Minimal Stimulation
If your baby is born less than 30 weeks, the first 72 hours of your baby’s life is very important! There are many risks for premature infants, and it is important we do everything we can to support your baby. One risk is bleeding in the brain, or intraventricular hemorrhage. This occurs because there are delicate blood vessels in their brains that are at a greater risk of bleeding. The risk is greatest in their first 3 days after birth, and up to a week of life. There are many factors that increase risks for bleeding, some we have no control over. However, one thing we can do is decrease the number of negative stimulation that babies are exposed to, especially early on, but also ongoing. This is why we provide ‘minimal stimulation’ care in the first 72 hours, and then beyond.
This means:
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Keeping the room DARK and QUIET!!
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Please speak just above a whisper and parents, please, sing or talk very quietly to me
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Keeping the HOB elevated 10-30°, but no higher
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Keeping baby’s nose in-line with their belly button at all times
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Keeping babies on their back or side, not on their belly’s yet
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If baby is doing fine, we do cares (when we asses, care for and feed your baby) every 6 hours – but it is ok to intervene if they need something inside the 6 hours
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We ‘cluster’ care, or provide care with many team members at the same time
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TWO person cares to keep babies feeling contained and safe- this means someone is always supporting the infant with facilitated tucking, or hang-hugging
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Limit the amount of negative stimulation – allow positive/good stimulation around cares (massage, OT involvement, parent involvement- always good!)
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Please log roll or slip diapers under babies for diaper changes - No leg lifts!
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Other procedures or care that is not necessary is delayed- bed and linen changes, we decrease the number of lab draws if we can
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If babies don’t have an umbilical arterial line, skin-to-skin or kangaroo care is great for your baby. (See family integrated care lesson in the family integrated care tab). We try to keep them in midline positioning for this.
Minimal Negative Stimulation
When your baby is 23-25 weeks, they are still very fragile and continue to benefit from many of the developmentally focused restrictions used during the 1st 72 hours.
Beyond 72 hours, we also focus on:
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Light: Dark Shade down
Giraffe Cover
Avoid direct light in eyes - Eye shields with cares
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Sound: Soft voices
Heartbeat/Ocean Sound machine (30 minutes max)
Parents Heartbeat with Kangaroo Time
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Touch: Slow and gentle handling during 2 person cares
Midline and flexed positioning
Hand Hugging and containment by parents
Avoid stroking, rubbing, or patting
- Gentle massage by parents after teaching from Occupational Therapy
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Temperature: High humidity with porthole covers
Air Curtain Button during cares
Heated and humidified oxygen
Hat and warm blanket with Kangaroo Time
Warm objects before touching infant
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Taste: Provide mother’s milk swabs as available
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Smell: Parent scented bonding blankets
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Positioning: Maintain modified midline head position (head turns <45 degrees side to side)
Avoid neck hyper-extension/flexion
Maintain flexed, tucked, aligned position with hands at midline and shoulders flexed forward
Utilize appropriate developmental aids and provide boundaries
Log roll diaper changes
Avoid leg flexion >90 degrees at hip joint
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Care times: Individualized by care team to every 4 hours or every 6 hours with every 3 hour feeds.
Skin to skin always great for your infant!