What Are Overstimulation Cues for Premature Infants?

What are overstimulation cues for premature infants?

Sometimes you will go into a house with a fussy, overstimulated baby. It is very easy to overstimulate a baby, especially if there are other children in the house or the household is noisy. Here are some cues to overstimulation. 

• Feels stiff (tense) or limp 
• Will outstretch arms and spread finger apart (Splaying) 
• Squirms, startles easily, or twitches excessively 
• Avoids eye contact and/or turns head away 
• Arches back while making a fist 
• Skin will pale 
• Frowns, fussy, cries 
• Spits up or chokes easily 

During your assessment and interventions, the baby may feel stiff or very limp. They will often outstretch their arms and spread their fingers, called "splaying." They will squirm, startle easily, or twitch excessively. They will avoid eye contact with you and turn their head away when you are trying to look at them. Arching is an important cue. They will make fists while they arch, especially when trying to change a diaper on a baby. They may bend backward, almost like the baby is trying to get away from you. Their skin will become very pale. They will frown, they will fuss, and they will cry. It may not even be a high-pitched, mad cry but a little whimper. They will let you know they are not happy. Then they will spit up and choke very quickly when they eat if they are nervous or upset.

This Ask the Expert is an edited excerpt from the course, Respiratory Concerns for the Premature Infant, presented by Tina Pennington, MNSc, RNC-NIC.