Born in week 36-42
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 brain is constantly developing. Most brain cells are in place and all the connections and pathways are being developed and refined. The brain continues to develop rapidly up to the age of two. Vision is the last sense to mature and will continue to mature even after 40 weeks. The baby can see fine up close, at a distance of 20-30 cm. The calm, still face of a parent is the best thing for a baby to see. Patterns and strong colours may be overstimulating for the baby. The baby will be able to recognise familiar sounds and starts to ignore noises that previously would disturb its sleep. At 40 weeks, the baby is able to detect moods by tone of voice.
The baby has some control over its movements and has the ability to curl up and bring its hands to its mouth. The baby has the energy to move its arms and legs forcefully and can grasp things by themselves. It can lift its head and hold it up by itself for short periods.
The baby now has more distinct periods of sleep and wakefulness, but still has some rapid transitions between sleep and wakefulness, and may require help to settle down and fall asleep. The baby is able to be awake for longer periods and may show more interest in being with its parents.
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 somewhat immature, care is focused on maintaining a calm environment. The baby is cared for in a sleeping pod, specially designed to provide support. To minimise any disruptions, care is meticulously planned.
Some babies require extra respiratory support for a period, such as a CPAP (Continuous Positive Airway Pressure). The baby may have imbalances in the regulation of heart rate and breathing.
Initially, nutrition may be provided in the form of nutritional solutions delivered intravenously. Some babies are given a small amount of feed through a feeding tube that is inserted through the nose and which goes down to the stomach, while others may be fed orally through breastfeeding, cup feeding or a bottle. This is a decision made by the staff and depends on what the baby is capable of and what you want as parents.
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, provided by the hospital. 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. The baby starts to take an interest in its surroundings and you can provide a calm, personalised and harmonious environment around the baby, in order to facilitate sleep and to help it cope with being awake. Many babies are able to stay awake and interact if their body is supported in a comfortable position. Speak in gentle tones or sing quietly to your baby. The baby will recognize your voice. 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.
Author: Tullikki Stendahl, RN