Born in week 32-35
Remember 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 development of the brain and the creation of cells and cell connections is constantly ongoing. Around week 34, the baby's brain is around two thirds of the size of a full-term baby's brain. At the same time, the pupil has developed sufficiently to respond to light by contracting. The eye lids have grown thicker to protect the eye. The ability to combine breathing, sucking and swallowing has started to develop. The baby now prefers sweet flavours.
The baby's movement patterns can still be expansive and jerky. The baby can grab things by itself, raise its head and is becoming more and more mobile. If there is too much stimulation in its surroundings, the baby may start to fret as it now has enough energy to object by flailing its arms and legs. Now the baby starts to make eye contact for short periods by looking up at its parents.
You can start to see a clearer pattern of sleep and wakefulness. During sleep, you can see rapid eye movements under its eyelids. The baby still mainly strives to sleep, in order to grow and develop. The baby sleeps approximately 80-90% of a 24 hour day.
During the first weeks of life, some babies will require a heated cot with a temperature-controlled water mattress in order to maintain their body temperature. Normal body temperature is crucial for the baby's well-being, growth and development. The heated cot has a canopy to protect the baby from bright light. As the brain is still immature, care is focused on maintaining a quiet and calm 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 somewhat immature, some form of respiratory support is required in order for the baby to breathe efficiently and deeply. CPAP (Continuous Positive Airway Pressure) may be needed for a limited time to support the baby's breathing. 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.
Initially, the baby's nutrients may be supplied through IV nutrition. The baby can often be given a small amount of feed 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.
Depending on the maturity of the baby (the week in which it was born and the maturity reached) it may be time to move it from a heated cot to a regular cot with a canopy to protect it from the light. When the baby lies in a regular cot, it also needs to wear a top, which the hospital can lend you. It may also be time for you to stay together in a family room on the ward.
What can I do, as a parent?
You and your baby will benefit from spending as much time as possible together. Plan your time around participating in feeding your baby, change its nappies, and washing or weighing it, so you can be there and care for your baby together with the staff and get to know your baby as it develops. At that age, babies are a little sensitive to all forms of sensory input. They interact very little with their surroundings, but are helped by a calm and harmonious environment, by doing everything very slowly and by incorporating regular breaks. 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. 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. The human face is the best visual stimulus for a small baby. 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 may be picked up and held skin to skin against your chest. Try to find as much time as possible to hold your baby skin-to-skin 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. The ward has several baby carriers, ask the staff which of these may be appropriate for your family.
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.
It is now important for the baby to learn to eat and to continue to grow. Besides tube feeding, it may now be time to start lying next to its mother's breast to learn to breastfeed, or a bottle can be introduced. The ward has a breastfeeding consultant to provide extra support if required.
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.