There’s a lot happening in the NICU; it can be noisy, the lights can be very bright, alarms go off, the telephone rings, and staff must perform emergency medical procedures. Here are some tips on doing what you can to protect your preemie while they're in the NICU.

Sleeping in the NICU

Sleep is a basic physiological need. It is very important for recovery, growth, brain development, learning, and memory. Disturbances in sleep can cause exhaustion, damage to the developing body, dysfunction of the immune system resulting in susceptibility to infection, and it can cause serious stress and agitation.

(Bertelle, Sevestre, Laou-Hap, Nagahapitiye, & Sizun, 2007; Graven, 1997)

Tips for optimising your preemie’s sleep

This sort of environment can be very difficult to ensure that your preemie is getting enough undisturbed sleep. But there are a few things you can do to limit the interruptions and noise.

• Switch off lights near your baby that aren’t in use
• Use a screen to protect your preemie if they are close to another baby who is receiving phototherapy
• Secure any drawers or cupboards if they are banging
• Ask people to talk quietly when they are close to your premmie
• Pop a sign on or near your baby’s crib asking for quiet
• Query whether common medical procedures can be undertaken at the same time, such as taking blood and changing diapers
• Allocate where possible periods of time uninterrupted for checkups and tests aside from when they are urgent

Research in the NICU

(Bertelle, Sevestre, Laou-Hap, Nagahapitiye, & Sizun, 2007; Dieter, Field, Hernandez-Reif, Emory, & Redzepi, 2003; Graven, 1997)

Protecting your baby’s eyes

The eyes are one of the last sensory organs to develop and so are immature at the time of birth, especially for infants born preterm. Therefore very early preterm birth can significantly alter the natural course of visual development. It is important to protect your preemies eyes because they are exposed to light before they are naturally supposed to.

Some NICU’s now use padded incubator covers in an attempt to protect the eyes of premature infants from bright lighting. Padding also has the added advantage of reducing the level of noise.

Partially covering on the incubator is another option and recommended by some specialists, particularly for premature babies that are medically unstable or critically unwell. In partial covering the preemie baby’s head is shaded while their body is not; the light enables easy viewing of monitoring equipment and tubes.

(Bradford, 2003)

Research

In the past the NICU has been a very brightly lit place but because a number of researchers suggested that the increased incidence of visual problems in preterm infants may be due to high levels of ambient illumination of the NICU and from stray light from phototherapy there has been a shift towards lower levels of illumination and lighting cycling regimens.

Others researchers have argued that early exposure to light does not significantly speed up or retard normal visual development, and it is not a factor in the development of serious visual disruption such as Retinopathy of Prematurity (ROP).

(Fielder & Moseley, 2000; Lefebvre, Mazurier, & Tessier, 2005; Madan, Jan, & Good, 2005) (Dobson, Mayer, & Lee, 1980; Sokol & Jones, 1979; Tsuneishi & Casaer, 2000)

Learn more about Visual impairment & preterm birth

Technical Reference List

Bertelle, V., Sevestre, A., Laou-Hap, K., Nagahapitiye, M. C., & Sizun, J. (2007). Sleep in the neonatal intensive care unit. J Perinat Neonatal Nurs, 21(2), 140-148; quiz 149-150.
Dieter, J. N. I., Field, T., Hernandez-Reif, M., Emory, E. K., & Redzepi, M. (2003). Stable preterm infants gain more weight and sleep less after five days of massage therapy. Journal of Pediatric Psychology, 28(6), 403-411. doi: 10.1093/jpepsy/jsg030
Dobson, V., Mayer, D. L., & Lee, C. P. (1980). Visual acuity screening of preterm infants. Investigative Ophthalmology and Visual Science, 19(12), 1498-1505.
Fielder, A. R., & Moseley, M. J. (2000). Environmental light and the preterm infant. Seminars in Perinatology, 24(4), 291-298.
Graven, S. N. (1997). Clinical research data illuminating the relationship between the physical environment & patient medical outcomes. J Healthc Des, 9, 15-19; discussion 21-14.
Lefebvre, F., Mazurier, E., & Tessier, R. (2005). Cognitive and educational outcomes in early adulthood for infants weighing 1000 grams or less at birth. Acta Paediatr, 94(6), 733-740.
Madan, A., Jan, J. E., & Good, W. V. (2005). Visual development in preterm infants. Developmental Medicine and Child Neurology, 47(4), 276-280.
Sokol, S., & Jones, K. (1979). Implicit time of pattern evoked potentials in infants: an index of maturation of spatial vision. Vision Research, 19(7), 747-755.
Tsuneishi, S., & Casaer, P. (2000). Effects of preterm extrauterine visual experience on the development of the human visual system: a flash VEP study. Developmental Medicine and Child Neurology, 42(10), 663-668.