Born too early – How you as parents can support your child

Dear Parents!

The birth of a child is always a very special moment in your life; as parents you have been trying to properly prepare. You will face many new challenges and worries. Uncertainties can arise in addition to joy. This is true for all parents who are newly responsible for a baby. However, when a baby is born too early, the situation for you as parents is often overwhelming and your baby must now prematurely prepare for life outside the womb.

This paper is designed to help you understand the specific needs of your premature baby, so that you can support your infant on its way into the world and find the confidence to take care of your child. You, as parents, are very important to your baby, and even when he or she is born too early you can still care for him or her.

During pregnancy, you gave your baby mental, emotional and physical protection. You were in contact with each other, you perceived each other. Your baby was nourished and was able to grow because of you. Your baby spent this time in the womb protected in the amniotic sac. It then lost this protective womb organ when it was born prematurely. We would like to show you the importance of this organ in the womb, and then develop ideas on how you can give your baby this kind of protected and nourishing space even after an early birth.

The amniotic sac, the primal place of protection

The amniotic sac forms the original covering that protects your baby – it is a protective organ par excellence. With its translucent enclosure it forms a boundary to the outside world, which remains slightly transparent, allowing only gentle first impressions from the outside world. It can be seen as the baby’s own little vaulted sky. In the womb, amniotic fluid makes a sea-like space for your baby. In this place of weightlessness your baby can develop without too strong an intervention of earthly gravity, which enables greater vitality, movement and growth. Your baby’s neurosensory system can mature in this protective covering and is shielded from too much stimuli.

If this protective covering is lost prematurely, the baby’s not yet fully developed small body is affected too early by gravity and the stimuli of the world. Its boundaries and its safe space are suddenly lost. An important part of your care of your baby is to help make the wide space of the world into a manageable, safe place that corresponds to your baby’s stage of development. This can be done by creating a kind of conscious, protective enclosure. You can give your baby a protective covering through skin-to-skin contact, through emotional togetherness and by caring for him or her in an enveloping way.

Enveloping your baby through skin contact

Now that he has left the womb, you can satisfy your baby’s need for closeness, security, safety and warmth through direct skin contact. Your baby can be placed directly on your chest. You can have intimate contact with your baby during these hours, helping him to come to terms with the early loss of the womb.

Your baby hears your heartbeat, feels your breathing and smells you. You can talk to her and caress her. This helps her in many ways to master life outside the womb. Her breathing is stabilized, she can become quiet, and she is in close emotional contact with you. After you leave the hospital it can be good to spend extended time in close contact and give both you and your baby time to adjust to your home environment and to find and orient to each other.

Especially when your baby experiences phases of agitation, you can offer him direct skin-to-skin contact with you. After you leave the hospital it can be good to spend such hours in close contact and you can give yourselves time to adjust to your domestic environment and find each other.

Surrounding your baby with protection at bath time

When being bathed your baby can feel the same sense of being cared for as previously in the womb. Babies usually perceive the lightness, the surrounding warmth and the feeling of being carried by the water as being very pleasant. You can envelop and protect your baby by covering her with washcloths or small cloths. Then she can feel safe in the water. Take your time bathing your baby and perform every movement calmly. Since the baby often enjoys this time of bathing, it can be unpleasant to come out of the water back into the world of gravity and coolness. Let her know when this is about to happen and tell her she is going to be wrapped safely in a warm towel. You can prepare the place so that there is a rolled up towel as a border and you can cover the baby immediately. You can make a conscious transition from the water onto the enveloping, warm and safely furnished place of the changing table. This is a little bit like the step the baby takes at birth. If your child could not come to you immediately due to its premature birth or if you were under anesthesia and could not experience the birth, you can arrange the transition out of the bath as a way to heal the birth process, arranging it as you would have liked the birthing process to unfold, and doing it at the speed that you would have liked.

Protectively covering your baby during an oil embrocation or massage

If you want to massage your baby or rub oil into his skin, it is especially important to first create an enveloping place where he can be safe and enjoy being touched. Your baby should be able to rest his weight on the surface beneath him, as otherwise he will be occupied with regulating his position during the treatment. If you put a towel roll around him, he can rest his legs and arms on it. Cover him with a cloth diaper. For example, when you are rubbing a substance into the upper half of his body, you uncover only that part of him. You can start the embrocation with an enveloping gesture: envelop his head with your hands, leaving a little distance between your hands and the baby’s skin.

