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Language development and premature babies – how can we help?

By Heather Cresswell, NP

From those first babbles and coos to the excitement of a baby's first words, every parent looks forward to their baby developing language. But did you know that language development starts much earlier than this?

Language development starts before babies are born and continues for years to come. Research and experts can help us understand how we can help babies with language, even if they are born premature and are in the NICU. Let's talk about how you can help your preemie with language.

Language development in preemies

During pregnancy and after birth, a baby's brain is developing rapidly. It is not only growing in size, but it is also forming millions of connections. These brain connections, called neural connections, are crucial to understanding and learning language and speech. Sensory input can change the way these brain connections are formed.

Sensory input is anything we see, hear, feel, smell, or taste. Premature babies have very different sensory inputs than babies born at term. The sights and sounds of the NICU and medical procedures give the brain sensory input. Sensory input can be negative (such as a painful procedure) and positive (such as kangaroo holding and hearing a parent's voice). The good news is that providing positive sensory input can help a baby's language development.

Research and experts are learning more and more about when and how to provide the right amount of positive sensory input for babies at different gestations. Next, let's explore the "when" and the "how" of helping a premature baby's language development.

How babies tell us "I'm ready" for interaction

Babies at different gestations and ages may be ready for different amounts of interaction.

The younger and more premature a baby is, the more time

Even the most premature baby can tell us when they are ready to interact and communicate. They can't use words but can tell us through physical signs and behaviours if they are ready for sensory input or if they need a break.

Some ways babies can tell us "I'm ready" to interact are:

· Making eye contact

· Looking awake and calm

· Having regular breathing and oxygen levels

· Bringing their hands to their mouths

Babies can also tell us, "I need a break," and rest. Some signs that a baby needs a break are:

· Changes in breathing or oxygen levels

· Turning their head away or arching their back

· Crying, yawning, sticking their tongue out

· Looking tired, stressed, or limp

· Wide, staring eyes

It can take some practice to recognize these signs. Your baby's nurse and NICU team can help you learn.

Helping your baby's language in the NICU

Babies at different gestations and ages will be ready for different amounts of interaction. Very small and premature babies may only be ready for a few minutes of talking at a time. Once your baby is more mature (about 33 weeks and older), you can start increasing the time you spend talking and singing to your baby. The best way to judge at any age is to use the "I'm ready" and the "I need a break" signs above.

Here are some things you can do in the NICU to help your baby have positive sensory experiences:

· Have quiet conversations near your baby's bed. If your baby is in an isolette and showing "I'm ready" signs, you can open the isolette door to let your baby hear your voice.

· Kangaroo Care. Skin-to-skin holding is a great time to talk, sing, or read a book to your baby. Holding your baby quietly also gives them positive sensory input, as they feel your warmth and closeness and hear your heartbeat.

· Read the same book or sing the same song over and over. Babies love and learn from repetition.

· Speak in whatever language makes you feel the most comfortable. Babies like to hear any language, but research tells us they prefer the one their parents speak the most.

Supporting your tiny talker's language after NICU discharge

Your baby's language development will continue after NICU discharge and for years and years to come. All of the tips above can be used at home as well. Here are a few more tips for when your baby is mature enough to be at home:

· Make lots of eye contact when talking and singing to your baby.

· When your baby babbles and coos, give them face-to-face responses. Positive responses help your baby's brain connections.

· Read books—every day.

· Avoid screens. Babies prefer and learn best from interaction with people, not screens. Screens can interrupt the important connection between a baby and a parent.

· Repeat, repeat, repeat. Babies love hearing the same stories, songs and words over and over again. Read the same book or sing the same song over and over, and watch your baby's face light up.

Want to learn more? Check out the new CPBF infographics all about language development!

If you need some help getting started, talk to your baby's nurse and NICU team; they are there to help.


Canadian Children's Literacy Foundation. Tips and Resources

Key Reference:

Heather Cresswell is a Neonatal Nurse Practitioner and health writer. As a nursing student in 1995, Heather discovered the NICU during a clinical placement and never looked back. She has spent her entire nursing career (more than 25 years and counting) caring for NICU patients (premature babies are her favourite!). When not caring for her tiny patients, Heather is also a health writer and is happy to contribute to the Canadian Premature Babies Foundation.

Heather lives with her family in Burlington, Ontario, and is a proud mom to one son.

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