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Pre-Term Infant

24-34 weeks’ gestation

35-40 weeks’ gestation

After 37 weeks’ gestation

Special Information

Term Infant

Newborn to one month

1-3 months

4-6 months

Choosing toys

PRE-TERM INFANT

Babies who are born at less than 37 weeks’ gestational age are unable to tolerate the play activities of a full-term baby. Remember these babies should still be in the mother’s uterus (womb) where they are positioned with arms and legs bent. When they move, the walls of the uterus help to bring their arms and legs back close to their face and body. Also, they are not exposed to lights and the only noise they may hear is mom’s voice.

There are interactions parents can have with their pre-term baby even before they hold them to assist in improving their later development and to help them be more comfortable and sleep better. The baby can show you if he likes a specific interaction by his behavioral cues.

24-34 weeks’ gestation

Things baby likes:

  • A finger or cloth roll to hold.
  • Cradling the top of baby’s head in parent’s hands.
  • Holding their feet, with their legs bent, in the parent’s hands.
  • Slow movements.
  • Quiet, soothing voices.
  • Rolled soft blankets placed around their body (as a nest).
  • A pacifier to quiet and soothe them, especially during gavage (tube) feedings.

35-40 weeks’ gestation

When a baby reaches 1000 grams and is off the ventilator (respiratory support) or has been stable for 48 hours on Nasal CPAP they can be held for short periods. Also, the baby will be waking up and showing interest in his surroundings. At about 1800 grams, the baby may be placed in an open crib, but this varies with each baby and the doctor will decide when it’s best for your baby to be moved to an open crib.

Things baby likes:

  • Swaddling in a blanket with hands close to their face with their legs bent.
  • Having their face about 12-14 inches from your face so they can “see” you.
  • You talking softly to them.
  • Dim lights so they can open their eyes better.
  • Quiet surroundings.

After 37 weeks’ gestation

Things baby likes:

  • To follow your face.
  • To turn toward the sound of your voice.
  • Parent interactions during bottle/breast feeding time.
  • Hand to mouth movements.

Special Information

  1. Remember: At any gestational age, watch for your baby’s cues. If he/she is showing signs of stress, just sit quietly with him/her.
  2. Examples of signs of stress include:
  • Finger splaying (fingers spread wide apart).
  • Crying.
  • Turning face away from you.
  • Yawning or sighing.
  • Frowning or “making a face.”
  • Going limp or stiffening of the arms or legs.
  • Arching of the body.
  • Shutting the eyes or turning the eyes to one side (called gaze aversion).
  1. When these signs appear, decrease the amount of stimulation so your baby can calm and organize himself.

TERM INFANT

NEWBORN TO ONE (1) MONTH (corrected gestational age for premature infants)
  1. Things baby likes:
  • The sound of your voice. He shifts his eyes or may turn his head toward a sound.
  • The sound of soothing, soft music. Play a music box, radio, or tape recordings to the baby.
  • He will follow your face briefly if you move it to each side of the baby. Stay within 8-10 inches of the baby’s face. He may also begin to look in an upward direction and imitate your lip movements.
  • To be held and cuddled. He cannot be spoiled at this age!!!
  • To be rocked in your arms or in a rocking chair.
  • To be kept warm.
  • To be wrapped tightly in a blanket (swaddled). See infant positioning guidelines.
  • Initially he likes to look at black and white objects or pictures
  • To be on your tummy as you lie on your back. He will raise his head for a moment or two. (Figure A)

Figure A

  1. Good toys:
  • Parent face.
  • Music boxes.
  • Mobiles—especially bright or contrasting colors. Hang them about 12-14 inches above the baby so he can look at it with his chin down (toward his chest) when lying on his back.
  • Soft clothing.
  • Slow, rocking in a rocking chair.
  • Rattles.

1-3 MONTHS

  1. Things baby likes:
  • Shiny, bright mobile or toys above their bed, but out of reach of the baby.
  • To watch bright colors (red and orange) or black and white colored objects. They will turn their head to follow toys moved in front of them.
  • Musical toys or animals in their bed.
  • Someone to shake bells or rattles for them to watch.
  • To talk in a lively voice to you and other family members. He starts to coo, gurgle, and “talk” back to you.
  • To play “copy cat” with sounds so repeats the sounds he makes.
  • To be on his tummy on the floor. He will lift his head and begin to bear weight on his arms. (Figure B & C)

Figure B

Figure C

  • To smile at you, so smile at your baby.
  • To have a toy held in front of him when he is lying on his back or sitting in your lap. He will get excited and may reach for it.
  • To put toys, his hands and feet, and a pacifier in his mouth.
  • To be held, cuddled, and rocked.
  • To sit in an infant seat so he can see from a different view.
  1. Good toys:
  • Rattles—different sizes and shapes; made out of different materials.
  • Crib gym—a toy with several toys on a rod that is hung across his crib or stroller. Often it has a plastic ball with a small bright wooden ball inside, handles to hold onto, a bulb to squeak. The baby looks, starts to reach and touch, then pulls and plays with the toys.
  • Stuffed toys—baby may hug and hold these toys. Many make noises or play music.
  1. Developmental concerns: If your baby shows any of the following, please be sure to report them to your doctor.
  • He is unable to lift his head or push up on his arms.
  • He has stiff legs.
  • He pushed back with his head.
  • He keeps his hands in a fist and has a stiff leg on 1 side—OR—has difficulty changing out of this position. (Figure D)

Figure D

4-6 MONTHS

  1. Things baby likes:
  • Bright, noisy toys, squeaky rubber toys.
  • To play with his feet.
  • To play “peek-a-boo.”
  • To look at your face and mouth.
  • To be on a blanket on the floor. He can roll from his back to his stomach.
  • To see himself in a mirror. He smiles at himself or pats the mirror.
  • To make sounds. Repeat his sounds back to him.
  • To have a toy held in front of him when he is lying on his back or sitting in your lap. He reaches for the toy with both hands.
  • To transfer objects from 1 hand to the other hand.
  • He is learning to sit at around 6 months. (Figure E & F)

Figure EFigure F

  • To hold a toy in each hand. He will begin to bang them together or to bang them on other things.
  • To put things in his mouth. Be sure these are safe, clean textures.
  1. Good toys:
  • Mirror (non-breakable)—the baby likes to see himself.
  • Bathtub—the baby likes to splash.
  • Bath toys—sponges cut into different large shapes, toy boats, funnels, plastic scoops or cups to empty and fill.
  1. Developmental concerns: If your baby shows any of the following, please be sure to report them to your doctor.
  • He is unable to lift his head.
  • He has a rounded back when he is in a sitting position. (Figure G)
  • He holds his hands at shoulder level with his arms back.
  • He has stiff, crossed legs in a standing position. (Figure H)

Figure GFigure H

  • He does not turn his head toward sounds.
  • He is not making sounds himself.

CHOOSING TOYS

  1. TOYS SHOULD BE SAFE.
  2. Toys should not have small loose parts or sharp edges.
  3. Remember the baby’s age when you buy or make toys. Babies like big, colorful toys that do lots of things.
  4. Make sure the baby cannot choke on or swallow toys he places in his mouth.

Reviewed/Revised:

11/96, 08/98, 3/01, 2/03, 6/05, 12/09

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