Premature Infant Occupations

What occupations are important for a premature infant?

I am already in the 4^th week of my rotation!  Time is flying and I am learning so much.  I feel like I am a sponge trying to soak as much up as I can.  As a future occupational therapist spending time in the NICU, it is only natural to think about our role within this setting and what occupations are important and meaningful for the infants we are treating.

Just as we would not expect each adult or child to value the same occupations, the same holds true for a premature infant and their family.  Each baby and their family must be treated individually and holistically. 

An occupation within the NICU that therapists are commonly addressing is an infant’s ability to explore.  Even though premature infants spend much of their time sleeping (which is very important for development and growth) the small amount of time spent awake is crucial for the wiring of their brain.  During that time, infants have the opportunity to explore their environment.  Exploration, specifically sensory exploration, is an occupation that will shape the infants cognitive development.  The way an infant experiences touch, movement, oral sensations, sound, and visual stimuli are all shaping the way their brain develops.

Within this post, I want to focus on the important of touch. Our tactile system is the  most developed at birth.  It is the foundation of all experiences and contributes greatly to future emotional and intellectual development.  Within the womb, the infant is continuously receiving tactile input that is comforting and soothing.  When that child is born early, the input quickly changes.  Medically, the baby is experiencing unpleasurable events related to their necessary medical cares.  These events can have lasting effects on their sensory development and the way they perceive their environment.  For example, when a baby is receiving painful heel sticks or an IV placement, the brain is learning that touch is negative and something they want to avoid.  An infant who has developed an aversion or hypersensitivity to touch may:

•           Demonstrate developmental delays
•           Experience difficulty bonding with parents
•           Develop issues with feeding later in life

This is why it is so important for families to understand the importance of positive touch and provide these opportunities so when they go home and continue to grow, they do not develop an adverse reaction to the tactile stimulation they will encounter during their daily activities. 

Positive touch helps parents connect and bond with their baby and enables the infant to learn all touch is not bad.  The purpose of positive touch is to:

•           “Buffer” the necessary but sometimes unpleasant experiences in the NICU
•          Empower parents to take control over caring for their baby in this setting
•           Increase the baby’s positive sensory experiences
•          Limit the negative effects that stress of the NICU has on development
•           Prevent your baby from being sensitive to certain touch experiences

There are multiple ways positive touch can be administered:

•           Providing skin-to-skin or Kangaroo Care
•           Providing gentle, firm pressure to areas of the body that have experienced any negative touch (commonly feet, mouth and face area)
•           Watch your baby’s cues to help you know if he/she is tolerating the positive touch
•           Perform appropriate infant massage techniques taught to the parents

It is important to provide positive touch experiences 1-2 times per day or anytime there is interaction with the baby to support their growth and development.