Babies are born into a world full of new sights, sounds and sensations. But sometimes they aren’t quite ready to make sense of it yet.

Even healthy full-term babies need time to adapt to their environment. Babies who are born early or who have special healthcare needs need even more support.

While your baby is in the NICU, you and your baby’s care team will learn what your baby needs to grow and thrive.

Your baby communicates with cues

Cues are the signals your baby uses to show what they are feeling and how they are coping with the world around them. Babies show this both through their behavior and through changes in their appearance. For example, you may notice that when your baby is ready to eat, they move their hands towards their mouth, or that when they are young they startle more easily.

Your baby’s developing brain

Preterm and VLBW (very low birth weight) babies aren’t just smaller versions of full-term infants that need to feed and grow. They need to mature. Their brains and nervous systems still need to undergo dramatic changes and reorganization. For example, at 35 weeks a baby’s brain is only 2/3 the size it will be at 40 weeks.

Your baby’s developing senses

Whether they are growing in the womb or in the NICU, babies learn using touch, smell, taste and sound. When caring for your baby in the NICU, it’s important to understand how they experience their world.

All babies are born with immature and underdeveloped brains and nervous systems. They can be easily overwhelmed. Your job is to protect and nourish them. This starts with the NICU environment. You want your baby to be comfortable. So it helps to keep bright lights, loud noises and strong smells away whenever possible. And remember that your baby needs lots of uninterrupted sleep.

Understanding your baby’s language

Your baby is surrounded by lots of new sights, sounds and sensations. They have to communicate using their most basic language – their heart rate, breathing and appearance.

Your baby’s “body language”

Your baby communicates how they are feeling by changes in their breathing, heartbeat and blood pressure. The monitors attached to your baby will help you keep track of these episodes of apnea and bradycardia (A’s and B’s). You can also look at your baby’s skin color. Babies who are in distress may change colors. Sometimes they get “dusky” and bluish. Other times they might turn pale or even bright red.

How your baby moves

You can also pay attention to your baby’s movements and muscle tone. Immature and upset babies have jerky, disorganized movements and low muscle tone (they are hypotonic, or
“floppy”). As they mature, their color will be better and their movements will be more organized and controlled.

Your baby’s cues

GO: These cues mean your baby is calm and ready to be engaged:

• Shows good skin coloring
• Has steady breathing/heart rate
• Turns towards sounds
• Has a calm, alert gaze
• Moves their hand to their mouth
• Shows smooth, steady movements
• Brings hands together over the center of their body
• Makes eye contact

SLOW/STOP: These cues are are signs that your baby may be overstimulated and needs a break:

• Looks away
• Yawns
• Startles
• Puts hand over their face or behind ear

CAUTION: These cues are signs that your baby may need medical attention:

• Changes in breathing/heart rate
• Turns colors
• Gags or vomits