As soon as the baby is in a stable health condition, parents can be involved in the daily care of their child. Healthcare professionals can explain to parents how to manage everyday tasks. Parents will become increasingly confident after some time. During the entire hospital stay, the daily care (e.g. nappy changing, bathing, feeding) moves from being mainly the responsibility of the nurse to shared responsibility of nurse and parent until parents are finally able to take full responsibility.
In the beginning, many parents are afraid to touch their baby and the separation can by very painful for them. Looking at the baby for hours is the way parents get to know their child. To fulfil their parental role it is important for them to observe and learn how the baby communicates and acts so that they can respond sensitively to the infant’s needs. The healthcare team can explain to parents how to read and interpret the signs of their baby. This is particularly important, as preterm born infants behave and react different from term born infants.
Parents may need time before they are ready to touch their baby the first time. Healthcare professionals can explain to them how to touch the baby in a comfortable way. Hands should always be clean and warm. Parents could start by offering a finger for their infant to hold, or by covering their infant’s feet, body, or head with the hand. Gentle firm touch is more comforting for the baby than light touch or light stroking.
As parents become more confident about touch they may be ready to comfort their baby. This can also be very important to parents. One possibility is the so called Comfort Hold, e.g., to help the baby to settle and fall asleep or to calm the baby during/after a medical procedure. The parent’s warm hand covers the infant’s head or feet. The other hand gently rests around the shoulders or holds the baby’s arms across their chest. The mother or father should be relaxed and breathe slowly and deeply. The baby can be hold like this until he or she settles. Afterwards hands should be removed slowly and one by one.
As a next step parents may now be ready to take over daily care procedures. Being the first person who provides care to the baby can mean a lot to a mother or a father. Sometimes it can be helpful for parents, to start with small steps such as finishing a task which was initiated by the nurse. In small steps they can now be more and more involved.
The following tasks could be taken over by the parents:
Cleaning the baby’s lips and mouth could be one of the first tasks parents could do. Therefore, a cotton bud can be dipped in expressed breast milk or sterile water. Mouth and lips of the baby can be cleaned slowly and very gentle with the cotton bud when the baby is awake and comfortable, e.g., during tube-feeding.
When a preterm or ill newborn baby is in a stable health condition, parents can practise skin-to-skin care (also called kangaroo mother care). This means that the mother or father holds the baby directly against the bear breast, skin-to-skin.
Breastfeeding and nutrition
Being responsible for the nutrition of a baby is one essential part of parenting. Breastfeeding can be challenging for mothers of a preterm or ill newborn babies, because these babies are usually not able to drink immediately from the breast. Therefore, expression of milk is the best solution to offer mother’s milk to a baby until breastfeeding is achievable. Mothers should be made aware that they will not produce a lot of milk at the beginning. However, every drop of milk is important for the baby and the quantity will increase over time.
At first it could help parents to watch the nurse change the baby’s nappy. After a while parents can take over this task step by step, beginning with fixing the clean nappy at the end of the procedure and comforting the baby afterwards. As the parents feel more confident, they could take the process further each time.
Parents may also be able to do the bath with the assistance of a nurse or midwife at some stage during their stay at the NICU. Some babies find a bath less stressful if they are wrapped up (swaddled) in a cotton blanket or towel. Even if this can be frightening for the parents in the beginning, it is usually a positive experience which helps parents to gain more confidence.