5 Ways to Help Your Baby Learn Coping Skills in the NICU

August 1, 2020

I'm katie, OTD, OTR/L, NTMTC, CNT & founder of blooming littles

Guess who has the greatest influence on a baby's NICU stay? It's YOU! Let's get you the tools, info, and resources needed to create positive NICU experiences, one interaction at a time.

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Your premature baby is not born with the ability to cope and regulate their environment, while also focusing on basic survival. 

The good news is that there are many ways you can help your baby learn coping skills and develop good self-regulation, even while they’re in the NICU.

If you have a baby in the NICU, I hope this information empowers you to know that you can make a major difference in your baby’s development and promote their sensory processing skills. 

I am sharing with you five ways you can help your baby learn self-regulation skills, no matter how little or fragile they are.

Let’s talk about helping your NICU baby learn to interact with their environment, no matter how little or medically fragile they are.

In the neonatal intensive care unit (NICU), we refer to this as self-regulation.

A huge part of your premature baby’s journey is helping them cope with all of the stimulation that is going on around them and teaching them to learn to live and interact with it successfully.

That’s where self-regulation comes in. 

Wondering what self-regulation is? 

Check out my detailed post on what it is, and why it’s so important for your sweet NICU babe!




Looking for a way to get your hands on your baby, help their brains develop, provide skin-to-skin contact, take away their pain, and/or give them some positive touch? 

How about “all of the above”? Yes, please!

A hand hug can accomplish each of those things…it’s THAT good! Curious what a hand hug is? I did a whole post on it here.


It is so important for you to learn to communicate with your baby… you can be the expert.

Focusing on your baby’s cues (aka behaviors) can clue you into:

1) how your baby is processing their environment, 

2) if they need your help,

3) if they are ready for more stimulation or need you to take some away. 

Your baby shows you all kinds of cues, like approach cues or coping signals.

If your baby is showing you approach cues, then they’re letting you know that they are able to regulate what they are experiencing, and they can tolerate more interaction or input. 

Responding to your baby’s approach cues by talking to your baby, giving a massage, or singing at their bedside (just a few examples), lets them know you see their cues, and you know what it means.

It starts building a trusting relationship between you and your little.

If your baby is showing you coping signals, then they are doing their best to cope with any input that is happening, but they’re working hard to regulate it on their own. 

If you see your little babe showing you coping signals…be prepared to jump in and intervene to help your baby regulate what’s going on around them.

Let me explain how this may play out in your NICU life. 

You are changing your 32 week baby’s diaper while they are in their incubator. 

Their arms and legs are flailing, and they have gotten the hiccups. 

What do you do? 

Well…flailing arms and legs and the hiccups are both signs your baby may need your support and could be experiencing some stress during the diaper change. 

Mamas…don’t worry, you’re going to learn what to do!

A 32 week baby is just learning how to cope with their environment successfully—they won’t have the ability to self-regulate on their own. 

That’s why you are here reading this…to help them along.

You are SO important.

Respond to those stress cues or coping attempts and provide your baby with a hand hug or their pacifier to help them re-organize before you continue on with the diaper change.

Anytime you notice coping or stress cues in your baby while you’re taking their temperature, getting a blood pressure, changing their diaper, or repositioning them—go ahead and respond to those cues with support like…

  • stopping whatever you’re doing to give your little one a break,
  • providing a hand hug, or 
  • giving your baby a pacifier to suck on.

Become the expert on your baby’s behaviors and check out:



Here it is.

One of the absolute greatest things you can do for your baby—kangaroo care! 

Also known as, placing your baby skin-to-skin.

If you are a NICU mom (or dad!), I am really hoping you have had the chance to hold your precious one skin-to-skin. 

Research confirms just how beneficial skin-to-skin care with your NICU baby is…and in my clinical experience, I agree wholeheartedly!

Placing your baby skin-to-skin is one of the earliest ways you can help your NICU baby develop self-regulation and set them up for success, as they learn to interact with the world around them in a safe and supportive way. 

When your baby is skin-to-skin, they are experiencing touch, movement, pressure, scent, and sound all at once. For a preemie, that’s a lot of input!

