Discharge day for a preemie is special, but it is just the beginning of a journey that often includes therapy at home. As an Early Intervention therapist, I thought parents could use some insights into what your team is really thinking when they begin to work with you and your baby.
We know that you are nervous. This is your first experience with a medically fragile child, but it isn’t ours. Most of us have worked in hospitals before, and are well-acquainted with universal precautions, shunts and feeding tubes. We are always looking for signs that things aren’t going well, and we will do everything we can to ensure your child’s safety at all times. That may mean that we will tell you that things like placing a Bumbo chair on a table is a risk, and those chairs do not give your child the correct support for growth. Regardless of what your sister-in-law said about her child.
We aren’t doctors, so we will not give you a diagnosis, even if we suspect something. Legally, we can’t diagnose, so even though we suspect that your child may have cerebral palsy or another issue, you won’t hear it from us. In the past 15 years, I have seen neurologists in NY delay diagnosing conditions such as CP for well over a year after birth, even when there isn’t any alternative diagnosis that fits. Parents are left waiting and wondering, hoping that it isn’t so. The internet allows parents to learn quickly what all that muscle rigidity and terms like “leukomalacia” can indicate. I suspect that medical liability issues are at the heart of this delay, and it is tearing parents up inside. But we aren’t allowed to tell you our suspicions.
You are the greatest determinant of therapy success. We can only guide you, demonstrate techniques, positioning, and give you therapeutic activities. What you do every day is essential and will determine much of the success of our work. If we suggest that you hold your baby in a manner that builds head control, reduces arching or encourages reaching, we know that your actions will determine if it works. If you ignore our suggestions without discussing your concerns, or worse, tell us you are doing them when you aren’t ( we can actually tell), you aren’t getting very much from your child’s therapy or your therapists.
Babies can feel fear or confidence, so ask questions and get more reviews and guidance if you don’t really understand what your therapists have suggested. We do this all day long, and most of us have been handling premature babies for years. We know this is all new to you. No judgements!
Preemies often wait a long time to start playing. NICU life isn’t about fun, it is about survival. Once your preemie is home, you will want to get the party started. If she has a weak grasp or isn’t coordinated enough to easily hold every rattle and toy that you got for your shower, you might want to consider the O-ball to develop visual-motor skills.
The Original O-Ball!
This is the basic O-Ball, a great toy that I recommend for my 1-4 month clients. I also recommend the next generation O-ball toys, such as the O-ball car, for equally easy grasp with my slightly older preemie or developmentally delayed kids.
Why do I like this ball over cloth balls or those bumpy sensory balls?
The web-like design allows a child to hold it with almost any type of grasp. Low muscle tone, spasticity, or weakness reduce a baby’s ability to grasp and retain a toy. It just isn’t fun if your toy keeps falling out of your hand.
Texture, but not too much texture. The plastic is a little bit grippy, so it doesn’t fall out of her hand like a smooth plastic ball, but not so textured that a sensitive infant would find it overstimulating. Preemies sometimes leave the NICU a little overwhelmed by sensation, and yet many need the extra touch input to really feel what is in their hands. This ball is a good balance of tactile inputs.
Fun at a fraction of the weight. A baby that has strength or tone issues needs lightweight toys to pick it up easily and continue to hold it as gravity pulls the ball down and out of his hand.
The O-ball is large enough and light enough for 2-handed grasp, an important developmental milestone. As an OT, we know that using two hands at midline (the center of your body) supports all the other movements that require a sense of moving around a center…rolling, crawling and walking! Start now to develop awareness of midline and two-handed activity.
Second and third generation O-balls have built-in rattles and are more colorful than this one. None have sharp edges or pieces that can fall out. Safety first.
Did you say “Spit up”? Wipes clean in an instant.
It is a bit squishy, which means it will bend, not break. If your child drops it on her face or on the floor, she might cry from surprise but not from injury.
It will still be fun to play with next year. This ball will still be fun to roll and throw later on in life, unlike those rattles that will be tossed out in a few months.
Is your preemie hypermobile? I wrote an e-book just for you!
The JointSmart Child: Living and Thriving With Hypermobility Volume One: The Early Years is finally out! I include techniques to hold and carry your child, how to use infant exercisers and how to do “tummy time” with a hypermobile baby. There are chapters on how to talk with your family, babysitter, and even how to talk to your pediatrician about your child’s needs. You can buy it on Amazon.com today! Don’t have a Kindle? NP! You can read it on any screen or desktop. Want a printable copy? Buy it on Your Therapy Source today!
Live in the NYC area and want to learn infant massage for your preemie?
Visit my website tranquil babies and make an appointment for an in-home lesson designed just for preemies today!