Helping Your Premature Baby Settle in at Home

Do premature babies develop at the same rate as full-term babies?

Every baby, whether they were born premature or full-term, develops at a different rate. Premature babies need to go through a few more changes before they can do things that full-term babies do. When you first take your baby home, you may notice they are a little bit different from full-term babies you may have known.

Developmentally, your baby may be physically less mature than a full-term baby. Your baby may:

• Be smaller, thinner and less energetic
• Need more head and body support during dressing and bathing
• Be more sensitive to changes in temperature

Which behaviors are typical for premature babies?

It is typical for premature babies to:

• Startle at unexpected noises or movement
• Have less energy than a full-term baby
• Become easily overstimulated
• Take longer to learn to breastfeed

Even once they reach term age, premature babies may still need to take things at a slower pace so they can save extra energy for growth. Some premature babies develop skills at a different rate than full-term babies. However, most premature babies eventually achieve their important developmental milestones, and grow to become active, healthy children!

How can I help my baby settle in at home?

During the first important weeks at home, there are lots of things you can do to help your baby settle in more easily that can help with their development.

• Read your baby’s cues. Babies communicate with their caregivers through facial expressions and movements. Your baby has their own special signals to let you know if they are calm, playful or becoming tired or stressed.
• Look for times when your baby is quiet and alert. These are ideal times for interacting with your baby.

What are the signs that my baby is ready to interact?

Your baby is feeling calm and ready for interaction when they:

• Have a soft, relaxed expression
• Keep their arms and legs relaxed, but not floppy
• Stays calm while being touched, looking at your face and listening to your voice

What are signs that my baby is becoming overstimulated, stressed or tired?

Your baby is becoming overstimulated (overwhelmed by sound, noise or touch) or is tired or stressed when they:

• Avoid looking at you directly
• Become pale or flushed
• Frowns, grimaces or looks worried
• Becomes limp or stiff
• Has startles or jerky movements

How can I help my baby when they feel overstimulated, stressed or tired?

There are many things you can do when your baby feels overstimulated, stressed or tired:

• Stop what you are doing and hold your baby quietly. Bring their arms and legs in close to their body.
• Let your baby grasp your finger.
• Help your baby to get their hands to their mouth or offer a pacifier. Sucking is very soothing for babies. It also helps them to save energy for feeding and interaction.
• When talking to your baby, do so quietly. Watch for a response. Sometimes just your face is enough stimulation for your baby.

Why is sleep so important for premature babies?

Premature babies sleep a lot – about 18 hours a day in the first few weeks at home. Sleeping is important for energy and growth. Premature babies often have trouble settling down to sleep at night in a quiet house. They have become used to the continuous background noise and light in the Neonatal Intensive Care Unit. Although they may startle at unexpected sounds, they often tune out continuous sounds, such as white noise machines. You may even find that continuous sounds help your baby sleep.

How can I help my baby sleep better?

There are many things you can do to help your baby sleep better at home. Here are a few ideas:

• For the first few days or weeks after discharge, provide a continuous sound, such as relaxing music, or a ticking clock near your baby’s crib.
• Swaddle your baby. Keep their hands near their face to help them self-soothe (when your baby can calm down and relax on their own). This gentle pressure helps lessen the chance of your baby startling awake. It also helps them sleep quietly.
• Place your baby to sleep on their back. Keep stuffed animals or soft materials out of the crib. Sleeping on their back in a crib without toys or soft materials is safer for your baby. Sleep will come sooner if your baby doesn’t have any distractions.
• Create a routine for going to sleep by putting your baby to bed with familiar activities, such as:
  • Reading a book with your baby
  • Rock your baby and sing a little song
  • Put your baby to sleep when they are drowsy, but still awake. Turn on special music to help your baby fall into a deeper sleep.

Will my baby's routine change over time?

Yes. It is okay if your baby’s routine changes over several weeks. As your baby grows and develops, they will be awake for longer periods during the day. Sleeping patterns may also change.

Rev. 4/2022. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treat any medical conditions.