© Natalie Hurst

Perhaps you have learned how to do an embrocation or massage, then you can fall back on this skill. It is less about technique and more about having gentle, attentive and calm hands. When you have the opportunity to give your baby an embrocation very early on the hospital ward, you can simply hold your hands steady in one place. Even if your baby is unstable you can touch him in this way. Enfold his arms, so that you hold his entire chest. Stay in place and only let your hands compress slightly, i.e., give a slight impulse in the direction of your baby and then release it again without losing skin contact. Your baby can adjust to this and is not overwhelmed by movements on his skin. Especially at the beginning, babies can still be very easily irritated and flinch. Start at the ribcage, then hold his belly and then his legs, staying in one place and giving only light impulses: contract a little and then loosen again.

Finish with an enveloping gesture and perceive your whole child once more.

© Natalie Hurst

© Natalie Hurst

© Natalie Hurst

© Natalie Hurst

If your baby experiences agitation again later, you can use this treatment to calm him down and bring him back to himself.

With older premature babies, who have now become ready to see what there is to discover in the world, you can also introduce motion. Your baby can always easily follow along with touch when it is flat, close to the body and caresses towards the extremities. Be slow like a snail, then your baby can follow everything you are doing well. He can become quiet and attend with all his senses to your touch.
Consider your baby’s arms as an example: start at the shoulders, touch both arms at the same time and slowly stroke out towards the hands.

Gently rubbing oil into your baby’s skin promotes the contact between you, stimulates his senses in accordance with his age and also supports temperature regulation.

Suitable body oils for embrocation or massage

In the first two weeks of a premature baby’s life, the skin is still open. The top layer, which protects the skin from moisture loss and mechanical influences, has not yet fully developed. This means that the application of oil has several aspects: it protects against loss of moisture, it helps to better maintain warmth, and it nourishes the skin. An oil that has been formed in a plant by the warmth of the sun is a kind of warmth that has become material. Oils gradually release this warmth over a longer period of time. Oil therefore has a protective, warming and nourishing aspect. On a hospital ward you will probably be offered the oil that is usually used there. If you later choose an oil for your baby, the following base oils can be used:

  • Almond oil, such as Organic Sweet Almond Oil PRIMAVERA
    (also available as Mandelöl bio)
    is nourishing; it provides security and a layer of protection; it harmonizes;
    it cares for the skin, it soothes irritations
    Organic almond oil has very beneficial ingredients as it calms and cares for irritated and sensitive skin. It nourishes the skin and thereby supports the well-being of newborns and premature babies. The scent of almond oil is reminiscent of marzipan, it is mild and warm and creates feelings of security and harmony.

  • Natural Demeter olive oil made by DR. HEBERER,
    or any other good, organic or Demeter olive oil
    is warming, analgesic; strengthening; regenerating for the skin,
    anti-inflammatory
    Olive oil is pressed from the pulp of the fruit. The flesh of the olive has stored warmth and sunshine for months and has converted it into oil, so that olive oil has a warming effect. Due to the high content of oleic acid and vitamin E, it is very beneficial for the skin and highly regenerating. It also has analgesic and anti-inflammatory effects. Its pain-relieving effect has proven very effective in embrocations after breech births, and after forceps or vacuum delivery. Overall, olive oil has a strengthening effect on the whole organism.

  • Rose oil (mix your own): 1–3 drops of pure essential rose oil,
    e.g., Essential Oil Rose Absolute PRIMAVERA,
    in 100 ml almond oil or olive oil

    is enveloping and promotes thriving; it is harmonizing; warming
    When your baby has left the clinic, you can also add pure essential rose oil (Rose absolute) to a base oil, such as almond or olive oil, described above. 1 to 3 drops per 100 ml base oil are sufficient. The enveloping character of rose supports the formation of warmth and thus also your baby’s well-being. Rose harmonizes the baby’s life processes and after a somewhat turbulent start rose oil can offer particularly balancing support.

