In the NICU - Caring for baby
Care activities
Be Involved
You are especially encouraged to be involved in the following care-giving activities for your baby, for example,
- Mouth-care
- Nappy changing
- Bathing
- Weight checks
- Feeding
Start by watching your baby’s nurse do them. You can get involved when you feel comfortable to do so. Even if only observing, you can take part by comforting your baby, e.g. your Soothing Voice, Gentle Touch or Comfort Hold, see ‘Ways you can comfort your baby’ LINK.
With practice, you will become more comfortable doing these activities yourself. Your baby’s nurse will help you. Before starting any activity, check with your baby’s nurse as your baby’s individual needs may differ.
Remember, some very preterm or unwell babies may find some care giving activities tiring or upsetting, so take your time and remember to watch your baby throughout and respond to their signals. See “Watch your baby and respond to their signals.” Ask your baby’s nurse to guide you.
Top Tips to help you to interact with your baby
- Ensure your baby is awake and ready for each activity.
- Watch your baby throughout to ensure that they stay comfortable and that you respond to their signals, see ‘Understanding how your baby communicates with you’.
- If your baby shows signs that an activity is becoming too much for them (see ‘Time-Out’ signals’, pause what you are doing and offer them reassurance and comfort, see ‘Ways to comfort your baby’.
- Only continue the activity when your baby signals that they are ready, i.e. ‘Positive Approach’ behaviours.
- Do not continue if your baby does not signal that they are ready.
- See ‘Interacting with your baby’.
Did You Know?
Breast milk contains antimicrobial properties that help to clean your baby’s mouth.
“Remember to watch your baby and respond to their signals.”
Care-giving Activities
This is a nice care-giving activity for you start with. Choose a time when your baby is alert and appears comfortable, perhaps during a tube-feed. If expressed breast milk is available, it is used to moisten and clean your baby’s mouth. If breast milk is not available, use sterile water.
Cleaning your baby’s mouth
- You need a cotton bud swab and tube, which will be available in the neonatal unit.
- In the early days, if you only have a very small volume of breast milk (colostrum), do not use a cotton bud as this may soak up too much of your precious milk. Use a gloved finger instead or use sterile water with a cotton bud.
- Pour a little expressed breast milk or sterile water into the tube and dip the swab or your finger in it.
- Use the swab or your finger to clean your baby’s mouth with a gentle ‘press and scoop’ action. This is more pleasant for your baby than a ‘wipe and stroke’ action. Ask your baby’s nurse to show you.
- Be very gentle, the mouth is a sensitive area.
Changing your baby’s nappy is one of the everyday care-giving activities that you can be involved with. Your baby’s nurse will show you how.
It is not always necessary to change your baby’s nappy before feeds. If your baby is awake and hungry, they may become impatient if their feed is delayed by the nappy change. Because of this delay, your baby may not be relaxed during the feed. If so, let your baby feed first.
see EFCNI guidance on care giving activities in the neonatal unit https://newborn-health-standards.org/
E.g. nappy change
Bath-time is another opportunity to interact with your baby. Check with your baby’s nurse to know when a good time might be.
Bathing classes are provided, ask your nurse for details.
Bathing your baby when they are in an incubator
- Your baby may be given a little ‘bed bath’ or a ‘top and tail’.
- Your baby’s nurse can show you how to gently clean your baby’s face, cleaning each eye separately, their ears, neck, body, arms, legs and all the creases.
Bathing your baby when they are in a cot
Your baby’s nurse can show you how to bathe your baby in water.
- Fill the bath with enough warm water to cover your baby’s tummy to allow them to float.
- Use your elbow to test the temperature of the water. It should feel warm, rather than lukewarm or hot.
- Tuck in your baby’s arms and legs and ease your baby into the bath by letting their feet touch the end of the bath first.
- To help your baby feel more secure during the bath, allow them to touch the end of the bath when they stretch out their legs.
- You may also wrap your baby in a light sheet to help them to feel contained at bath-time. Ask your baby’s nurse if this is appropriate for your baby.
Support your baby at all times
- You may like to use your own towels, sponge and face cloth.
- You may also like to take photos or a little video recording of your baby’s first bath.
- To protect the natural oils in your baby’s skin, it is usually enough to bath them once a week.
Weighing your baby is another opportunity to be involved in caring for your baby. Your baby’s nurse can advise you.
Weighing your baby
- Make sure that the scales say zero before you place the baby on.
- It may help your baby to relax by placing them on their side in the weighing scales.
Feeding is a special time for you to be with your baby. Even if your baby is not ready for feeding by mouth and is fed via a feeding tube, try to visit the neonatal unit at feed times, so that you can take part in feeding your baby. See Section Feeding your baby in the neonatal unit and ‘Positive Oral (mouth) Experiences.
Spending time with your baby and doing cares for them helps you to really get to know them and what they like.
You may also notice when something is not right. If you observe that your baby does not seem right, let their nurse or doctor know – your instinct as a parent is valuable.
