What premature babies might look like
Premature babies look different from term babies. Premature babies might also look different from each other, depending on how early they were born.
A baby born at 36-37 weeks will probably look like a small term baby.
But an extremely premature baby – for example, a baby born at 24 weeks – will be quite small and might fit snugly into your hand. This baby might have fragile, translucent skin, and their eyelids might still be fused shut.
It’s natural to feel worried about the way your baby looks, but your baby’s appearance is typical for their gestational age. The neonatal intensive care unit (NICU) team will carefully monitor your premature baby’s weight, length and head size to make sure they’re growing as expected.
Your premature baby’s bones and muscles
A premature baby’s bones aren’t always fully developed.
In the last months of pregnancy, a lot of minerals – including calcium and phosphorus – are transferred from pregnant women to their babies. In term babies, this helps bones grow and get strong. Also, term babies spend their last few months in the womb stretching and flexing their muscles, which helps their bones to develop too.
Premature babies don’t get these important minerals in the womb. They also often lose more minerals through their wee than term babies. And they don’t have time in the womb stretching and flexing their muscles.
After birth, it can take a while for your premature baby’s bones to grow and get strong.
Helping your premature baby’s bones and muscles to develop
Staff in the NICU might recommend a powder containing supplementary calcium and phosphorus that can be added to expressed breastmilk for premature babies. This helps their bones grow and strengthen. Sometimes a specially formulated and fortified formula milk can be used.
Gentle exercises specially designed for premature babies can help your baby gain weight and build stronger bones and larger muscles. It can also help to prevent delay in muscle and movement development.
These exercises might include bending or straightening your baby’s arms and legs.
The exercises will need to fit into your baby’s overall medical plan, so speak to your doctor before you try them. Your baby’s doctor will know when your baby is ready to start exercises. A hospital physiotherapist will probably do these special exercises with your baby to start with, while you learn how to do them.
When you take your premature baby home, you can play games that encourage your baby to move their arms and legs. For example, let your baby kick while lying on the floor, or play ‘Row, row, row your boat’ while gently moving your baby’s arms.
Your premature baby’s skin
When a premature baby is born, their skin might not be fully developed. It develops quickly, though.
Skin has 2 very important functions. It lets your baby sense the world through touch and temperature. It also protects all the vulnerable tissues and organs inside your baby’s body.
Sensation
Your premature baby learns about the world mainly through touch, and touch is a key way for you to bond with your premature baby.
It can be soothing for your premature baby if you warm your hands and place them gently on their back or head. Just keep them still. Too much pressure or the wrong kind of touch can be stressful for your baby.
Your baby’s nurse will show you how to touch your baby to soothe and comfort them.
Protection
In a term baby, the skin acts as a barrier against bacteria and viruses that can infect the body. The fat under the skin also insulates the baby by keeping in heat and fluid. It prevents dehydration too.
Sometimes, the skin of very small premature babies – those born at around 26 weeks – hasn’t fully developed. It might look smooth and shiny or translucent, and it’s very fragile. It doesn’t yet act as an efficient barrier. So if anything gets on the baby’s skin, the hair follicles and glands might let it through. This could include any lotions or creams put onto the skin.
Later – at 30-32 weeks – your baby’s skin might look wrinkly and loose, because the skin surface has increased, but your baby doesn’t have much fat underneath the skin.
Because premature babies sometimes have very little fat, they can’t keep a steady body temperature. Your baby’s incubator will be warmed and might be humidified until their skin strengthens 2-3 weeks after birth.
It’s also common for premature babies’ skin to get dry and flaky.
Taking care of your premature baby’s skin
Each NICU will have its own procedures for looking after premature babies’ fragile skin. For example, your NICU might use oil or cream for premature babies with very dry skin, and staff will take care handling premature babies with very fragile skin.
You can also help to care for your premature baby’s skin by:
- using soft cotton baby clothes rather than synthetics that don’t breathe or coarse-fibred wool that can be scratchy
- not putting anything onto your baby’s skin without first checking with the nurse or doctor
- learning how best to touch your baby – your baby’s nurse or doctor will be able to help you.
Without much body fat or muscle, premature babies tend not to move very much. Some of their first movements can be jerky. But as their muscles develop and their nerves start connecting to the brain, their movements become more smooth and controlled.
