Before Reaching in Your NICU Baby’s Incubator Do These 4 Things First

January 16, 2021

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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Since we’re all about creating positive experiences for you and your NICU baby, let’s talk about some things we should all be doing before we reach into a baby’s incubator and start interacting with them. 

It doesn’t matter how old your baby is, if they are in an incubator (also called an “isolette”), they will benefit from some of these amazing tips! Plus, you’ll be building positive pathways in the brain by slowing down the pace of NICU life and prioritizing good, positive, touch experiences.

Small changes can make a BIG difference as your baby prepares themselves for touch and interaction.

1) Check to be sure it’s a good time—if it is, move on!

Many NICU parents have shared that one of the most frustrating parts of their NICU journey is having to ask for permission to interact and care for their baby.

When talking with your baby’s nurse the best times to interact with your sweet baby, you can come to the conversation with some good information. 

It really is an important part of development and care to check for certain things before we disrupt or interact babies on their healing journeys in the NICU.

Here are a couple things to ask yourself.

Is it your baby‘s assessment time?

If it’s not your baby’s care time and they are sleeping comfortably in their incubator (also known as an isolette), it’s not the right time to reach in and provide stimulation.

It can be SO tempting because their little hands are so sweet, but protecting your baby’s sleep is one of your greatest jobs.

Babies in the NICU often have specific care times that happen every 3 to 4 hours, to possibly ever 12 hours. Talk with your baby’s nurse about their care schedule, so you can make sure you’re able to visit around the times when your nurse (and you!) will be doing care.

Is your baby medically stable?

In the NICU, sometimes we hear this as, “My baby is having a good day”. Before adding in extra stimulation, or interacting with your baby, it’s important to make sure that they are doing well managing their medical stability.

Your baby will work hard to prioritize their breathing rate over opening their eyes and interacting with us.

If we add something else into the equation, like touch or movement, we’re adding one more thing to their world as they learn to process their environment.

Before reaching in, learn about your baby’s day and understand what their medical status have been.

Is your baby awake?

Did you peek into your baby’s incubator, and see them quietly awake, looking around their incubator home? 

That means it may be “go time”.

If your baby is in a natural awake state, it may be an appropriate time to provide your baby with a hand hug, finger hold, or talk at their bedside.

Make sure your baby is showing you some approach cues, letting you know they are ready for some interaction.


What’s one thing you do over and over and over again when you’re in the NICU? 

Washing or gelling your hands! Constantly!

Not only does this leave you with incredibly dry hands (ugh!), but it exposes your baby to strong chemical scents.

Sometimes we forget about how NICU babies are affected by smells.

Your baby’s sense of smell is more important than we give it credit for. It started developing while your baby was still in the womb. By the second trimester, your baby has smell receptors that have developed in their nose, and they’re actually breathing in the scent of your amniotic fluid. Yep!

That’s one reason we like to encourage the use of mom scent at the bedside, because it’s a comforting and recognizable smell for your baby.

In contrast to mom‘s comforting smell, the smell of freshly sanitized hands entering the port holes of an incubator and filling your baby’s space can be stressful and overstimulating.

Where’s one of the first places we place our hands when we reach in an isolette?

It’s usually either on their head to check something on their face, or to place a pacifier.

We’re putting our sanitized hands right under their sweet nose. 

Go ahead and give it a try.

Gel your hands, and then bring your hands up to your face….

How do you feel?

When I started doing that as a test myself, I was honestly shocked at how overwhelming it was for me.

Now, I’m super conscious about doing this little trick first!

After you gel your hands, but BEFORE you reach into your baby’s isolette…wave your hands around in the air. 

It’s going to seem silly, but by waving your hands around after gelling them, you’re dissipating the smell.

You can be subtle about it, just a little waving at your sides.

So before reaching in to interact with your little baby (in the words of Taylor Swift), “shake it off, shake it off”.


This one tip can change the entire way your baby reacts to you when you reach in to give them a hand hug.

Warm those hands y’all. Our hands matter. 

The skin is the largest organ in the body. To touch your baby’s skin is to support the development of their brain.

This is not only important when thinking about supporting your baby’s sensory processing or providing positive touch experience. Making sure your hands are warm is also a way to ensure your baby has good thermal regulation, and their temperature stays regulated during care.

Here are a couple of tricks to try if you’re trying to warm your hands at your baby’s bedside.

  1. Rub your hands together quickly to create friction and heat.
  2. Run your hands under warm water.
  3. If your baby’s isolette is warm, warm them with the air in the isolette before touching your baby.
  4. Place your hands under your baby’s positioning device and rest there for a second (be sure not to jostle or disrupt your baby, if you choose this method).

Avoid blowing on your hands to heat them up, remember we’ve just put hand sanitizer on, or washed our hands to clean them. We don’t want to blow germs back on them.


That’s right, let’s warm your baby up to the idea of some interaction. Before touching your baby, talk to them quietly first.

Their brain can start processing some sensory input without being startled. Just a little bit at a time is a good rule of thumb for the NICU.

Then, their body can prepare for the touch, diaper changes, hand hugs, and cares that are about to come. 

Not sure what to say? 

Talk sweetly to them, say their name, ask them how they’re doing. 

Your baby will simply be happy to hear your voice. 

If your baby is in an incubator, keep your voice low and quiet.

If the doors of the isolette are opened, the sound can amplify (grow louder!). Being conscious of our conversations and noise level around the incubator can help support your baby’s sensory processing skills and set them up for success!

why a slow introduction is best for your nicu baby

Your baby will prioritize basic life functions FIRST. 

The more medically fragile your baby is, typically the more they struggle with tolerating touch and other sensory experiences.

It is important to grade interactions with babies in the NICU, which means we start with very little stimulation, and gradually work up to more.

That’s why I always recommend talking to your baby first, then reaching in to provide a hand hug.

Your baby receives a lot of procedure-based (touch during medical care and procedures) touch experiences in the NICU.

So, when it’s time to interact with your sweet one...use these strategies to support a positive, comforting and relaxing experience. 

How does your NICU baby do during their cares? Have you tried any of these tricks?

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