RJ was said to be born at 37 weeks at gestation; however, the doctors said that he was 35 weeks by examination. “What does that mean?” Melinda, RJ’s mother, asked. I explained to Melinda that the doctors thought she was 37 weeks when RJ was born. However, RJ appears to resemble a baby who was born at 35 weeks because he was about 5 pounds at birth.
As I talked to the baby, I observed his behavior. RJ took self-comforting actions such as making sucking movements and bringing his hand to his mouth. I used one of his rattles and played with RJ, shaking the rattle and moving it so that RJ could follow it with his eyes. When I held RJ’s hands to his chest, he pushed it away and placed his hands around his face. I recognized these early feeding cues and placed baby skin to-skin with his mother.
After a good feed, RJ engaged in active sleep for about 5 minutes. I talked gently to RJ and rubbed his back and he settled back and then showed his parents what deep sleep looked like: characterized by being totally still, not making any sounds, with regular heart rate and breathing.
“That’s what I do,” Robert Sr., RJ’s father said. “When he wakes up in the middle of the night, I rub his back and tell him that it’s okay.” I validated Robert Sr.’s actions and explained that as babies mature they must pass from deep sleep to light sleep and back to deep sleep in order to learn to sleep for longer periods of time. However the lactation consultant at the hospital had explained to Robert and his mother that babies born early are still developing these sleep patterns. RJ will need to be put to the breast to feed more frequently until these sleep patterns mature. I reiterated that as RJ moves past his due date, rubbing his back is a great alternative to picking him while he’s still engaged in active sleep in the middle of the night.
Knowing that there is a lot to learn about caring for an early baby, I made plans see this family more frequently over the next few weeks.