The Best in Daily Life – How to …reduce stress

Did you know…

A baby’s behaviour is affected by the type of stimulation (light, noise, touch, etc.), its intensity (anywhere from low to high), and frequency (sometimes, all the time). The neurological maturity of the baby and his overall state of health will determine the quality of the response.

In this section, we will suggest ways to increase your baby’s sense of well-being.

Keep in mind that it is first important for you to pick up on signs of stress:

Become aware of signs of withdrawal as opposed to attention-seeking
Be able to decode the child’s behaviour

Then, modulate your actions and the surrounding stimuli accordingly.

The senses – Adapting your actions and surrounding stimuli

Sight (vision)	To relax the baby (induce calm), lower the lighting, with curtains partly closed, incubator covered with a thin sheet, etc. So that the baby can gradually adapt his sleep cycles to the time of day, make sure that daytime and nighttime lighting are different. To get the baby’s attention (stimulate), look at your baby face-to-face, with your face about 12 inches from his, so he can see you. Then gently move your head from left to right and see if the baby’s eyes follow.
Hearing	Lower surrounding noise levels. Ask people to speak softly and not yell. Turn off the TV or radio, or lower the volume. Lower the volume of the telephone, pager, and cell phone; better still, set them to mute or vibrate, if possible. Close the door to the baby’s room when the baby is asleep. To stimulate the baby, you can add low-intensity sounds for short periods of time. At home, put on soft, relaxing music. Sing lullabies.
Taste	Limit bad tastes or unpleasant procedures near or around the mouth. Give your baby some breast milk: the taste is pleasant.
Smell	Limit exposure to unpleasant odours or strong smells (cleaning products, perfume). To stimulate the baby’s sense of smell, increase skin-to-skin contact.
Touch	Increase skin-to-skin contact whenever possible, to both stimulate and relax. Swaddle or position the baby comfortably in fetal position. To avoid heat loss, put a cap on the baby’s head. Make sure your hands are warm before touching the baby. Touch the baby gently (without moving your hand around) rather than grazing the skin lightly. Touch the baby with the palm of your hand, not the edge of your fingers. Make sure that the bath water temperature is 38^oC. After bathing, swaddle the baby.
Balance and movement	Let the baby grasp your finger or a small roll of material during feeding or handling. Hold the baby against your skin as often as possible. When moving the baby from one position to another Use rolling movements Use slow, gentle movements; the smaller the baby, the slower the move. Gently rock the baby in fetal position.

Further details on best in daily life…

Diapering the baby, giving medical care, and so on…

Try to group procedures so you won’t disturb the baby any more than you have to.
Try to wait until the baby is already awake, so as to let him sleep as long as possible.
Before touching the baby or doing anything, speak to him softly.
If the baby seems uncomfortable or stressed, let the baby rest for a few minutes. Apply a relaxing strategy (as suggested above), if need be.
Once the procedure is over, stay with the baby for 2-5 minutes to ease the transition.

Skin-to-skin contact

For the utmost calm for both you and your baby, try holding him against your skin, close-to-close, without clothing in the way, his abdomen against yours. The baby’s head is gently flexed to allow him to breathe more easily. Keep a cap on his head, and his back covered. You can sit this way on a sofa or chair for an hour or more (ideally two hours in a row) several times a day, promoting complete sleep cycles. If the baby has specific equipment or medical interventions, let the hospital staff guide you. It will be their pleasure to help

Benefits of skin-to-skin contact for the baby:

Helps induce calm
Stabilizes breathing and heart rate
Reduces crying
Increases waking time and helps baby get back to sleep
Helps to set the baby’s internal clock
Favours growth
Favours neurodevelopment
Increases breastfeeding time or, if not yet established, eases the transition to breastfeeding
Cuts the frequency and severity of infections
Reduces length of hospital stay

Benefits for the parent:

Can be done by either mother or father
Alleviates stress
Increases parent-child bonding
In the mother, eases breastfeeding and milk production
In the father, allows him to participate in childcare
Increases sense of control
Increases self-confidence in competent provision of care and procedures

Sucking when not feeding

Sucking helps the baby relax and calm down. Outside of oral feeding times, you can offer the baby your little finger or a pacifier to suck on. You could also pour some breast milk on your finger or on the pacifier.

Benefits of sucking for the baby:

Helps baby self-regulate and relax
Reduces agitation
Reduces stress associated with tube feeding
Improves ability to bottle-feed
Helps baby get back to sleep
Helps alleviate pain

For all these reasons, sucking outside of feeding times reduces length of stay in the NICU.

Best ways to comfort and calm your baby

Ways to soothe a crying baby:
- Let the baby try to relax on his own for a few moments
  - Without your touching him, he may bring his hands to his mouth and calm down by himself
- Looking at the baby, speak softly to him without touching him
- Offer a comforting hand
  - Put a hand on his tummy and wait
  - Bend his arms gently and bring them closer in to his body
  - With one hand on his head, fold his legs gently over his tummy with your other hand
  - Enfold both arms flexed in one hand and both legs flexed in the other
  - face him and put one hand on his head, the other on his hip, keeping the legs flexed
  - If the baby is on his back
  - If the baby is on his side
- Swaddle the baby, either partly (freeing the arms) or completely (including both arms and legs)
- Cradle him in your arms, in a flexed position
- Rock him gently
- Give him something to suck on

To summarize

This module describes a few basic strategies for decoding your baby’s behaviour, stimulating the baby, and comforting the baby. There will be times when these strategies may not be enough. Some babies require more, and there will be times when even an easy-going baby becomes trying.

Through the blog on this website, or better still in person, we invite you to share your suggestions, rewards and tribulations with a health care professional with years of experience in preterm births.