Protecting your baby through clothing and swaddling

Clothing keeps your baby warm and enfolds her. It gives her a boundary. Make sure that you use natural materials, such as cotton, silk or wool. Natural materials let the skin breathe and they regulate warmth. Take your time when dressing and undressing your baby, so that she can follow along with what is happening. Announce each step in advance. Your baby will then be calmer. Your slow movements and gently rolling the baby to one side or the other will encourage her own movements. All such activities of caring for your baby are contact time between you. Be completely present, see what your baby is showing you with her movements and facial expressions, and tell her what you have noticed. In this way you can interact with one another and understand each other better. This contact envelops your baby on the level of soul, in addition to the purely material envelopment of clothing, and this can support her development and well-being.

If you want to lay your baby down to sleep, and if he is restless and has trouble falling asleep, or if he wakes himself up again with movement, you can provide a boundary by swaddling him. Swaddling enables your baby to feel his own body. He can clearly perceive the cloths wrapped around him, which helps him to settle down. Besides the boundary, swaddling gives him warmth. Wrap your baby in such a way that he can still move his arms and legs, but retain clear contact with the swaddling cloth. You can also just swaddle the baby’s legs, or put him in a sleep sack, as shown in the first illustrations.

A protected place to thrive in

In the first days and weeks of a premature baby’s life, a lot of attention is paid to the topics of food intake and well-being. It may be that your baby needs support from a feeding (nasogastric) tube at the beginning in order to receive sufficient nourishment. Breast milk is the best nourishment for your baby. In the first days and weeks of life she may be too weak to drink milk directly at the breast. If so, you can pump out your milk and your baby can get it through a feeding tube, a supplemental nursing system or a nipple. The first drops of breast milk (colostrum) are particularly valuable. These can be collected with a small syringe while milking out the breast and dripped directly into your baby’s mouth. Even if your baby is not yet sucking hard enough, it is good to place her at the breast. She can smell the breast and the milk, possibly lick off a few drops and be in contact with you. This promotes your breastfeeding relationship and milk production.

If your breast milk itself is not sufficient or if you cannot or do not want to breastfeed, your baby can be given an initial infant formula. You can then also feed your baby while maintaining direct skin contact, the same as when breastfeeding. It is not only food itself which allows your child to thrive, it is also the environment in which he grows. He can thrive better when he experiences peace, warmth and affection. You can also help your baby thrive by rubbing his skin daily with a natural oil (see “Protectively covering your baby during an oil embrocation or massage”). The oil allows your baby to maintain warmth better and therefore consume fewer calories creating warmth. If your baby is restless after a meal, seems uncomfortable or has flatulence, you can support his digestion with a warm oil compress.

Suitable oils

  • Natural Demeter olive oil made by DR. HEBERER,
    or any other good, Demeter or organic olive oil 

  • Fennel oil (mix your own): 3 drops of pure essential fennel oil,
    e.g., Demeter fennel oil PRIMAVERA, in 100 ml almond oil or olive oil

  • “Tummy oil” specially formulated for babies,
    e.g., Baby Tummy Oil WELEDA (also available as Baby-Bäuchleinöl) 

Instructions:

  1. Apply several drops of oil to a small cotton cloth.
  2. Warm the piece of cloth on a hot-water bottle (you can put the oil cloth in a small bag when warming it in order to better contain the essential oils).
  3. After warming up the cloth, apply the compress to your baby’s stomach (first check the temperature on your forearm). You can cover the compress with sheep’s wool fleece or a cotton diaper and pull the baby’s clothing over it. The compress can be left on the skin until the next diaper change.

The connection between soul experiences and digestion

The gut has a complex nervous system. You have probably already noticed that your own digestion reacts to stress or excitement. Your baby’s digestion can also react to mental and emotional experiences. An early birth and the experiences of a hospital stay must also be “digested”. If you have the impression that your baby’s digestion is affected in this way, you can provide her with some relief by applying an oil compress in the upper abdominal area, where a large part of the nerve plexus of the abdominal cavity is located. The procedure for the compress is the same as described above, except that the compress is placed on the upper abdomen.

Suitable oils

  • Oxalis oil, e.g., Oxalis e planta tota W 10% WALA

  • Melissa oil (mix your own): 1 drop of pure essential Melissa oil,
    e.g., Melissa essential oil Demeter PRIMAVERA,
    in 100 ml almond oil or olive oil