When Can I Hold My Premature Baby?

Signs Your NICU Baby Is Ready to Be Held

The moment when parents first hold their premature baby is one of the happiest NICU milestones. Preemies are very small at birth and have complex medical needs, so parents may not be able to hold NICU babies for days or even weeks. Helping to settle a premature baby into a parent's arms for the first time is one of my greatest joys as a NICU nurse.

There are many things to think about when deciding when a NICU baby is ready to be held. We know that when parents hold their babies—especially when doing kangaroo care—there are benefits for both parent and child. However, there are also risks when babies are held before they're ready.

When You Can Hold Your NICU Baby

Once your baby meets these milestones or criteria, you will usually be able to hold them.

  1. A stable baby: In the first days of life, a preemie's blood pressure and heart rate are still stabilizing. NICU staff may have trouble getting oxygen to your baby's cells and vital organs, and blood pressure fluctuations can cause IVH. Even small changes to a baby's position can cause big changes in his circulation, so we move very small preemies as little as possible in the first few days.
  2. Secure lines and tubes: Premature babies in the NICU are often hooked up to many tubes and wires. Most of them are just monitors, but others might be delivering IV nutrition to the veins or oxygen to the lungs. Before you can hold your baby, NICU staff must be confident that these lines are in good position and very secure. 
  3. Handles diaper changes well: Babies who are ready to be held can handle routine care such as diaper changes, temperature checks, and repositioning well. They may alarm or need extra oxygen for procedures, but they don't have multiple bradys and desats whenever they're touched or examined.
  4. Recovered from surgery: If your baby required surgery in the first days of life, you may have to wait until after the immediate post-op stabilization period. Drains and chest tubes must, like other lines, be well secured and in a good position.
  5. No more humidity: Extremely premature babies have immature skin and can get dehydrated quickly by losing water through their skin. Micro preemies are usually kept in a humidified incubator early on to prevent this type of dehydration. If your baby was born at less than 27 weeks, you won't be able to hold him or her until high levels of humidity are no longer needed.
  6. Doctors/nurses agree: NICU doctors and nurses are professionals who specialize in the care of premature and sick babies. They care passionately about your baby and want to help you and your baby form strong bonds. If your baby's doctor or nurse doesn't feel that your baby is ready to be held, try to listen to their reasoning. 
  7. Parents feel ready: Finally, you must feel confident and ready before holding your baby. It's natural to be scared, but don't feel forced to hold your baby if you're terrified and really just aren't ready. Get comfortable with your baby by participating in diaper changes and feedings. Spending time in the NICU and getting to know the environment and how your baby reacts to different things will help you ease into holding your baby in your arms.
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  • Bassan, H. (2009). Intracranial Hemorrhage in the Preterm Infant: Understanding It, Preventing It. Clinics in Perinatology. 36(4):737-62.

  • DiMenna, L. (2006). Considerations for Implementation of a Neonatal Kangaroo Care Protocol. Neonatal Network. 25(6), 405-412.

By Cheryl Bird, RN, BSN
Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia.