Part 4: Babies born in weeks 32-35

Verified and reviewed by: Midwife Maria Midstam

In this five-part series, you will be able to read about premature babies and the neonatal unit.

Development in weeks 32-35

When the child reaches 34 weeks of pregnancy the brain is approximately two-thirds as large as in a full-grown child.
Development is rapid and the child shows several new skills:

• Vision and skin: The pupil now reacts to light. The skin and eyelids have become thicker.
• Motor skills: Movements are still jerky but more controlled. The child can grasp things and lift their head.
• Taste and reaction: The child prefers sweet flavors and may show displeasure by wiggling its arms and legs.
• Eye contact: For brief moments, the child can now meet their parents' gaze.
• Sleep: The baby still sleeps a lot - around 80-90 % of the day - to grow and develop.
• Coordination: Breathing, sucking and swallowing start to interact, which is important for future feeding.

Care in the neonatal unit

Many babies born during these weeks are cared for in heat-regulating beds with warm water mattress and canopy.
It helps the child to:

• Maintaining an even body temperature
• Protected from bright light
• Feeling safe in small bed nets

Respiration and circulation

Lungs are still immature and the child may need support to breathe deeply and effectively. Most common are CPAP treatment, where the baby breathes against a slight air resistance that helps open up the air sacs. The pulse and breathing may still be uneven and require monitoring.

Nutrition and feeding

The child may need drip and/or tube feeding via the nose to the stomach. When the child is alert and stable, small amounts of food can be put in the mouth.
As the child matures:

• the drip is tapered off
• tube feeding is replaced by food by mouth
• the child learns to suck and swallow in a coordinated way

When the child can handle its temperature better, it can move to ordinary bed, often in family room where you can be together around the clock.

Parenting and intimacy

Proximity is crucial for both the child's development and the parent's safety.
You can participate in your child's care by

• changing a diaper
• washing and weighing the baby
• participate in mealtimes
• talk or sing softly to the child

Everything should be done at a leisurely pace with smooth movements and breaks to avoid overstimulation.

Skin-to-skin contact (kangaroo method) is recommended and there are carrying aids to borrow from the department.

Feeding and breastfeeding

When you stimulates the breasts you can give the first drops colostrum (raw milk) directly into the child's mouth after consultation with staff.
Once milk production has started:

• you can give tasting portions of fresh breast milk during the baby's waking hours
• the child may start lie at the chest to practice breastfeeding

If you choose not to breastfeed, you can baby bottle is introduced.
The department includes specially trained staff in breastfeeding - feel free to ask for support and guidance.

FAQ - Frequently asked questions

1. Why does the child need a warming bed?
To keep the body temperature stable until the child can regulate its own heat.

2. What is CPAP?
A breathing support where the baby breathes against a light pressure that helps the lungs to expand.

3. Can the child make eye contact now?
Yes, brief moments - often a few seconds at a time - but it is an important part of the interaction.

4. How much does the baby sleep in week 34?
Around 80-90 % of the day. Sleep is crucial for brain development.

5. Can I participate in the care?
Yes, you are encouraged to be involved in everything from changing diapers to feeding and skin-to-skin contact.

6. When can the baby start breastfeeding?
Once the sucking and swallowing reflexes interact, the baby can start practicing at the breast, often already during these weeks.

7. What if I don't want to breastfeed?
A bottle can then be introduced - the staff will help you find the right method for your child.