Hands Full Parenting: Helping Your Preemie Thrive

The answer to this question lies in an experience I had one morning, not so long ago.

I was getting ready to leave my house one morning, packing my work bag, when my cleaning lady arrived, and informed me that there was a baby deer nestled under the rear tire of my car.

In Monsey, where I live, deer aren’t unique, and, especially at that time of year, tiny, adorable baby deer appeared regularly.

But when I saw the deer, I noticed it was tiny – close to the size of a squirrel! – and realized it must have been born prematurely.

There was no sign of the mother. The tiny fawn was alert, with doe eyes, its thin frame visible. Its body slowly rose and fell with each breath. It looked so lost and vulnerable. I melted.

I called Chaveirim (an organization of volunteers that helps people in a tight spot). I was terribly afraid of hurting the deer and considered Ubering to work. Two volunteers carefully navigated my car out of the driveway without hurting the delicate creature, and left the tiny fawn on my lawn.

In all the commotion, I forgot my lunch. When I came back for it at 2 p.m., the deer was still there, in the same spot. My gardener, Eric, came by and declared, “Either he gets up and joins the deer community, or he dies here.”

“But he can’t walk!” I protested.

“Of course he can,” Eric said. He swiftly lifted the baby, and pulled its legs out. He set him down on his spindly legs with a gentle pat. I watched in shock as the tiny thing ran off into the woods.

Eric had saved its life.

Despite my years of experience in behavioral psychology, I needed my gardener to teach me a crucial lesson about behavior and survival. I was fully focused on how sorry I felt for the poor little thing, while he focused on the goal: if I don’t push him to walk, he’ll die.

That experience sparked a thought about preemies and other babies who have a rocky medical start to life.

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Skills and Survival

When a tiny, precious preemie is born, survival is the initial goal.

There’s often fear and uncertainty, and the last things we think about in those early weeks are the skills we have to teach this child; our focus is narrowed in on stabilization and survival.

But here comes the chicken-and-egg question. Does a child survive and then learn? Or does the child need to learn in order to survive?

Or, as Eric caused me to ponder, do we hope he survives so he can learn how to walk, or do we teach him to walk so he can survive?

To the preemie mother asking this question: Your child was born into a world defined by the goal of survival. No one thought about skill-training.

Ask yourself, “When was the first time I looked at this child and had a conscious thought about teaching him to cope with mainstream societal life?” I’d assume it was probably when he was at least two years old. Maybe even three or four.

The training process in a baby who is developing typically begins at approximately six months of age – a common time for parents to sleep-train, structure feeding schedules, etc.

And naturally, without realizing what they are doing, parents begin an emotional training process as well: setting limits, not responding with urgency to every whimper. They’re not fearfully measuring food intake or checking their baby’s weight; there is no urgency around every bottle.

In the case of a preemie or a child with complex medical needs, this process could take significantly longer. Parents and caregivers anxiously respond to their needs immediately. Additionally, most parents feel compassion for what the child had to endure during his or her days in the NICU and are often unable to induce any further frustration or discomfort. “Didn’t he or didn’t she go through enough?” is the mantra you often hear.

Therefore, children born preterm or with medical complications often go through the first two, sometimes three years of life without ever experiencing the frustrations that would naturally occur through the training process.

Then, when you do try to teach frustration tolerance, self-regulation, or self-soothing, these children struggle to integrate a brand-new skill set that is typically taught at a much younger age.

Furthermore, an older child’s tantrums will be longer and more intense, so if you’re starting the training process later, it will appear as if they can’t self-soothe.

Here’s the principle to remember: most children are able to self-regulate to some extent. They simply need the correct environment to do so.  

Children should never get the sense that their parents don’t believe in their potential skills or are afraid for their welfare. If children do get that feeling, they may subconsciously ask themselves: “If the people who are taking care of me are so worried about how to handle me, then what’s going to be?” This can result in internal unrest and prolonged or intense tantrums.

Alternatively, if a child is having a tantrum, and his parents appear calm and collected – even if they’re frustrated! – the child will sense deep down that the people who are taking care of him are capable and confident. Over time, that knowledge will nurture calm and happiness.

Self-regulation During Tantrums

So, how can you help children self-regulate during a tantrum?

Just as being told “calm down!” when you’re upset doesn’t help you become calm, the same is true for children. They do much better when placed in an environment where they can experience frustration and learn to deal with it on their own.

In order to create that environment, follow this rule: no talking during tantrums.

It’s a hard rule; most parents instinctively want to help their children calm down because they can’t tolerate seeing their child frustrated or they can’t handle the noise or misbehavior that comes along with that frustration.

And, unfortunately, there are some parents whose own frustration tolerance is low, so they quickly leap in to solve their children’s problems to restore a sense of calm. 

However, when you give in to a tantrum, you’re reducing your child’s ability to self-soothe, and creating a situation where it will be ever harder for him to tolerate upsetting situations.

Let Your Preemie Grow

So, ask yourself this extremely important question. If your child was born prematurely, and, through the miracles of current technology and with the help of G-d, survived and is high-functioning, how much of this child’s “preemie-ness” do you want to follow him or her into adulthood?

You want to give your child the best shot at success in mainstream society by letting go of the preemie label and the anxieties that may come along with it.

Even if your child has delays or disabilities, know that in every child, some percentage of their IQ, EQ, or other generalized function is trainable. Sometimes you might have to search hard to find where you can nurture growth. Sometimes it will be hidden. But it’s usually there.

A powerful scene in Helen Keller’s The Story of My Life describes her teacher, Annie Sullivan, refusing to cooperate with the family’s ritual of allowing Helen to walk around the table and stick her hands into everyone’s plate and eat whatever she wanted. “She doesn’t understand,” is what the family said of the blind and deaf youngster.

Annie’s refusal to allow this misbehavior resulted in a huge tantrum, followed by an uproar from the entire family. But at the end of the difficult evening, during which Annie sent both parents out of the room, she managed to teach Helen to fold her napkin. And Annie clung to that hope. She kept repeating, “She folded her napkin, she folded her napkin. If I could teach her to fold her napkin, what else can I teach her?”

Keep searching for that trainable part of your child. It’s there. You’ll uncover it one piece at a time. And remember that one of the greatest gifts you can give your fawn is the ability to stand on her own two feet.

Things can get easier, starting today.

If you’d like to learn more how OPWDD services can support your child’s growth and development, reach out today.

Our dedicated service specialist will walk you through your options, explain eligibility, and give you clear next steps.