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Your Baby's Development

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What to expect when you visit your baby in the NICU.

Also see our Glossery of Terms.

Therapeutic Handling  

  • Premature infants are highly sensitive to touch. We encourage gentle but firm holding of your infant in a tucked, flexed position using your hands or a blanket instead of light stroking.
  • We also encourage "kangaroo care". This is that very important skin-to-skin contact between Mom and baby or Dad and baby. Usually your baby is dressed in a diaper and hat and is placed on your bare chest under a button down shirt and then covered with warm blankets. Your body temperature will help regulate your baby's temperature. Your baby will feel your warmth and hear your heart beat which is very comforting to him. Many times the baby's heart rate, breathing and oxygen saturation will stabilize while doing kangaroo care. Some times may not be good for holding your baby depending on what kind of day it has been. Ask your nurse if kangarooing is appropriate for that day.

NICU Milestones

Less than 26 weeks

  • Your baby's skin is very fragile, wrinkled and transparent. Veins are easily visible through the skin. Most of the body is covered with light hair called lanugo. Very little fat covers the bones.
  • The genitals are not fully developed at this time. The testes in the male are not yet descended. In the female the clitoris protrudes out from the surrounding labia.
  • The eyes may still be fused closed. If they are not fused, they may be unable to protect their eyes from the light, because they are unable to tighten their eyelids well. Your baby is unable to focus on objects and the eyes can easily cross.
  • Your baby is unable to maintain a stable body temperature. Your baby will be under a heat source called a radiant warmer or in an isolette.
  • Your baby will require some type of respiratory support to maintain oxygenation.
  • Movements are jerky and you may notice twitching. Your baby will have very low muscle tone with arms and legs extended.Your baby can hear at about 25 weeks. Speak softly because loud noises may startle your baby or make him become disorganized.

26-28 Weeks

  • Your baby is still unable to maintain a stable body temperature and will remain in an isolette.
  • Your baby still requires some type of respiratory support.
  • His eyes are most likely opened at this time but he still cannot protect them well by closing the eyelids. He is still unable to focus and has poor control of eye movements.
  • The skin is still very fragile and sensitive to touch. Use firm touch instead of stroking so that your baby does not get over stimulated.
  • Your baby's movements are still jerky with the arms and legs extended and low muscle tone, but at times will pull them in briefly.
  • Your baby may begin to have very brief times when he is "alert."
  • Talk to your baby and let him hear your voice but continue to speak softly. Loud and/or sudden noises may startle your baby.
  • When feedings are started your baby will be fed through a nasogastric tube (placed through the nose and down into the stomach) because he does not have his sucking and swallowing reflexes yet.
  • Your baby may develop brief times of periodic breathing or apnea (not breathing) and bradycardia (decreased heart rate) that may require stimulation and additional oxygen and/or medication to treat.

28-30 Weeks

  • Your baby is starting to grow scalp hair as well as eyebrows and eyelashes.
  • Your baby will start to open his eyes more and has more control of tightening his eyelids to protect the eyes.
  • He may continue to have episodes of periodic breathing and apnea and bradycardia.
  • He is getting more control of his extremities. While the legs are still mostly extended he will move them around more.
  • Your baby is still very sensitive to touch and likes that firm touch instead of soft stroking.
  • Your baby may start to respond to voices at this time but they need to continue to be soft.
  • Apply one form of stimulation at a time so that your baby does not become over stimulated.  

30-33 Weeks

  • Your baby may continue to have episodes of apnea and bradycardia.
  • Your baby may start to wake for feedings and will begin to have more defined wake/sleep patterns.
  • Your baby will continue to have jerky movements and startle easily.
  • The movements your baby makes are becoming more controlled now. He moves the arms and legs frequently and bends them easily. The legs are now flexed more at sleep.
  • Your baby will focus briefly on faces and at about 32 weeks may start to make eye contact for short periods. He will also open his eyes more when there are not bright lights on.  

33-36 Weeks

  • Your baby may continue to have episodes of apnea and bradycardia.
  • Your baby should start to develop more body fat now. Around this time your baby will be able to maintain a stable body temperature on his own and will be taken out of the isolette and put into a bassinet with clothes and blankets.
  • The skin is still fragile but your baby can tolerate your touch more often including some gentle stroking.
  • The toenails are present and the fingernails have reached the tips of the fingers.
  • The eyes are continuing to develop. Your baby can now focus for short periods of time and may be able to track an object from side to side at about 35 weeks.
  • Your baby will develop definite sleep/wake patterns and may sleep more soundly.
  • Your baby will be more flexed at sleep and kick and move extremities more when awake. Movement will not be as jerky but will become smooth and controlled.
  • Somewhere around 34-35 weeks your baby will develop the ability to coordinate sucking, swallowing and breathing. During this time bottle feedings may begin.

36-40 Weeks

  • Your baby should be off or weaning off of respiratory support and able to breathe well on his own.
  • Your baby should be able to open and close his eyes periodically. He should be able to focus for brief times with a preference for objects 8-10 inches away, especially the human face.
  • Almost all of the lanugo is gone.
  • The genitals are more developed.
  • The extremities are now well flexed at sleep with great movement during wakeful periods. Resistance should be met with passive movement.
  • Your baby now handles socialization well. He may be more actively involved with you and his environment.

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Edward Hospital & Health Services
801 S. Washington, Naperville, IL 60540 • (630) 527-3000

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