Can occupational therapy help preterm babies for real?

Premature babies are infants born before a full–term pregnancy is completed. These tiny babies face serious challenges as they adapt to the outside world, since their organs aren’t fully developed. So, more than happiness, the parents of premature babies often suffer anxiety, wondering whether their babies will attain the natural developmental milestones. Babies who are born prematurely require extra care and support to help them face these challenges. Occupational therapy plays a pivotal role in supporting children who are born prematurely. 

What is a premature birth?
A normal gestational period in humans, or a full-term pregnancy, typically lasts between 37 and 42 weeks. A preterm baby is an infant born alive before 37 completed weeks of pregnancy. Because they are born early, these babies are generally smaller and may have a lower birth weight than full–term babies. Besides, these infants often face multiple challenges like uncontrollable body temperature, loss of eyesight and hearing, difficulty latching and breathing difficulties. 

Premature babies
Preterm babies are categorised into four groups based on their gestational age. 
34 to 36 weeks – Most preterm babies are born between 34 and 36 weeks. They often struggle to latch and suckle, to control body temperature, and to breathe. Although they are healthier and stronger than the other groups, these babies also require special care and attention. 

32 to 34 weeks – These infants are likely to have more health risks than the first group of preemies. They struggle to breathe, cannot control body temperature and may have difficulty latching. Most babies born between 32 and 34 weeks survive with proper medical treatment and care. However, they might face growth challenges in the initial days of their lives. 

Born before 32 weeks – These are extremely premature babies who face many developmental challenges and struggles. Their lungs, brain and digestive system are underdeveloped. These infants require intensive care. 
Born before 25 weeks – These babies have low viability and might face severe health challenges. They are born before most of their internal organs are fully developed. Although the survival rate has increased due to advances in modern medicine, they often face long-term health and developmental challenges. 

Factors that lead to preterm birth
These are the factors that lead to premature delivery among mothers:
•Mothers who expect two or more babies
•Women who are below 17 years or older than 35
•Those who have a history of preterm birth or in their family
•Smoking and alcohol consumption while being pregnant

Stages of development
Parents of preterm babies often get worried whether they will achieve developmental milestones like normal babies. Each child has different levels of growth or intellectual prowess. However, the developmental milestones of premature babies are closely monitored by healthcare experts. Besides, the baby's actual age and gestational age are clearly calculated. 

Tips for parents
•Create an atmosphere of love and care to stimulate the baby
•Try to motivate them gently to indulge in developmental activities
•Note whether the baby is achieving each developmental milestone at the right age
•If you notice any delay in those milestones, consult an occupational therapist as soon as possible
•Make sure to follow up with the experts and show up with the child for doctor’s appointments. 

Advantages of occupational therapy
Occupational therapy plays a crucial role in nurturing the premature babies who are admitted to the Neonatal Intensive Care Unit (NICU), as well as during their initial period of growth and development later at home. It also offers support to the parents and families of these infants. 
1)Holding and handling the infant
•Helping the parents hold the infant in the right way to support joint alignment, improve breathing, and prevent disabilities.
•Gently handling the babies would develop instincts in them to console themselves and to have a better understanding of their own bodies. 

2)Breastfeeding support
•Corrects the feeding positions of both the mother and the infant
•Helps in developing oral motor skills in premature babies who do not have the strength to suckle or coordinate breathing while feeding.

3)Sensory regulation
•The sensory system of preterm babies is often underdeveloped
•An atmosphere that offers the calmness of the NICU and the warmth of the womb is created to develop the infant’s sensory regulation
•Training the parents in gentle touching, swaddling and right stimulations when the babies are in the NICU or at home to promote sensory regulation

4)Motor development
•Premature babies are more likely to have delays in the development of motor skills
•The therapist analyses factors like the infant’s movements, reaching for objects and grasping skills at the right stages and encourages them through various methods to develop motor skills.

5)Safe positioning
•Occupational therapists help in holding the infants in safe positions that promote breathing, eating habits and brain development. 
•Unique nests and rolls are chosen for each baby to prevent disabilities, reduce stress and promote good sleep. 
•Occupational therapists train the parents in safe handling of preterm babies, side sleeping, monitoring prone lying and Kangaroo Mother Care (KMC).

6)Empowers and educates parents
•Educates the parents about holding the infant safely, handling them gently and training them in developmental activities. 
•Gives instructions about each developmental milestone, the ways to track them and steps to build a strong bond with the baby
• The occupational therapist plays a pivotal role in building the parents’ confidence to ensure the effective growth and development of preterm babies. 

Every preterm child who is destined to be born before completing their gestational age is a real survivor. Although they face multiple challenges even at the very beginning of their lives, it is possible for them to enjoy a good quality of life with the help of modern medical science and the loving care of their dear ones. From a premature baby’s first days in the NICU to the initial stages of home care, an occupational therapist plays a significant role in their overall growth and development.

They raise awareness among parents of preterm babies and help infants reach developmental milestones at the right age. These little fighters can surely lead happy, healthy lives with the love and care of their parents, the expert advice of doctors, and the support of an occupational therapist.    

(The writer is an honorary secretary of All India Occupational Therapists Association as well as the founder of the Kochi-based Prayatna Centre for Child Development.)