However vulnerable, tiny, or early your baby has been born, your baby will benefit from you being with them. This will also support you to get to know your baby and be in a relationship together.
It can feel very worrying to imagine how you can bond with your baby on the neonatal unit.
Building a relationship with your baby may develop over time, as you learn each other’s signs and cues.
Here are some things to help you find your way. Remember, the team on the neonatal unit are very experienced at helping you learn to be with your baby and to look after you too.
Contact-touching, holding, and being close to you
Your touch is very powerful and can help your baby feel safer, more comfortable and cared for. You may be able to hold your baby in skin to skin cuddles.
Some baby’s are not ready for this, but you can hold your baby’s hand or foot to let them know you are there. Your touch can help soothe your baby in stressful moments including during procedures. You can read more about skin-to-skin contact.
Your smell
Your natural scent is really calming and comforting for your baby. Your baby will be familiar with your natural scent from being inside you. You are the familiar safe place for your baby. You may also become familiar with the scent of your baby.
Having 3 small comfort cloths can provide comfort for you and your baby:
- one with your baby
- one with you
- and one spare or in the wash
Circulate these every time you are together, so they can smell you, and you them, when you are apart. This helps release the hormone oxytocin, which is important for bonding relationship building. Keeping the one from your baby near you if you are expressing your milk, can help with your milk let down too.
Discovering your baby’s cues and communication
Learning your baby’s cues can open the door to being able to communicate and recognising how important you are to your baby.
Your baby’s cues may be very subtle at first. They may not be immediately recognisable, and you will learn these over time. Breathing, skin tone (if they look pale, or flushed), body tone (are the tense or relaxed?), facial expressions, and body movements, are all cues – your baby’s language.
Your preterm baby’s cues are not quite the same as a term baby (born around the due date), because they are not as mature.They are likely to be really sensitive to the environment so keeping sound low, and touch gentle, will help your baby to feel more calm.
Over time you will begin to know if your baby is showing engagement, or disengagement cues (search ‘cues‘ in the R2R Toolkit) showing that they are ready for you to interact, that they are enjoying something, or that they have had enough and need a break. As your baby matures, other cues will become clearer, happen a little more often, and for a little longer.
When your baby is calm you may learn to identify that they are feeling more comfortable as their breathing is relaxed , their muscle tone is relaxed, their movements may be smoother, their eyes may be brighter and they may look more alert and focused. This is a good time to gently engage, by talking, singing, sharing some eye contact together, or simply holding.
Your baby will have different sleep states too. The neonatal team will support you in learning the sleep states and to gently be along side your baby with some gentle touch.
Even though you may expect your baby to cry, babies born prematurely don’t always cry as often as term babies at first. The may cry more as they get a little older-this is not because they are more distressed, but because they are more developmentally able. You can see more about crying and soothing and if you are struggling with crying the ICON resources for parents can help you cope.
All babies become distressed sometimes and babies on the neonatal unit may need procedures done to them to help them be well, but these procedures may upset your baby.
You may notice some of the following signs:
- their breathing becomes faster
- their heart rate gets faster
- their skin colour may change, becoming paler or redder
- they may gag, spit up, sneeze, yawn or hiccip
- their movements may be busy and jerky
- they may cover their faces
- their fingers and toes may screw up or extend tensely
- they may look distressed, frown or dull eyed
- they may seem tense and be unable to sleep
- they may be drowsy and keep dropping off to sleep
The sound of your voice – talking and singing
Babies develop hearing at around 23 weeks antenatal. As your baby’s hearing develops, they will recognise your voice and it’s familiarity will be calming for them.
Chatting, reading a book or singing to them will help them know that you are close by and soothe them. Sometimes it can be tricky knowing what to say to your new baby. They don’t mind what you are talking about when they are very little, they are listening to the tone and rhythm of your words.
