Sleepy premature babies

What can I do for my sleepy premature baby?

Premature babies do best when they are in conditions that re-create those in the uterus. When their situation is changed, they can be stressed and may look worried, feed poorly, have abnormal breathing and heart rates, or shut down and go to sleep. This can be harmful. Speak softly near premature babies, keep them away from windows and overhead lights, and move slowly with them, holding them with steady pressure. They like to be curled, not stretched, and need plenty of physical support to allow them to relax and breastfeed. Many stresses can be reduced or eliminated by breastfeeding and having the baby in skin-to-skin care.

A) Signs of stress

Premature babies are easily stressed and if severe, can be harmful in the long term. Premature babies who are stressed may:

  • Scowl or look worried.
  • Breastfeed poorly. 
  • Have abnormal breathing and heart rates.
  • Shut down and go to sleep.

B) Causes of stress and possible solutions

Premature babies do best when they are in conditions that re-create those in the uterus. When their situation is changed, they can be stressed by any of the following:

  • Noise: Even regular speaking voices may be too loud for some premature babies (Pike 2017).
  • Light: As their eyes are still underdeveloped, keep babies away from windows, overhead lights and glare.
  • Movement: Move slowly with the baby and avoid tapping or light touches. The best touch is steady pressure.
  • Positioning: They dislike being stretched out and prefer being curled up in a bit of a ball as they were in the uterus.
  • Positioning at the breast: Premature babies are not strong and tire quickly. They need a lot of physical support to allow them to relax and breastfeed.
  • Heat and cold: The best way to keep them at the right temperature is in skin-to-skin care.

Premature babies may shut down when handled too much. One study (Pereira 2013) of babies in a neonatal intensive care unit found they were handled an average of 38 times a day. Premature babies also undergo many painful procedures, further adding to stress.

Many of these stresses can be reduced or eliminated by breastfeeding and having the baby in skin-to-skin care and using kangaroo mother care.

References

Pereira FL, Nogueira de Góes Fdos S, et al. [Handling of preterm infants in a neonatal intensive care unit]. [Article in Portuguese] Rev Esc Enferm USP. 2013 Dec;47(6):1272-8
 
Pike M, Kritzinger A, Krüger E. Breastfeeding Characteristics of Late-Preterm Infants in a Kangaroo Mother Care Unit. Breastfeed Med. 2017 Sep 20