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Developmental Care in the NICU

Developmental Care is one of the most important tools in the NICU to make your baby's stay the best it can be. It takes into consideration the age of the baby and the maturity of their organs to determine the most appropriate level of medical care. Developmental Care is a way of adjusting infant care to protect and promote normal growth of the organ systems. It is research based and hospitals that practice this have seen their baby’s breast feed or bottle feed earlier, gain weight quicker and go home sooner.

How the brain looks differs and how well it works is different from 23 weeks to 40 weeks gestation. At 23 weeks, there are not very many folds in their brain and the brain has minimal functionality and cognitive development. As the brain matures, the brain creates these folds to allow more space for nerves to communicate and store information. The speed that the nerves communicate impulse will become quicker the more the brain develops and develops normally.

There is an orderly process of nerve and organ development. The first system to develop is the tactile (touch) system. The maturing of this system is from hands and feet towards the brain. Next is the vestibular or equilibrium. Motion and sudden position changes can be very upsetting. Therefore, it is important to watch your baby to see how they react to position changes such as moving side to side in the bed or going from bed to your arms. The ability to taste different things is the next order of development. The taste system is closely linked to the smelling system. Eyesight begins around the 5th month of gestation. The eyelids are fused until somewhere around 25 week’s gestation. Somewhere around 30 weeks gestation the infant is able to react to light. However, this reaction is not consistent until around 32 to 35 weeks gestation. The infant is not able to regulate their pupils to adjust for the levels of light until after 33 weeks gestation. Therefore, it is important to shield your infant’s eyes from light until they are at least 34 weeks gestation.

When one of these senses is stimulated, it affects the other senses in either a good way or a bad way, depending on the amount, type and timing of the stimulation. Each infant’s maturation will determine their response and tolerance to various sensory inputs. Each infant is able to communicate their positive or negative feelings of the stimulation through behavior cues that we can watch for. One of the best things you can do for your infant as parents is to observe your infant’s behavior and watch for their pleasure cues and stress cues.

Your baby’s caregivers will use a variety of ways to create an environment to help your baby’s body mature. Some things that you may see are blankets over the isolette, soft rolls around your baby, beanbags that help position your baby so their muscles grow and ease your baby’s breathing, swaddling in blankets, ears muffs to decrease noise, holding your baby skin-to-skin (kangarooing).