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Development at

26-28 Weeks

Before Your Baby Is Born

  • Your baby is thin with very little fat.

  • Muscles are present but are very weak.

  • Breathing and swallowing movements are present.

  • Eyelids are partially open.

  • The skin begins to thicken on hands and feet, forming footprints and fingerprints.

  • Bones are soft and joints are moveable.

  • Lungs and nerves are immature.

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

Appearance

  • Babies at this age have red skin color, regardless of ethnic background. Natural skin color will develop over the next six weeks.

  • The skin is almost see-through. Tiny veins are visible just below the surface of the skin.

  • Facial features are developed.

  • Visible, soft, fine hair cover the body. This is called lanugo (la-nu-go).

Tone and Posture

  • Your baby is flexible and limp.

  • If arms and legs are lifted and released, they flop to the bed surface.

  • Your baby needs to have the head and body supported at all times.

Movement

  • Nerves are not fully developed.

  • Movement of the arms and legs is not smooth at this time.

  • You will notice shaky or jerky movements.

  • If you place your finger in your baby’s palm, he/she may grip your finger for a few seconds.

  • Your baby tires easily from moving around a lot.

Vision

  • Can open up the eyes and blink, but is unable to focus.

  • Closes eyes tightly in bright lights.

Hearing

  • Hears and knows parents’ voice.

  • Loud noises are stressful.

  • Mother’s voice is calming and may cause the baby to stop moving, open mouth or widen eyes.

Feeding

  • Sucking and swallowing are present but weak.

  • Gag reflux is not fully developed.

  • Your baby will get some or all of his/her nutrition 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 down into the stomach since the baby is too small to breast-feed or take a bottle.

Touching

  • Too much touching can be stressful to your baby, or cause him/her to tire out.

  • Your baby will only be able to stay awake for a few seconds at a time.

Behavior

  • Your baby is a light sleeper and therefore is more sensitive to noise, light and handling.

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

  • Your baby sleeps almost 100 percent of the time.

  • When your baby is in deep sleep, it may be hard to wake him. It’s important to allow your baby to have undisturbed sleep.

  • Your baby may be irritable when awake.

  • When your baby is stressed or becomes upset, you may notice jerky movements, changes in color, heart rate or breathing.

Things To Do For Your Baby

  • Learn what normal behavior is for your baby.

  • Learn the cues that your baby gives you when he/she is ready to interact. These cues are called "I'm Ready" Behaviors (see "I'm Ready" Behaviors section).

  • Discover the type of touch that soothes and comforts your baby.

  • Learn how to lay your baby in comfortable positions.

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

  • Learn how to nest your baby in the incubator. This is called containment/ cradling. It is done by loosely wrapping your baby in a blanket and placing rolls completely around his/her body. This gives the baby boundaries on all sides and helps him/her stay in a tucked position.

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

  • Know that moving and handling your baby makes him/her tired.

  • Allow your baby to have periods of undisturbed sleep.

  • It is important for your baby to hear your voice.

  • Talk to your baby in a soft voice.

  • Learn to read your baby’s cues that signal that he/she is stressed out and needs a rest.

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

  • Bring in a blanket or afghan from home to cover your baby’s incubator. Your baby needs to be in a dark environment just like when the baby was inside of you.

 

"I'm Overwhelmed" Behaviors

(see "I'm Overwhelmed" Behaviors section)

Minimal stimulation or minimal handling is best at this age. Babies born at this age are not old enough for social contact. These behaviors may mean that your baby is stressed and needs a rest.

  • Change in breathing pattern, heart rate, and/or color.

  • Frowning or grimacing.

  • Flailing arms or legs, or spreading fingers out wide (splaying).

  • Crying and fussing.

  • Yawning.

  • Arching back and neck.

  • Squirming.

  • Frantic movements.

© 2017 SCL Health, Saint Joseph Hospital NICU, Denver

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