Having a baby who is born prematurely can be very distressing. Parents can have a range of emotions which include shock, denial, guilt, fear, anxiety, anger and helplessness. If your baby is in an incubator, there may be little opportunity for skin-to-skin contact or eye contact. Pre-term babies in neonatal units are handled frequently as part of their essential medical and nursing care and often find this type of touch disturbing and distressing. Gentle touch and holding techniques are a way of giving love and comfort to a pre-term infant and can help parents get to know their baby.
Bonding With Your Baby
Being There
As soon as you can, talk or sing to your baby. Babies find it reassuring to hear their parents’ voices – their mothers’ voices in particular. It has been found that term babies turn towards their mother’s voice in preference to a stranger’s when only a few days old. Even if your baby appears not to respond, he will feel comforted and soothed by your voice. This is especially helpful to his well-being and the process of bonding if he is in an incubator.
Still Touch
Premature babies should not be massaged initially. Instead, parents should use a technique known as still touch or resting hands. This is a gentle touch, with the whole hand placed on an area of your baby’s body that you feel comfortable with touching, such as his back, head, arm or leg. This touch may be the first chance you have to be close to your baby. See it as an opportunity to send your love to him. Choose a time when he is awake, calm and alert. Place one or two hands on the chosen area and ask your baby if you can touch him before you do.
Observing Reactions
Watch your baby to gauge his reaction to this touch. He will show you, by his actions and facial expressions, whether or not he is enjoying the experience, which will help you understand what level of touch he is able to manage at this time. Keep a constant watch for stress cues and no cues. These indicate that he is becoming over-stimulated, tired or distressed. As soon as you see any signs that tell you he has had enough, stop. You can try again the next time you notice he is awake, calm and alert. Before using still touch or massage on your baby, talk to the nursing and medical staff about what you intend to do.
Beginning Massage
It is important to wait until your baby is ready for massage before moving on from still touch. This may be while he is still in the hospital, or you may wait until you take him home. When you do start, begin very slowly, with just one new stroke at a time. You may like to sit on a chair and massage your baby on your lap. Ensure that the massage strokes you use are smaller and gentler than those you might use for a term baby. For instance, use two or three fingers rather than the whole hand. The touch needs to be gentle but firm – too light a touch may be unpleasant and over-stimulating. Before you start the massage warm some oil in your hands. For each new body part, begin by placing your hand on that area and ask your baby if you can massage him. After each stroke, stop and observe how he reacts to it. Watch out for stress cues and no cues. If he cries, use still hands to offer comfort and reassurance. If you respond to his cues and start a little at a time, the massage programme will build up and your baby will soon anticipate and enjoy the massage.
When Not to Massage
Massage or touch techniques can be used to soothe and relax most premature infants. However, when you are using touch with your baby it is important that you watch his reactions, especially if he is in an incubator. You should stop the massage immediately if:
- your baby’s colour changes
- he vomits
- his breathing becomes more rapid or stops
- his muscles become tense
- his pulse rate increases or becomes slow.
If any of these changes occur, inform the medical or nursing staff straight away or contact your doctor.
First Massage
Massage your baby on your lap once he is well enough. Begin by massaging the part of his body you feel most comfortable with touching and which you feel he will most enjoy. Use two or three fingers to massage a premature baby, with firm but gentle strokes. Observe your baby and gauge his reaction to each stroke.
Avoiding Over Stimulation
It is important that you do not over-stimulate your premature baby with touch or massage. Observe him throughout still touch or massage to watch for when he has had enough. He will have his way of telling you that he is becoming distressed by the massage by using a `stress’ cue, or that he wants the massage to stop by using a `no’ cue, so that he can rest or sleep, for example. Signs may include:
- yawning sneezing
- hiccupping
- avoiding eye contact
- raising his hand or placing it in front of his face
- having an increased or decreased heart rate
- breathing too fast
- not breathing for periods of time.
Notice if your baby tends to use particular stress cues or no cues more than others. Learn to pick up these communications from him and respond to them. By doing so, you will improve both his well-being (by providing him with what he needs in that moment) and your relationship with him
Gentle Holds
Holding your baby’s hand, arm or leg is the ideal physical interaction for a premature baby. Wrap your hands carefully around the hand or limb and simply hold it for as long as your baby is happy with the touch. This gentle communication lets him know that you care for him and provides him with love and security.
Limiting Stimulation
Although, ideally, it would be lovely to talk or sing to your baby, make eye contact and touch him all at once, he may be able to deal with only one of these forms of stimulation at a time, especially during the early days or weeks. Limit the amount of stimulation he receives at any one time to begin with. Either talk to him or make eye contact with him. If he seems happy with this it may be appropriate to move on to still touch, always watching for his reaction. In this way, progress slowly towards massage. Assess his surroundings – are his senses being over-stimulated by his environment? Is the room too noisy or bright? If he is in an incubator, put a towel over part of it to limit the amount of light shining on him. Once noise is reduced to a minimum and the lighting is dimmed, he may be more able to accept interactions with you.
Benefits of Massage and Still Touch for Premature Infants
Perhaps the most important benefit of still touch and massage for your premature baby is that it helps you both to bond. This is especially helpful if your baby has spent the first days of his life in an incubator. You can give him love, comfort and reassurance through your voice and gentle touch. Massage can also:
- have a calming and soothing effect
- help to improve weight gain
- enhance growth and development
- encourage greater responsiveness
- improve digestion and metabolism
reduce pain by stimulating the production of endorphins, the body’s natural pain killers.
Loving Touch
If your baby does not respond positively to massage, there are other ways giving him love and comfort. Cuddles and soft words will bring you closer together.
This information has been sourced from the Huggies website and originates from Baby Massage by Dr Alan Heath & Nicki Bainbridge