Preparing for your preterm baby's discharge from the hospital

Uploaded by SunnybrookMedia on 02.08.2011

As your baby begins to mature you now have begun to interact and take care of
your baby more often.
One of the major things that you are now doing is beginning to
participate in the feeding process of your baby. So be it bottle feeding or
you'll be
doing this more and more as your baby is becoming more and more awake.
The other thing that you are now beginning to think about is discharge planning.
You now have to learn,
how to be able to take care of your baby
and help your baby develop on discharge.
As you begin to be feeding your baby more and more this becomes an
opportunity where you can start also handling your baby and starting to do
some developmental tasks.
So for instance as your baby begins to wake up you can allow him to begin to
move around
on his own therefore all the blankets and rolls and headhuggers are out of the
bed and so a good idea is to move your baby into the middle of the bed so you can be face
to face with each other.
This will allow him to move randomly and spontaneously therefore
exercising and moving his muscles nicely against gravity.
It will also give you the opportunity
that you may be able to begin to achieve eye-to-eye contact.
He will not be able to actually see you
clearly for another few weeks
but it's the beginnings up that visual contact.
You may also have seen that the babies tend to like to face to the right side.
This is very common especially for those babies who spend time in an NICU
because most of the caregivers are right handed,
so they tend to set the babies up facing to the right so that it's easier to care
for the babies. One easy way to help this is to take a blanket, make a roll,
and tuck it around the baby. Make sure that the bump of the head goes on the middle
of the roll,
and tuck the arms of the blanket down along the side of the baby.
This will help him keep his head in the middle, help us bring his hands to his
face and his mouth,
and he can now move freely
in this sort of flexed midline position. As your baby is waking up you may
find he's starting to get a little fussy,
so you want to be able to try and calm him down.
One way is obviously giving him a pacifier. The pacifier has been shown
clearly to help calm the baby. The other way is place your hands gently on his trunk
and this will help calm his movements, help him become a little bit more
and therefore you gain another chance where you may be able to interact with
your baby.
The other thing that we need to begin to do is help him strengthen his abdominal
muscles and his shoulder muscles, particularly his pec muscles.
One way you can do this is gently put your fingers on his upper chest and squeeze those
fingers together. This will activate the pectoralis muscles.
For the abdominals, put your fingers on his tummy, spread your fingers out and
squeeze them gently together and that will activate his tummy muscles. You'll
see his legs pull up into flexion and he'll bend forward. Babies who are born
premature are often very weak through the abdominal muscles, and the shoulder
or the pectoralis muscles. Again, squeeze his pecs together and you'll see the arms come
together and the legs come up.
This is our way
to help make the baby do his abdominal exercises
and this will help strengthen these muscles so that he will be able to
begin to gain head control, abdominal strength and this will help him develop and
move forward in his gross motor skills.
The butterfly pillow is often a device that is used in the intensive care unit.
It is a pillow shaped like a butterfly. This will help your baby keep the head in
the midline and bring the arms to the middle. You can place the baby on the
pillow, his head should be just below the head of the butterfly.
While in this position he's very nicely positioned and held in a
beautifully flexed midline position
and now he can move freely against gravity and again, develop the strength of
his abdominal and pectorals muscles.
Since your baby now will be spending all sleeping time on his back, it is now
important when your baby is awake
that he starts to spend some time on his tummy.
Tummy time is crucial. This is where the strength of the abdominal muscles will
be developed.
So with each diaper change, gently turn your baby over onto his tummy,
flatten him out, try and straighten out the legs but if he continues to tuck into
that's ok. Allow him to try and squirm around, move around. See if you can keep
his elbows
just under his shoulders. This will allow him to push some weight down
through his arms and he will start to try and make an attempt to lift his head
and try and turn from side to side. Sometimes it does help to straighten out
his legs and give a little pressure down through the legs as that will take
the weight off his face. Tummy time is crucial. You must try and do it every time
you change the diaper. You only need to do it for one or two minutes and just
the fact of seeing the baby
move his head from side to side shows you that you have been quite productive
during this little period of exercise.
Once you've done your tummy time, turn him back onto his back
and now it's probably time to begin to feed. In order to pick your baby up nice,
come in under the head, gently flex the head up, centre the head,
bring it into flexion, bend up the bum, and pick him up gently and then from
here, you can either bring him to the breast
put him up on your shoulder, or appreciate your beautiful baby.