Interacting with your baby
Your baby will benefit from your interactions with them. Very young babies are easily exhausted so just take things slowly and focus on one sensory experience at a time: let them listen to you talk or listen to a song or a hum or let them see your facial expressions, or let them see you wiggle your fingers. Watch baby’s body language for cues and give baby space when they are tiring – they will give disengagement cues. Let baby have rest too as this is also valuable for their development and well-being.
Feeding your baby on the neonatal unit
You will have lots of support from the neonatal team to help you with feeding your baby. This can be a very challenging time and bring strong emotions.
Everyone will have their own situation and there is no one right way of feeding for all babies and parents.
Remember, however you feed your baby, feeding is a really important part of your relationship together. Feeding can be a time to connect and learn about each other.
Breastfeeding, expressing, and bottle feeding
Sometimes breastfeeding, or expressing, is not an option due to maternal health, or important medications which you may need to take.
If you are able to establish breastfeeding, the staff on the neonatal unit will give you everything you need to start expressing your milk for your baby, and storing it for when your baby is ready. It is really important to start expressing as soon as possible after your baby is born, as your body will be ready to start making milk. Early and frequent expressing should enable you to establish a milk supply.
Although feeding your baby human milk is natural, it is not necessarily easy to breastfeed or express milk. When we are stressed, anxious or frightened we release cortisol and this can impact the milk supply by triggering a “flight or fight” response, which can inhibit the release of oxytocin, the hormone that supports the milk ejection reflex (let-down). That you may be stressed is understandable. We recommend that you ask for support from the neonatal unit. Some ideas that may help include:
Skin to skin or looking at pictures/videos of your baby, smelling their clothing, or breastfeeding in a quiet, warm, and comfortable environment helps trigger let-down.
Drinking warm beverages, listening to calming music, or laughing can reduce adrenaline and boost oxytocin.
Prioritizing sleep and asking for help with chores may help stress levels and support your body to recover, which helps reduce cortisol and increases the capacity for oxytocin release.
Nursing on demand (8-12 times a day) stimulates nerve endings in the nipple, which sends signals to the brain to release more oxytocin.
Try warm compresses on the breasts to promote relaxation.
Your baby may need to have timed feeds to support their growth and help. They may start with tube or cup feeds before they are ready to learn to breast feed or suckle from a bottle. As they grow and develop, they may start showing feeding cues and you will be supported in noticing these.
The feeding section gives you information about feeding a term baby, this may be helpful for when your baby is ready to feed in response to their cures.
There are many different reasons why mothers bottle and formula feed, breastfeed, or feed their expressed milk by bottle, cup or tube. It is important that you make the right decision for you and your situation.
Looking after your baby
The neonatal unit team will help you gain confidence with caring for your baby. This is your baby, and learning how to look after them is an important part of getting to know each other and building your relationship.
You can provide care inside the incubator, or in your arms. Changing nappies, or washing your baby, are all things that you can be part of. Your support in taking these cares on, when you are ready, will benefit you both. Providing these cares helps you get used to handling your baby and recognising their cues. They help you get to know your baby and for your baby to get to know you.
Looking after yourself
It can be worrying and stressful when you baby is cared for in the neonatal unit. You may have a mixture of emotions. Your may feel at times like running away or perhaps you feel scared and anxious, guilty or angry. For some parents, the whole experience may feel unreal or as if they are watching events from the outside.
Remember that many parents experience some of these feelings:
- Some parents may feel shocked.
- It is common to feel lonely.
- Some parents feel that they have failed.
- It is common, at first, for parents to feel that their baby belongs more to the neonatal ward than them.
- Some parents find that difficult feelings hit when neonatal care ends.
- Many parents feel exhausted.
Accept your emotions, they are reactions to the difficult situation. It is important that you do not blame yourself. Many babies need neonatal care and their parents did nothing wrong – difficult things happen to anybody. It can be useful to stop and ask yourself, “What would I say to a friend in this position?” as this question can help us spot when we are not showing the compassion to ourselves that we would show to others.
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