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Special Care

Providing special care for sick and premature babies

There have been many advances in the care of sick and premature babies, not just in technology and medicine, but also in meeting the special emotional and developmental needs of these babies. In the NICU, babies are often subjected to tests, procedures, noises, and lights--very different from the warm, dark, comfort of the mother's womb. Some babies are too sick to be held or have difficulty comforting themselves when not being held. Premature babies especially need a supportive environment to help them continue to mature and develop as they would in their mother's womb.

What is developmental care?

The practice of developmental care is used in many NICUs to meet babies' special needs. Developmental care involves many aspects: from meeting comfort needs and helping babies feel secure and develop normal sleep patterns, to decreasing stimulation from noise, lights, or procedures. Research into developmental care is finding many benefits for babies, especially for premature babies, including shorter hospital stays, fewer complications, improved weight gain, better feeding, and enhanced parent and infant bonding.

Developmental care includes changes in:

  • The overall physical environment--changing the physical surroundings to provide normal day/night cycles and decrease noise and stress.
  • The baby's immediate environment--providing cushions for supporting the baby's position and keeping the baby's arms and legs in proper arrangement to help with development and comfort.
  • The way care is provided--using signals from the baby to plan care at times when the baby is awake and least stressed rather than interrupting sleep patterns or performing procedures when the baby is at a high stress level.

What is Kangaroo Care?

Kangaroo Care is a practice that originated in Colombia in the late 1970s that has been adopted worldwide because of the advantages for premature babies. Kangaroo Care means holding an NICU baby skin-to-skin (against the parent's chest) for varying lengths of time. Premature and sick babies that "kangaroo" appear to relax and become content. Numerous studies have shown that Kangaroo Care has many health benefits that include the following:

  • Higher blood oxygen levels
  • Improved sleep
  • Improved breastfeeding
  • Improved weight gain

Kangaroo Care also helps parents feel close to their baby, and gives them confidence in their ability to meet their baby's needs. Mothers who "kangaroo" also show improved breast milk production.

What is co-bedding of multiple birth babies?

Co-bedding of premature multiple birth babies is a practice being implemented in many NICUs. Co-bedding is based on the idea that babies who grow and develop together in the mother's womb become used to having each other nearby. When these multiple babies are born and placed in separate beds, they may be difficult to comfort and settle without the presence of the other baby or babies. Co-bedding gives the babies back the comfort of the other multiples and may help them develop similar sleep and wake patterns. Studies are currently underway with premature multiples to show whether co-bedding has a positive effect on their growth and recovery.

Multiple birth babies in the NICU may be co-bedded in the same incubator or open warmer bed once they are stable and are without infection. All the equipment and medications must be carefully labeled and checked. Caregiving can be timed when both babies are ready. Consult your babies' doctor for more information about co-bedding in the NICU. Currently, the American Academy of Pediatrics (AAP) does not recommend bed-sharing for twins or other multiples.

The AAP states that premature infants are at increased risk for sudden infant death syndrome (SIDS) and should be sleeping on their back before being sent home from the hospital. Please talk with your infants' health care providers about the AAP's recommendations to reduce the risk for SIDS and other sleep-related infant deaths.

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