Before Your Baby is Born

• Your baby is thin with no fat.

• Breathing and swallowing movements are present.

• Eyes may not be open.

• Bones are soft and joints are movable.

• Lungs and nerves are immature.

• Babies born this early will need special care in the NICU to survive.

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Appearance

• Babies at this age have red skin color, regardless of ethnic background.

• Skin looks wet, shiny and sticky.

• Skin is see-through. You might be able to see tiny veins just below the surface of the skin.

• Eye lids may not be open yet.

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Tone & Posture

• Muscles are present and weak.

• Arms and legs are floppy and are extended, not pulled up tight toward the belly.

• Nerves are not fully developed.

• Your baby may be able to lightly grip your finger.

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Vision

• Some babies are unable to open their eyelids at this time.

• Eyelids will usually open within 1-3 weeks.

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Hearing

• Babies can hear and often know their parents’ voices.

• Loud noises are stressful.

• Babies will calm to the sound of their mother’s voice.

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Feeding

• Sucking and swallowing are present but weak.

• Gag reflex is not fully developed.

• Your baby will get most or all food from IV fluids called TPN.

• When breast milk or formula is started, it will be given through a tube that goes through the nose or mouth into the stomach.

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Touching

• Touching may be stressful.

• When upset, some babies have changes in color, heart rate or breathing. These may be "I'm overwhelmed" signals for your baby.

• Your nurse will teach you to look for the different "I'm overwhelmed" signals.

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Behavior

• Before 28 weeks, it is hard to tell when your baby is awake.

• Your baby may not move around much at all and sleeps most of the time.

• It’s important to allow your baby to have uninterrupted sleep.

• It may be hard to wake your baby.

• Light and noise may easily upset your baby.

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Things To Do For Your Baby

• Know that your baby can only tolerate a small amount of touching at this time.

• Learn how to lay your baby in comfortable positions.

• Learn how to keep your baby nested in the fetal position. This means bringing your baby’s legs and arms close to his/her stomach and chest.

• Position your baby’s hand up close to his/her mouth or face whenever possible.

• Know that moving makes your baby tired.

• Learn about kangaroo care. This is when mom or dad holds the baby on their chest with the baby’s skin next to theirs.

• Know that your baby needs a lot of sleep to grow and gain weight.

• Know that it is very important for your baby to hear your voice.

• Talk to your baby in a soft voice.

• Know that even if your baby’s eyes are open, they are not able to see anything yet.

• Know that your baby cannot maintain eye contact, smile or coo at this time.

• Bring in a blanket or afghan from home to cover your baby’s isolette. Your baby needs to be in a dark environment just like he/she was when they were inside of you.

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"I'm Overwhelmed" Behaviors

(see "I'm Overwhelmed" section)

• Minimal stimulation or minimal handling is best at this age. Babies born at this early are not old enough for social contact. These behaviors may let you know when your baby is stressed and needs a rest.

• Change in breathing pattern (sometimes breaths faster and harder) or stops breathing.

• Change in heart rate (sometimes becomes faster or slows down).

• Change in color (pale, bluish).

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