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Your premature baby’s body language

0-3 months

Premature babies behave and communicate differently from full-term babies. With time you’ll be able to tell how your premature baby is feeling by watching what he does in different situations.

About premature babies’ body language

Premature babies have different body language from full-term babies. This is because they’re less mature, smaller, more sensitive to touch and noise, and not as strong. Their early experiences of life are very different from a full-term baby’s.

Also, the body language of a premature baby born at 24 weeks will be different from that of a near-term baby. For example, very young premmies aren’t ready to interact with you in the way that a full-term or near-term baby is.

Your premature baby’s body language and responses to feeling uncomfortable or overwhelmed will change over time as she gets bigger and stronger. You’ll get more obvious clues to how your baby is feeling – for example, you’ll notice her crying or wanting to make eye contact.

And you’ll see more definite ‘states’. Where a very young premmie might open his eyes only occasionally, your older baby will gradually have more and longer spells of being awake and alert. He might be deeply asleep, lightly asleep, drowsy, awake and alert, awake and fussy, or crying.

And always expect the unexpected – premmies might not respond in the same way from one day to the next.

How premature babies show their feelings

Like all babies, premmies can’t use words to tell us when they’re feeling uncomfortable or tired, or to go away when they’ve had enough. Very young premature babies often don’t even cry very much, but they have other ways of showing us how they’re feeling. 

Everyone has an autonomic nervous system – this is what keeps you breathing, your heart beating and your temperature stable, all automatically. Every now and then, you sneeze, shiver, yawn or twitch without meaning to. These can be signs that something in your body is a little bit out of balance, and your body’s systems are kicking in to fix it.

It’s the same with premature babies. The signs can be very quick, such as a faster heart rate, or going pale, but they can tell you that in that moment your baby is feeling stressed.

As premature babies get bigger and more mature, they start to cry when they don’t like something.

In the early months at home, premature babies are more likely to ‘switch off’ than other babies. That is, they’re more likely to get cranky, turn away from faces, and go to sleep rather than have social time with you. When this happens, it’s a sign that your baby needs some quiet time.

From your earliest days together, you can try to match how you cuddle, play with and feed your baby to her ability to cope. This might mean your baby is less likely to shut down, turn away or switch off. Learning how your baby shows that she’s stressed or overwhelmed can help you to do this.

 Body language that shows your premature baby is feeling overwhelmed

When premature babies are uncomfortable, overwhelmed or stressed, they can show this in their body language.

Your premature baby might:

  • wake up or stay awake and be upset
  • change from being alert to being drowsy or fussy, or start crying once he’s bigger and stronger
  • have a distressed look on his face or have a wrinkly forehead – sometimes called ‘brow bulge’
  • make jittery or jerky movements of his arms and legs, cover his face with his hands, or splay or fist his fingers and toes
  • breathe faster, or have a faster heart rate
  • change skin colour to pale, red, mottled or blue
  • yawn, sneeze, hiccup, gag or spit up.

If you see these signs while you’re handling your baby, cover her, keep her still and do nothing for a moment. This should help her get back to balance.

If your baby is in an incubator, tell the nurse and see whether you can work together to change your baby’s environment so he’s more comfortable. For example, you might need to adjust the noise or light or your baby’s position.

Our article on helping your premature baby feel calm has more tips on easing your baby’s discomfort.

Signs that your premature baby is relaxed

You might be able to tell that your premature baby is happy and comfortable just by the fact that she isn’t showing any of the signs of being uncomfortable.

If your premature baby is feeling OK, you might also see that he:

  • has regular, relaxed breathing
  • has a relaxed body
  • moves in a less jerky and more gentle way 
  • is still and alert and might even want to look at you or something else.

Your baby might also be very interested in looking at something (often a face), and her body will be quite still and her breathing slow. This is your premature baby’s way of smiling. 

As your premature baby gets older, he’ll be able to stay awake and engage for short periods. This is the time to play with your premmie, by talking, cuddling, singing or making eye contact.

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Last updated or reviewed
13-05-2016

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Raising Children Network is supported by the Australian Government. Member organisations are the Parenting Research Centre and the Murdoch Childrens Research Institute with The Royal Children’s Hospital Centre for Community Child Health.

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