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skin contact meets the infant’s need for nurturing touch and parental contact under the most natural conditions available outside the womb. · Because preterm infants are not able to modulate sensory input well, light touch or gentle stroking can seem over-stimulating and irritating · Demonstrate gentle but firm “static containment” (“quiet hands” or “hand hugs”) · Encourage frequent and extended periods of skin to skin care (KC) · When parents are uninvolved or unable to visit frequently, encourage consistent use of cuddlers or available staff to provide swaddle holding 7C. Vestibular/Proprioception: The vestibular and proprioceptive systems develop after the sense of touch. The vestibular system includes parts of the inner ear and brain that control balance and eye movements. Proprioception refers the sense of the orientation of one’s limbs in space. In more practical terms, proprioception allows us to control our limbs without directly looking at them. The womb provides the optimal setting for these sensory systems to develop. The secure boundaries of the uterine wall promote generalized flexion and gentle containment, supporting the development of proprioception. Maternal movement and fetal activity within warm amniotic fluid offer vestibular and tactile stimulation. In the NICU, skin-to-skin contact is the most logical means of providing essential proprioceptive sensory input to the developing brain. Caregivers can further support the development of the vestibular/proprioceptive systems by careful positioning and handling practices. · Provide containment during caregiving, change infant’s position slowly and without sudden movements · Utilize supportive positioning devices such as the DandleRoos/Wraps · Facilitate skin to skin opportunities NICU Brain Sensitive Care Committee/Terrie Lockridge/ 11-2015/Swedish Medical Center – used with permission 23 7D. Taste and Smell: The gustatory (taste) system is intact by 24 weeks GA and even young preterm infants are capable of responding to bitter, sweet, or salty flavors. Maternal diet and flavors are identified in amniotic fluid, and flavonoids in amniotic fluid are identical to those in maternal breast milk. Mother’s milk appears to be recognized by the preterm on a biological level. Providing the scent and taste of mother’s milk has been shown to promote infant cueing, sucking, and arousal in anticipation of eventual oral feedings. “Pacifier dips” with mother’s milk increase nonnutritive sucking, intake, and growth. The olfactory system is functional by 28 week GA, with olfactory input communicated directly from the nose to the cerebral cortex. Cleaners, disinfectants and alcohol (both wipes and hand sanitizers) represent the most common odors within the immediate vicinity of hospitalized infants. One small study (Bartocci et al, 2000) noted that the scent of NICU detergent triggered a response in neonates that actually reduced cerebral blood flow.