Your touch, your skin, your smells, your voice, and your overall presence is helping your baby not only cope with the new world they’re living in, but supporting them medically as well.

Only a few of the MANY, MANY benefits of holding your baby skin-to-skin are:

  • A more stable heart rate
  • Temperature stability
  • Weight gain
  • Improved breathing rates
  • Improved oxygen levels
  • Better long-term outcomes (like school performance, motor development, and sensory processing!)

Talk to your nurse about what kangaroo care options there are for you within your baby’s unit—even some of the sickest and most fragile babies can be transferred to their mama’s chest for some adapted snuggle time!

Keep in mind, there are some little ones who are not quite able to tolerate the transfer for kangaroo care depending on their medical stability, age, or medical equipment.

If your little one isn’t ready for kangaroo care yet, let them hold onto your finger or provide a hang hug— your baby gets major benefits from that too!

I hope the opportunity to hold your baby skin-to-skin is near, Mama.


Your baby’s suck reflex starts at around 32 weeks gestation, but you may notice your little one sucking on their breathing tube or wanting a tiny pacifier before then—each baby is different. In general, most babes will start exploring their ability to suck around 32 weeks.

You may hear your nurse say the words “non-nutritive suck”. That means your baby is sucking, but they aren’t transferring or swallowing any milk. It is another medical term for sucking on their pacifier or their breathing tube.

At the beginning of your premature baby’s life, your little one’s suck may be weak. They are learning to coordinate the movement and breathe at the same time. 

Don’t worry, they will get better at it with practice!

Sucking is a really supportive reflex for your baby, and it helps them cope with stressful (or even painful!) input.

Do you have a toddler who still likes their pacifier at bedtime or when things are overwhelming? That’s because it is a very calming sensory input for their nervous system.

The same goes for your premature baby. 

Providing your baby with a pacifier (when they show they’re ready for it!) supports their attempts at self-regulation, because you’re providing them with a very regulating and organizing experience.

Eventually, they may bring their hands to their face or suck on their hands in an attempt to cope on their own. 

If your baby has a breathing tube, you may notice your baby sucking on their tube. 

That gets me SO EXCITED! Your little one, even though they’re learning to breath, gain weight and live in the world, is enjoying sucking on their breathing tube, and it’s sending positive, happy signals to their brain.

Babies in the NICU who use pacifiers progress to taking bottles quicker, can practice their sucking skills, have a lower risk of sudden infant death syndrome, and it can improve their heart rate and oxygen levels.

So much goodness, such a little thing!


Basically, I want to empower you to become the expert on your baby, provide them with the supports they need, respond to their cues when they show you they’re stressed, and be proactive in creating a healing environment for them. 

I think it’s safe to say that every single one of us wants the absolute best for our baby, you want to provide your NICU baby with the best and most supportive care possible.

I want that for your baby too.

Here are just a few ways you can provide a supportive environment for your little one while they are in the NICU.

  • Protect their sleep and try to focus on interacting with them around their scheduled care times
  • Talk softly to your baby before you start touching them, so they know you are coming
  • Keep your baby supported in a flexed (tucked) position during their assessment and diaper changes
  • Protect your baby’s eyes from direct light
  • Provide kangaroo care
  • Provide your baby with a hand hug for at least 1 minute before starting any care or interaction
  • Be cautious of the sound level surrounding your baby’s bed space

Think about how you can start doing just one of these things on a regular basis during your baby’s care.

I know your baby will be so thankful—and you just might feel empowered too.

And you can KNOW it’s good for your baby.

Whew, that’s a lot of information.

I hope I didn’t overwhelm you with some of the things you can do to support your baby while they’re in the NICU. 

If I did, I understand if you can only take one nugget of information from this entire article.

It is a TON of information, and you’re reading this on top of processing and healing from your own birth story, endless medical information, lack of sleep, pumping, worry, and trauma. 

Have an anxious or stressed heart, head on over to:


This information is not to overwhelm, but to fill your heart with hope as you enter your baby’s NICU space today. 

You have a role with your baby!

Leave me a comment, or shoot me an e-mail with a story about how your little one is doing, I would love to know! 

I hope you have the opportunity to give your baby a hand hug or participate in kangaroo care today.

Proud of you, Mama!

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