Baby Massage: Premature babies

As you will realise there are degrees of prematurity. Extremely premature babies (ie under 28 weeks gestation) stay in hospital neonatal units for a long time and the experience is tough both for them and their families, sometimes with long term implications. Even being born between 28 and 32 weeks gestation can mean a long stay in hospital with quite a lot of medical support. Most babies born under 36 weeks gestation will spend at least their first week in hospital and in any event will be more delicate and vulnerable than babies born on or around their due date.

It is sometimes suggested that the time to start massage with your prem. baby is when they reach their ‘due’ date (the time they were expected if they had been born at term). However individual assessment in conjunction with your baby’s health care professionals will be the most helpful way to decide.

Babies have a very keen sense of smell, hearing and touch. Premature babies, even more than new babies born at term, need a lot of sleep and they have an extra need to feel secure – often wanting to be supported in a womb-like environment in a fetal or semi fetal position.Their nervous systems are not fully developed and are very sensitive so stimulus (eg bright lights, loud noise and handling) is best kept to a minimum.

For this reason ‘containing’ holds can be an ideal way to give nurturing touch. * See pictures of embracing holds in ‘Illustrated Baby Massage Guide’ for some ideas. Containing holds can either be done with your baby still in the incubator or in your arms. What is even more beneficial for you both is skin to skin contact (eg your baby has minimal clothing and tucked inside your shirt, next to your skin).

Parents with premature babies being cared for in neonatal units need to liase with the health professionals caring for their baby and see what may be possible.

Suggestions for what may be possible in the NICU:

• Provide props that your baby can have in the incubator or cot to help them feel cosy and secure (eg small soft toys they can rest against, small soft blankets that can be rolled and placed to support specific positions in conjunction with nursing approach, a soft blanket or cot sheet that smells of you).
• Make yourself comfortable and sit by your baby if it is not possible for them to come out of their incubator for a cuddle. Relax and read your current novel but read it quietly out loud so your baby is comforted by the flow of your voice without needing to react in any way.
• If you can’t hold your baby, hold them where they lie. Wrap one hand gently but firmly around the crown of their head and fold the other over their tummy, or around their buttocks or legs and be still with them. Feel them settle and relax a little more deeply into peace and/or sleep. Don’t take your hands away too soon. Be with them in that settled state so that when you do let go they are deeply enough relaxed or asleep to be able to stay that way themselves for a while.
• Even with tubes or lines still attached you may be able to hold your baby, even skin to skin.
  Make sure you have plenty of time just to sit quietly holding your baby so neither of you feel rushed. The more your baby is able to settle in one position with you and just sense you through your smell and feel your breathing and your heartbeat, the more they will feel secure and loved and the more their nervous system has a chance of calming and regulating. This unhurried form of touch is not only comforting for both of you but may enhance the journey to wholeness that can be so difficult with an early start in life.
• When you and the health care professionals feel your baby is mature enough to accept some simple massage strokes start with the legs and feet. Be slow and gentle but firm enough for your baby to feel secure. (Refer to ’Massaging Your Newborn Baby for further guidance. You will also find information there about ways babies tell us if they are feeling stressed or comfortable with what we are doing. Stress signals are our prompt to stop.
  Comfort signals tell us this is a good time for massage).
• Consider enlisting some extra guidance and support from a trained Infant Massage Instructor.
  You can look for one in your area by going to www.nz.iaim.net for New Zealand and www.iaim.com.au for Australia.

For more information see Baby Massage or Baby Care

Contributed by Anne White
Nurse, Massage Therapist, IAIM trained Infant Massage Instructor