Exercises for Preemies: Post 1 Shoulders and Arms

In honor of the March of Dimes’ March for Babies walks, I am providing some exercises that families can do with their former premature infant upon discharge.

The posture of a premature infant is often characterized by the baby having trouble holding themselves tucked in like a full term infant.  Instead former preemies tend to have a straighter posture.  This posture often over-activates the muscles of the back of the body and under activates muscles of the front of the body.  This may result in difficulties with activities that require flexion like sitting, rolling and crawling.  It is for this reason that preemies would benefit from  stretches to promote elongating of the muscles in the back of the body and exercises to activate muscles in the front of the body.

Exercises for Arms and Shoulders 

1.  Gentle shoulder stretch

shoulder down

  • Purpose:  Premature infants often have trouble with breathing,so they use their shoulders (specifically their upper trapezius) to help them pull in air.  This causes the shoulders to be tighter than we would like.  Try this exercise to help your baby relax his or her shoulders
  • General tips: Take time during the day to exercise your baby.  Try to do exercises one time per day.  Pairing the exercise with a dialy activity like feeding or playtime is helpful.
  • Pressure: Babies in general prefer firm but gentle pressure versus light touch.
  • Position: Place your baby in your lap on her side with bottom at your belly and legs bent.
  • Exercise: Place your hand on shoulder and gently pull down, hold for 3 seconds, then stroke your hand down the baby’s arm to their hands bringing hands together.
  • Repetition: Do this 5-10 times as your baby tolerates

2.  Hands to Mouth and Hands Together

hand to mouth  hand to hand

  • Purpose: Former premature infants need help to activate the muscles in the front of their body.  Practicing self calming skills (hand to hand and hand to mouth) reinforces the flexor muscles in the front of the body to activate.
  • General Tips: Take time during the day to exercise your baby.  Try to do exercises one time per day.  Pairing the exercise with a dialy activity like feeding or playtime is helpful.  
  • Pressure: Babies in general prefer firm but gentle pressure versus light touch.
  • Position: Place your baby in your lap on his side with bottom at your belly and legs bent.
  • Exercise: Bring the top hand toward baby’s mouth and stroke the side of the mouth with his hand.  The baby will want to suck on their hand.  Let him!  When he is done, bring hands together with gentle pressure,, this is very calming.
  • Repetition: Do 5-10 times as your baby tolerates.

3.  Upper Back Stretch

shoulder to hand

  • Purpose: Former premature infants can pull their arms back and have trouble bringing ands together.  This exercise will elongate the muscles of the upper back making it easier for baby to bring arms forward.
  • General Tips: Take time during the day to exercise your baby.  Try to do exercises one time per day.  Pairing the exercise with a dialy activity like feeding or playtime is helpful.  
  • Pressure: Babies in general prefer firm but gentle pressure versus light touch.
  • Position: Place your baby in your lap on his side with bottom at your belly and legs bent.
  • Exercise: Place your right hand on them middle of her upper back, right at the shoulder blades.  With gentle, but firm pressure, bring your hand from shoulder blade to wrist, following the arm.  Do the same with your left hand.  Think of this as a waterfall with continuous massages from shoulder to wrist alternating hands.
  • Repetition: Do 2-3 minutes as your baby tolerates.

Do 1-3 on the left side and repeat on the right side.

Disclaimer: If you are uncomfortable performing an exercise please consult with your pediatrician or physical therapist. If you are concerned that your child is delayed, please consult your pediatrician or a physical therapist in your area.

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