The developmental treatment of premature infants

By: Shiri Kertin, developmental physiotherapist, with a master's degree in occupational therapy

Mazel Tov! The period of hospitalization in Pagia is over and you are home. The development of a premature baby (with a normal neurological system) is very similar to the stages of development of a baby born on time, but it has unique characteristics. Many premature babies show typical developmental difficulties in their first two years of life. Sometimes the difficulties accompany them throughout their lives and sometimes they pass. The developmental difficulty is caused by the immaturity of the body's systems and the presence of effects of the environment of the fetus. Neurologically, there are difficulties in the sensory system (hypersensitivity or hyposensitivity of the system), movement (changes in tension/muscular tone), and in the body's regulatory systems (heat-cold, satiety-hunger, sleep-wakefulness). In addition, some premature babies have digestive difficulties (reflux, etc.), and difficulties in the respiratory system that affect cardiopulmonary endurance. All this and more, affect the development of the premature baby.

Studies show that the younger the premature baby is born in a week, the greater his risk of developing developmental difficulties and depends on the complications that occurred in the premature baby (such as cerebral hemorrhage). In addition, it has been found in studies that a premature baby born in late weeks (34 or more) has a high risk of developing a developmental delay compared to babies born on time. An encouraging statistic is that most premature babies manage to bridge the developmental gaps by the age of two and some, even earlier. The most common developmental difficulties are a delay in acquiring milestones such as rolling over, crawling to walking, delay in acquiring language and communication, delay in playing and sensory and emotional difficulties. In addition, there are difficulties in transitioning to eating solids, and sometimes there are difficulties in sleep and anesthesia processes. Each pelagic has its own developmental rhythm and characteristics. It is possible that one preemie will be able to complete movement gaps quickly and will be late in language/play and another preemie vice versa. There are premature babies who do not need treatment at all, but in any case it is recommended to seek developmental diagnosis and treatment, as needed. The first professional who meets the premature baby and his family is a developmental physiotherapist. The developmental physiotherapist is licensed by the Ministry of Health to treat premature babies. The physiotherapist will accompany and instruct on motor, sensory, emotional, mental development, daily functions and eating. Premature babies born under 33 weeks and/or with a birth weight of less than 1500 g are entitled to premature follow-up through the health services. If you are accessing a private consultation, ask to see certification certificates and a valid license from the Ministry of Health.

Welcome home!

The home environment can be an environment that encourages emotional, sensory, and movement development for the premature baby. Here are some helpful tips for moving home from Pagia:

Hug, kiss, wrap him/her in warmth and love, and also in a carrier/blanket/hammock. Continue with the gathering position of the premature baby's body with the help of a rolled towel/diaper, called a "nest" or "pretzel". This position will encourage touch, soothing and a physiologically fetal flexion position (important for the muscular system). From a safety point of view, it is recommended to put the "nest" under the bed sheet.

Age appropriate game: talk and sing to him/her. In the first months, the parent is the most interesting "toy". From the corrected age of two months, the baby can be exposed to a single game.

In terms of the sensory system: continue in the kangaroo position, teach premature babies massage - massage has long-term effects on the functions of self-soothing, sleep and eating. Reduce the stimuli of light, noise and unpleasant touch. It is recommended to light the house with dim lighting or daylight. It is recommended to play pleasant and calm music, show one toy at a time.

For premature babies who suffer from reflux, it is recommended to raise the bed mattress. A good method is to place a large binder under the mattress, at the head of the bed.

In terms of traffic systems - To prevent torticollis (head tilt), maintain symmetry in the neck position of the premature baby by holding each time, with a different hand of the caregiver, correct positioning of the neck when it was in the cradle with a rolled diaper, and changing the position of the toy/mobile/book in the bed, dresser and stroller once a week.

Lay the premature baby on his stomach whenever he is awake. The instructions for lying on your back are for sleeping only. Lie in front of him and talk/sing to him or help with an interesting show/game.

Wishing you a pleasant and easy transition home!