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Touch, holding and massage for your premature baby in the NICU

0-3 months

Touch, holding and massage are great ways to care for your premature baby and bond with her in the neonatal intensive care unit (NICU). When your baby is ready for physical contact, it can help you both adapt to the premature birth experience.

Touch and premature babies

Touch is the first of a baby’s senses to mature.

Touching your premature baby will help him feel cared for and supported. Touch can be the beginning of your relationship with your premature baby, and it’s a good way to bond with your baby.

Premature babies in the neonatal intensive care unit (NICU) have many people touching them in many different ways. A lot of the time, the touching can be stressful, uncomfortable and upsetting for them – for example, if they’re having a heel prick or being ventilated.

But when you touch your baby, you do it to help your baby feel calm, cared for and loved. Your baby will get to know that you’re the one who touches her in this special way. She’ll learn that when you touch her she won’t be overwhelmed by sudden changes, rough handling or too much stimulation.

Getting started with touch and holding for your premature baby

If your baby is very small or sick, you might not be able to hold him yet – but you can still touch him. Just like any baby, your premature baby needs the comfort of human touch. But touch can also overstimulate and stress a very tiny, fragile premature baby.

Starting small
It’s a good idea to start with something simple, like holding your premature baby’s hand or letting her hold your finger. It’s also a good idea to do this on its own and not to talk or sing to your baby at the same time. This is because your baby might find both things together overwhelming. But it can be a good idea to say something before you touch your baby so she knows something is about to happen and that it should be pleasant.

As your premature baby grows and gets stronger, you’ll be able to sing or talk to your baby while you touch or hold him.

Comfort holding
You could also try deep touch, or comfort holding.

To do this you pretend that your hands are like the walls of the uterus. Place cupped hands on your baby’s head, feet, bottom or back and keep them there with constant pressure. Watch your baby’s monitors to see how she’s coping with this new stimulation.

Your baby might be happy with comfort holding at some times and on some days, but not others. Watch to see whether your baby likes one kind of touch better than others.

Being careful
It’s a good idea to avoid stroking, patting or using your fingertips across your premature baby’s skin. After a while, this can be slightly painful for new premmies. As your baby gets older and his skin isn’t so sensitive, he might enjoy patting, stroking and massage.

Just relax with your baby. Feel her breathing. Your rewards for sensitive touching and holding will come later – with a close, loving and physically relaxed relationship with your baby.

Try not to use perfume or scented deodorant when you’re holding your baby. These can interfere with his recognition of your smell.

Kangaroo care for premature babies

Kangaroo care is simply holding your premature baby in an upright position, skin to skin, on your chest.

Your baby’s nurse will place her on your chest and cover her with a warm blanket. Then you can sit back, relax, listen to your baby breathing and feel her relax into you. You’re making a protective mini-pouch for her, and being together in a separate world.

Your baby’s nurse will help you work out how long to give your baby kangaroo care. To start with, it might just be a few minutes, building up to several hours as your baby grows.

Quiet humming or singing during kangaroo care is a great combination if your baby can cope with multiple forms of stimulation.

You’ll need to check with your baby’s nurse or doctor before doing kangaroo care because some very tiny or ill premature babies can’t have kangaroo care while they need lots of monitors and other equipment that might get dislodged. Kangaroo care also won’t do as much good if your baby is stressed.

Most hospitals encourage kangaroo care. But in some hospitals the staff might not suggest it, so you might need to ask your baby’s nurse. It’s a good idea to work with your baby’s nurse to get kangaroo care as part of your baby’s care plan.

Kangaroo care can help you become sensitive to and understand your premature baby’s signals. This is all part of bonding with your baby. It can also help you adapt to the premature birth experience.

Kangaroo care can help premature babies control their body temperature, improve the oxygen level in their blood, keep their heartbeat and breathing stable, sleep better, get started with breastfeeding, improve weight gain and motor development, cry less and go home sooner. It also has long-term physical and behavioural benefits.

Massage for premature babies

Massage is good for premature babies.

Premature babies put on more weight when they’re massaged and they can leave hospital earlier. Massage might also help your premature baby’s brain develop, promote his sleep, boost his immune system and circulation, help his tummy and bowels work better, and satisfy his need for touch and closeness.

It can also help you to learn more about your premature baby’s behaviour and responses.

Most NICUs have a physiotherapist who can teach you about massage. You’ll need to speak to your baby’s nurse or doctor before massaging your baby. Massage is helpful in many ways, but it won’t do as much good if your baby is stressed or not well enough for it.

Tips for massaging your baby

  • Keep your baby warm by using towels or an overhead heater. Make sure your hands are warm too.
  • Move your hands slowly so your baby gets to know the difference between your massage and other kinds of touch.
  • Massage your baby using firm strokes or circles. Light touch can be ticklish and annoying. It’s easier to use your whole hand for firm touch.
  • Massage different parts of your baby’s body in the same order every time – for example, head, arms, legs, back, bottom, chest and tummy.
  • Watch your baby’s reactions to your touch. A still body, slow stretching and holding hands near her face or mouth are all signs of enjoyment. If she makes a face, arches her body and makes lots of jerky movements, it might mean she doesn’t like this touch right now. Pause, keep your hands on her and rock her gently, then you can try massaging again, pacing yourself in response to your baby’s signals. 
  • Have fun. Baby massage can be relaxing and enjoyable for you too.
Video

Baby massage

1:14

This short video demonstrates baby massage. It outlines the benefits of massage for soothing an irritable newborn and includes tips on the best methods for relaxing and connecting with your baby. The video notes that you should stop the massage if your baby gets upset.

You might also like to download or print out our illustrated guide to baby massage. Note that the big difference between massaging premature babies and massaging full-term babies is that you need to be particularly careful about keeping premature babies warm.

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Last updated or reviewed
12-05-2016

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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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