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Developmental Care: Overstimulation and Your Premature Baby

By Maren Peterson-DeGroff

Preemies come into the world and to a lot of handling and procedures and stimulus before their neurological system is matured. In the NICU they try to block out stimulus somewhat. But it is impossible, really, with all they have to do to keep them alive and healthy. As a parent the best thing you can do for your child is to pay attention to her cues that she is overstimulated. At first the baby will avert their eyes from you if the stimulation is getting to be too much. (My son, Gabe would avert his eyes if there was more than one face before him, or if the face was too animated -- it was just too stimulating.) They might just close their eyes and try to go to sleep to block it out. Then the baby will start to stick out their toungue as an aversion response, then yawning, and finally start to show agitation in their bodies, arching her back, squirming to get away, fussing, crying, etc.

The trick is to really pay attention and then respond to their signal by reducing stimulus. If you are rocking, patting and singing to your child in a brightly lit room with the TV or radio on and she seems to become more agitated, then stop and recognize all the stimulus in her environment. You could first turn down the lights or stop the singing. You can try a soft repetitive sound, "bababa" that might be more rythmic and soothing. If she is still agitated, crying and arching her back, then stop the patting, etc. until you find the "just right" amount of stimulus from you. Some babies are used to the noise and lights of the NICU, and this is comforting to them. In this case the lights and TV might be good, but the physical patting and rocking might be too much. You will have to experiment and look for the signs. Let her lead you.

Babies who don't have mature neural systems are "disorganized." They can't synthesize all the sensations and stimulus they are receiving, and they need help to get organized. The first thing a full term baby does naturally is to put their hands together in front of their body, to their "center line", to organize. If your child isn't doing this, help her, gently hold her hands together. (I used to do this for Gabe in the NICU when a lot was going on or he was agitated or in pain.) Babies also suck on their hands; you can bring her hands to her mouth if she doesn't on her own. This is calming and organizing. This work to organize is important to the brain development, so your job is to help give her an environment that will allow her to do the work, create the neural pathways in her brain that will be the building blocks for later complex activity. That center line is key to later on development, so help her find it.

Full term babies in the womb also spend a lot of time curled up in a ball, legs and arms tucked in. They try to simulate that in the isolette, but it is really hard. If your child is agitated, you can put her on her tummy on your shoulder, and help get her legs and arms tucked, hand in mouth, maybe wrapped in a blanket, and put one hand on top of her head and one on her bottom. This is a containment that is somewhat like the womb. Babies need that pressure, the "walls" around them. Experiment with your child to see what kind of containment might make her feel better. Sometimes a tightly wrapped blanket (even on older babies) is helpful, but she might hate having her hands down in there. Let her hands stick up over the blanket so that she can grasp them together, to hold her hands or suck on them.. (When Gabe held his hands together I knew he was somewhat distressed, even when seemingly calm, but he was handling it on his own!)

I think a lot of infant toys on the market are too stimulating and complex and chaotic for any baby. I wonder about attention problems in the future. Waldorf folks suggest more subtle environments: pastel colors, a feather on a string spinning in the breeze, a fish tank to watch, curtains blowing, laying under a tree, a candle flame... These foster a deep attentiveness, long curious staring and wondering.

If you stayed with me through all this, I hope it helps. Your preemie is likely to have trouble organizing the sensations in her body and in her environment. You can help her now so she won't be too sensitive later.

Maren Peterson-DeGroff is an educator and advocate for children and families.  She and her husband Dave live in Eugene Oregon with their son Gabriel, who is very healthy and happy.

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