Reducing stress in the nursery baby, the premmie at home, social-emotional development
ALL ABOUT PREMMIES. Number 1, February 2016
Survival was the first miracle. The second miracle is a journey. Premmies are at increased risk of developmental problems. Yet they can be helped and developmental trajectories changed. Both “miracles” are based on science and dedicated carers. All About Premmies aims to provide parents and professionals with some of the information they need.
We aim to keep you informed from the latest scientific literature. This information rarely gets to parents, and professionals are often overwhelmed keeping up-to-date with the latest journals. You are invited to give us feedback and also to request specific information.
In this edition:
Why is it so important to reduce stress in premmies?
Reducing stress in hospitalized premature babies
Reducing stress in premmies at home
Social and emotional competence in 2-year-old premmies (and why parents need to be proactive)
Vaccinations for premmies
In the news – drugs to raise IQ in premmies?
Why is it so important to reduce stress in premmies?
Stress is toxic to all brains, and especially toxic to young developing brains
The amount of stress experienced by hospitalized premmies directly affects the structure of the baby’s brain
The structure of the brain directly affects the child’s abilities
Brain plasticity allows stress to negatively change brain structure, but it also allows an “enriched” environment to positively affect brain development
Reducing stress when we can not only helps the mother-baby attachment relationship; it also helps positive, or what we think of as “normal”, brain development
IN THE NURSERY
Acupressure for heel prick stress Heel pricks are a necessary stressor in the daily life of a hospitalized premmie. Some babies receive many heel pricks (“bloods”) every day, increasing their overall stress load.Non-drug therapies are routinely used to reduce stress, including oral sucrose. Acupressure is 2000-year-old Chinese healing art. For premmies, it is simple, quick and safe, and is well tolerated. A randomized controlled study found that acupressure resulted in shorter procedural time and shorter infant crying time. Read more
AT HOME WITH BABY
Reducing stress at home Premmies can still be incredibly “jittery” and nervous little people after they come home from hospital They cannot know that daily medical procedures have ceased. They will know they are in a totally different environment but they don’t yet know what to expect. Their one constant is their parents, who will hopefully provide a feeling of safety and calm.
What can parents do to manage their baby’s stress reactions? To help premmies overcome their nervousness, parents can watch for signs of stress and adjust their handling of the baby accordingly. If babies’ skin colour changes (to mottely, pale, or red), if their movements are jittery, if muscle tone is tight (fists or splayed fingers and toes) or flaccid (like a rag doll), if breathing is rapid, or if they shut down or turn away – these are all be signs that the baby is not coping.
do everything slowly and carefully – no big shocks or sudden changes.
when you see stress in your baby, stop handling for a moment.
if you are changing a nappy or bathing your baby, make sure they are warm (covered with a rug or water) and just stop until they are back to normal, then go very slowly and carefully.
try not to overload your baby with too many different kinds of stimulation at once- sound (your voice), touch, rocking, sight. Some babies can’t cope with more than one sensory stimulation at any one time.
you cannot spoil your baby by giving them too much attention or cuddling. They have been deprived of your safe, reassuring presence, and may become quite demanding of it after they realize that you will be there for them all the time. This is a good thing as it will help them feel safe with you. You can wean them off your body and presence when they learn to become calm on their own.
MIND THE GAP PREMMIES ARE MORE LIKELY TO HAVE DEVELOPMENTAL “GAPS” ……such as trouble learning at school and emotional and social difficulties. Gaps in basic skills are difficult to pick up by parents in the preschool years and can become evident when children go to school. Identifying gaps, giving practice in those skills to “mind the gaps” in early years when the brain is most plastic, can eliminate or reduce later cognitive and emotional problems in most premmies.
Premmie problems…. and why they need empowered parents
It used to be thought that “late-born” premmies were relatively free of developmental problems. A very large population-based study looked to the social competence (such as empathy, prosocial behavior,and compliance) of 638 premmies and 765 full-term children at 2 years of age.
At 2 years of age the premmies had delayed social/emotional competence, and other studies have found the same results at later ages up to adolescence. Childhood difficulties in relating to others and having happy and easy social relationships can affect school performance and the feeling of well-being. Ref: Johnson S. et al (2015). Read moreRaising Premmies helps parents with programs to “Mind the Gaps”, including difficulties with social and emotional confidence and competence. The early detection and intervention with these problems can improve outcomes in children in the long term.
Premmies receive vaccinations at their chronological age. This is their “normal ” age – the time since they were born. However, because their bodies are less mature than babies born at term, the immune response that is mounted in response to the vaccination is often weaker. They still need the vaccination, it just doesn’t work as well as it would otherwise. Premmies often need additional boosters when they are a little older. Do you have trouble keeping up-to-date with your child’s vaccination schedule? This might help.
IN THE NEWS
Two blood-building drugs given to premmies soon after birth boosted IQ by 12 points when these babies were 4 years old. The drugs build red blood cells and increase oxygen levels in the blood. Developmental problems are common in babies born extremely early and lower amounts of circulating blood oxygen may be a factor in early brain development. Read more
Knowledge is proud that he has learned so much. Wisdom is humble that he has learned so little.