CONFESSIONS OF A PREEMIE- HOW AM I DIFFERENT FROM A FULL TERM BABY?

Before I was born
I was growing in my warm, dark, and comfortable home. I heard the sounds of my mother’s rhythmic heart beating, her rumbling belly, and bowel sounds thundering in the distance. I could hear her soft gentle voice muffled by the thick walls of my protected environment. I was in cadence with her changing day and night activities. The swaying motions of her walking were soothing to my developing systems. I felt my limbs move against the warm and protected fluid that surrounded me. I often practiced sucking my thumbs and fingers in short bursts; all to get ready for the real world that was awaiting my arrival. My home was perfect for me, and although I spent most of my time curled up and asleep, I felt comfortable and protected in my environment.

In my new NICU environment
I am now growing and learning in a whole new world. A world I didn’t expect (and I am sure you didn’t expect either.) The NICU can be scary, for both of us! Please be patient with me as I learn my new environment, my surrounding, and how to react to them.

I speak to you in the only language I know, through my behavior. If you pay close attention to my body language, you can learn what I am trying to tell you and how to react to it to give me the very best start possible.

I can hear you!
My hearing was developed by 20 weeks gestation.
I can pick out my mother’s voice, and I prefer it over all other voices I hear.
I will show I dislike loud noises, (by frowning or startling) like machine alarms, incubator doors that slam shut, and loud voices.
I like low to medium pitches better than high pitches, so please remember this when using “baby talk” with me.
I like soft music; it can be soothing to me as I transition in and out of my sleep cycles.

I am trying my best to see you!
My eyes take longer to mature than my hearing, so please be patient with me as I try to focus on my new world.
In the beginning, I will spend only brief periods of time with my eyes open and I cannot focus on anything. As I grow and get stronger, I will open my eyes in soft or dim light and begin to focus on objects. Faces are my favorite!
Bright lights bother my eyes and will make me blink and shutter in discomfort. The intense light accompanied by too much sound may be overstimulating to me. I may begin to show you my stress signals by throwing my hand in my face like I am waving. I may begin to hiccup, spit up, sneeze, or even drop my heart rate and oxygen levels. Please remember the importance of my environment when you interact with me.

I sleep a lot!
I have two sleep states, quiet sleep, and active sleep. These are very important for my growth and development. My brain is creating new pathways and perfecting my wiring during these cycles. Please pay close attention to them and be mindful of when you wake me up to visit with me.

Deep sleep– Also called quiet sleep or non-rapid eye movement (REM) sleep.
This is when I am very still. Every now and then, you may see me startle or sigh, but my breathing is quite even and rhythmic. This deep sleep is my most restful stage of sleep and is important for my growth and development. I will, however, have very little deep sleep until I am closer to term gestation. (40 weeks)

Light sleep– Also called active sleep or REM sleep.
When I am in a light sleep, I will move around quite a bit, and I may make little noises. My breathing is uneven and my eyelids may flutter from time to time. My eyes may open briefly and you may notice me rolling my eyes back into my head. Don’t worry; this is okay and very normal. I will spend most of my time in light sleep. As I grow older and stronger, I will begin to have more periods of REM sleep and then deeper sleep.

It may be hard to tell when I am asleep and when I am awake because I will have my eyes closed most of the time. I may stretch, grunt, and open my eyes briefly and go back into a light sleep several times before I really wake up.
I may only spend 2-5 minutes at a time in a deep sleep state before going back into a light sleep state. During each of my sleep periods, I will go through two or three light-deep-light cycles. It’s important for me to be able to finish out my sleep cycles because this is when I grow and develop. Please listen and look at my body language to know when it is the very best time to interact with me.

Please pay close attention to my subtle signs.
Because my nervous system (my brain) is continuing to develop and grow in my new NICU environment, you may notice a few things about me:

I may have trouble handling several different kinds of things going on at the same time. If you talk to me and look me in the eyes at the same time, or talk to me while I am feeding, I may have a hard time focusing on what I need to do. I may get confused, overwhelmed, and overstimulated.
I may not be able to focus on you for very long and may get worn out trying to respond to you in just a short period of time.
I may not have the energy to cry to show that I am unhappy, but I can communicate with you in different ways. You can learn my secret language by paying attention to my body language.

When I am stressed or unhappy:
I may have color changes. I may look gray, mottled, or may even turn blue in deep stressful conditions.
I may be stiff with my arms and legs splayed out in an unorganized state.
I may show I am overstimulated by the noise and my environment by gagging, sneezing, hiccupping, or even spitting up.
I may spread my fingers wide, covering my face and showing you a waving motion.
I may become irritable, turn away, and go back to sleep. If I do this, please don’t try to wake me up by tickling my toes, rubbing my skin, or calling my name. I am simply not ready to interact and need to save my energy to grow.

When I am stable or happy:
I will be pink in color.
I will be loosely curled up in a flexed and organized state.
I will slowly wake up and begin to focus my attention on your voice.
My movements will be smooth, and I will bring my hands towards my face.
I may suck on my fingers or pacifier.
I may open my eyes and begin to focus on my environment.
When I am happy, I like to snuggle, and kangaroo care is my favorite way to transition back to my growing sleep state.

I know you must be super excited that I am here but also a little nervous that I made an early arrival. Learning my cues, what I can and can’t do, my likes and dislikes, and my special preemie language will help both of us transition into this new and scary world. Please remember to be patient with me as I learn and grow.