided by the hospital.
What can I do, as a parent?
Spend as much time as possible with your baby and participate in its care so you have a chance to get to know one another. At that age, babies are very sensitive to all forms of sensory input. They interact very little with their surroundings, but are helped by a calm and harmonious environment, and by the fact that everything is done very slowly with several breaks, and preferably using one stimulus or sensory input at a time. You can therefore hold your baby with soft, warm and still hands, applying mild, gentle pressure. Help the baby to adopt and maintain a comfortable position with its arms and legs held in towards its body with its hands near its mouth or face. From its time in the womb, the baby is used to having a boundary around itself. Speak in soft tones or sing quietly to your baby. The baby will recognise your voice. Holding a hand over its eyes to shade them may help the baby to look up. Let the baby have a piece of cloth with your smell on it close to its face.
As soon as your baby has stabilised it can come out of the incubator to be held skin to skin against your chest, as this has a range of positive effects on the baby's development and well-being. It may help the baby to stabilise its breathing, heart rate, body temperature and digestion. It also releases "feel-good" hormones in both you and your baby. The staff will help you put the baby in a good position so that you are able to enjoy some time together.
After giving birth, you can begin to stimulate your breasts to produce milk. The first energy-rich drops of breast milk (colostrum) can be given straight into the baby's mouth upon consultation with the staff. When you have started to produce milk you can make a habit of producing a small portion of fresh milk to give to your baby when it is awake.
Learn the ward's hygiene procedures to help prevent infection. Avoid strong scents, such as perfume, and let the hand disinfectant dry properly before holding your baby.
We would like you to participate in the daily ward round and tell us about your baby, and plan its care together with the medical team.