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Your Preemie Baby's Sense of Touch and Pain

By Brenda Lykins, RNC and Edited by Jeanette Zaichkin, RN

Your preemie baby responds to touch and pain at a very young age. This discussion of touch, comfort, and pain management in the NICU explains how can you help your baby feel more secure.

The sense of touch develops very early in the fetus, and your baby is able to feel cloth against her skin, the warmth of your skin against hers, and heat and cold for the very first time after birth. Our baby's face, the area around the lips, and the hands are especially sensitive to your touch. Touching your baby is a wonderful way to connect and help care for your baby. You can help quiet your baby with soft, gentle stroking, or by holding her hand.

In addition, to touching our baby, you can give her a sense of security by providing boundaries. Inside the uterus, your baby was surrounded and contained by the springy uterine wall. Now, outside the uterus, she has lost that form of body containment and may be unable to bring her arms and legs in close to her body without help. Your hand placed under your infant's feet or on top of your baby's head can sever as a boundary As your baby matures, you may find that your hand under her feet and legs is all she needs to quiet her. Babies prefer boundaries, or a "nest," made of soft surfaces that yield to their movements. Some units use special buntings or enclosure resembling sleeping bags to provide containment, or your NICU nurses may place soft blankets under your baby.

Your baby will transition away from the soft quilts and "nesting" materials in the weeks before she goes home. Unless your baby has unique sleep position requirements, your baby will sleep on her back on a firm mattress without any extra bedding or blankets to reduce the risk of sudden infant death syndrome (SIDS).

You may also wonder if your baby can feel pain. Historically it was believed that an infants' nervous system was too "disorganized" to recognize pain and that an infant's brain did not perceive conditions to be painful. Current research demonstrates that infants do indeed experience pain. Studies show definite physiological (physical) changes - such as increased heart rate, respiratory rate, and blood pressure, as well as increased oxygen use - during painful procedures. Based on this research, Pain control is now an important part of NICU practice. Your baby may be given local anesthesia for painful procedures, and may also be given medication for general discomfort or agitation. You may find that your baby is less responsive and alert if she is receiving pain medication to keep her comfortable.

This excerpt about breastfeeding your preterm baby from the book "Newborn Intensive Care" is copyright by the American Academy of Pediatrics. Reprinted with permission.

Jeanette Zaichkin is the editor of Newborn Intensive Care: What Every Parent Needs to Know. She has been a neonatal nurse for more than 30 years. As the neonatal outreach coordinator at Seattle Children's Hospital, she facilitates education for health care providers caring for sick and prematrue infants and their families in Washington, Alaska, Montana and Idaho.

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