Developmental Wednesday #6

Reading your baby's signs/cues

Preemies can easily become stressed or overstimulated - especially when they are in a new environment or surrounded by a lot of people (familiar or unfamiliar). Once you recognize your own preemie's signs of stress and over stimulation, you can help him/her calm down and reorganize. For example, our daughter gets over stimulated in large crowds and when she does she simply stares at everything with no expression and breathes with her mouth open. Being able to help your preemie calm down, can go along way towards helping him/her interact better.

If your preemie is getting overstimulated or stressed, he/she may:

• Turn his/her body or face away from you
• Arch his/her neck and back
• Cry or fuss more than usual
• Start having rapid-shallow breathing
• Avoid looking at you or shut his/her eyes
• Spit up
• Hiccup and then cough
• Change color
• Straighten his/her arms out to the side
• Withdraw

You can try one of the following techniques (or something that works for your preemie) to try and help him/her reorganize and calm down. Note the emphasis on trying one technique - you don't want to further stimulate your preemie by doing several things at once. This is an important thing to talk about with family or other caregivers. People tend to naturally talk to a baby, while they rock them and smile or look at them. This can often be too much for a preemie. It's a hard concept to learn but easy to fix once people are aware of the situation.

• Give your preemie some quiet time - put your preemie in his/her crib or just let your preemie play by him/herself. Don't force any toys or other noises on your preemie - he/she just needs time to relax and reorganize.
• Place your hand on his/her chest
• Talk to him in a soft voice
• Gently rock him/her in a cradled position
• Let him/her suck on his/her hand, your finger, or a pacifier
• Stay quiet and look away from him/her - sometimes eye contact is too much for a preemie
• Hold your preemie's hands so he/she is grasping your thumbs and slowly bring his/her arms folded close to his/her chest
• Change your preemie's position - if he/she is on his/her tummy, put him/her on his/her back or vice versa.
• Just like in the NICU, place one hand on his/her head and the other at his/his feet to help get him/her into a "tuck" position

Tip: if you're with a group of people who just "don't get it" when it comes to the issue of over stimulation or you need to try and quickly help your preemie before a full on melt down you can: tell people you want to check his/her diaper and then go somewhere quiet to help your preemie, say that you need some mommy time with your little one and gently take your preemie back to help him/her calm down, tell them he/she looks tired and needs to rest. Anything that works for you!

Once you start to recognize the signs of stress and over stimulation in your preemie, you can quickly try and help your preemie with whatever technique works best for him/her.