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Before Your Baby Is Born

• Your baby is gaining weight.

• Body muscle and fat are increasing.

• Eyes open and close.

• Bones are fully developed but are soft and flexible.

• 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. Natural skin color will develop over the next four weeks.

• The ears are very soft and bend easily.

• You will see soft, fine hair that covers the body. In some areas it may be very dark. This is called lanugo.

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Tone and Posture

• Muscle tone is improving.

• Arms and legs are slightly bent.

• The muscles in the legs will develop strength first. Your baby will attempt to pull legs up toward the stomach.

• Baby’s head will fall back unless supported.

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Movement

• Nerves are not fully developed.

• Movements are not smooth at this time. You may notice shaky or jerky movements.

• Your baby is able to open and close hands.

• Your baby is able to maintain a grip for a short period of time.

• Planned movement is first seen in your baby’s legs.

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Vision

• Blinks or closes eyes tightly from light.

• Has poor control of eye movements. Eye movements may be jerky.

• Eyes may appear to be crossed.

• By 29 weeks, your baby may be able to focus on an object and follow it.

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Hearing

• Your baby is unable to turn his or her head toward sound.

• Your baby easily startles with loud noises.

• Loud noises are stressful to the baby.

• Soothing sounds help the baby to calm. He or she may stop moving, open mouth or widen eyes.

• Your baby knows the sound of your voice and calms when he/she hears you speak.

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Feeding

• Your baby may be able to suck and swallow, but it will be slow and awkward.

• Sucking can maker your baby tired.

• Swallowing is irregular.

• Gag reflex is not fully developed.

• Babies at this age are still fed by a tube that goes through the nose or mouth to the stomach.

• Your baby may benefit from non-nutritive sucking at the breast or with a pacifier.

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Touching

• A gentle touch may cause your baby to move and awaken.

• Your baby may be awake for several minutes at a time.

• Your baby may be able to tolerate longer periods of touching without becoming stressed or upset.

• Painful procedures or stimulation will cause your baby to pull away and cry.

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Behavior

• At 28 weeks, your baby sleeps most of the time. As each week passes, the periods of alertness increase.

• Your baby is able to focus on something for 30 to 60 seconds.

• Your baby may become upset if he/she has too much activity.

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Things to Do For Your Baby

• Learn what normal behavior is for your baby and what causes your baby to be stressed.

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

• 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 isolette. 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 your 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.

• Support your baby’s head while holding.

• Hold your baby wrapped in a blanket or skin-to-skin (kangaroo care). This is when mom or dad holds the baby on their chest, with the baby’s skin next to theirs.

• Touch your baby with a firm caress rather than soft stroking movements.

• Have the nurse instruct you on bathing techniques for your baby.

• Once your baby can open his/her eyes, allow him/her quiet time to just focus. Babies have a hard time handling several things going on at a time, such as talking, looking around and being touched. Your baby can become very tired just trying to focus on you or an object.

• Shield your baby’s eyes from bright lights.

• If possible have your baby look at your face.

• Bring in a blanket or afghan from home to cover your baby’s incubator. Your baby needs to be in a dark environment when sleeping and have periods of light during awake times.

• Talk or read to your baby in a low quiet voice for short periods of time.

• Offer a pacifier during tube feedings if you notice your baby making sucking movements.

• Your baby needs sleep in order to grow.

• Use only one form of interaction at a time with your baby, like speaking softly, rocking, or touching.

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"I’m Overwhelmed" Behaviors (see "I’m Overwhelmed" Behaviors Section)

Minimal stimulation is best at this age. These behaviors may mean your baby is stressed or upset and needs rest.

• Change in breathing patterns, heart rate or color.

• A worried facial expression

•  Frowning/grimacing

• Limp posture

• Looking away from you

• Flailing arms or legs

• Squirming

• Tremors or startles

• Spreading fingers apart (splaying)

• Yawning

• Crying/Fussing

• Arching back and neck

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"I'm Ready" Behaviors (see "I’m Ready" Behaviors Section)

Babies born at this age are capable of brief periods of social contact. These behaviors may mean your baby is ready to interact.

• Relaxed arms, legs and facial expression.

• Sucking on fingers or hands.

• Awake and quiet with bright, shiny eyes.

• Focused attention (looking).

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