Being born premature is a trauma. Especially when a NICU recording was needed.
Here we speak of preverb trauma. This is a trauma that occurs during a critical period for the growth and development of a child before it can talk. During an NICU recording, the child is largely separated from the parents who can be less good for the child than in a normal situation where the child is at home. Being separated from a parent figure is the most stressful experience for a baby. In addition, the NICU is a very stressful and stimulating environment. Furthermore, prematures experience stress and pain through the actions that cover everything from changing a diaper to medical operations such as putting in a probe, surgery or ventilation.
Premature regulation
As in the item about stress discussed, the nervous system has a major influence on how people handle stress. In prematures on the NICU, the nervous system is not mature enough and cannot regulate itself properly. Even when a baby is born on time, the child still needs his or her parents to regulate (to calm or comfort). The difference between the premature and the baby born on time is that the last nervous system is ripe enough to address the parasympatic nervous system. Among other things, this part allows a child to influence his own heartbeat.
A premature treatment is needed because the parasympathetic nervous system does not have much influence on the baby until the 30th week of pregnancy.*
Fortunately, at the NICU departments, more and more attention is being paid to this and we look at what the premature needs are. When good (i.e. consistent and reliable) is dealt with according to the needs of a premature child, the child will become more resilient. In addition, it will be better able to deal with stressful situations during the rest of his or her life.**
But what happens if there is not enough attention to it?
Then the nervous system doesn't learn to relax. It remains constantly alert, as if it is always ready for danger. It's set to alarm mode and sees almost everything as a potential threat.
In babies who have been on the NICU, the nervous system experienced this insecurity early because of all the painful, stressful actions and the lack of a parent figure. This makes it more "on" and that effect can remain visible even at a later age. Adults born prematurely often notice that they are always tense or alert and therefore have trouble really relaxing.
When they encounter a trigger later in their lives, for example, a smell, a sound, a certain feeling or a situation (such as blood shots or a dental appointment) their nervous system reacts as if there is another danger. The body recognizes the situation as something of old and reacts as if it is back in that situation.
The body does this by giving different signals: fear, panic, re-experiences (the feeling as if the nasty experience of the past is now happening again), disassociation (the feeling as if you are "away" or separated from yourself or your environment), or the tendency to fight or flee. If nothing is done, the nervous system will continue to experience the same situations as dangerous and will react more and more violently. It doesn't teach that there is another way.
What can I do about this?
The good news is that the nervous system can also recover so that someone feels safe and can come to rest. Someone can learn step by step to put themselves at ease, to comfort and to release tension. Where necessary, a therapist can help to process the old experiences and to learn new ways to deal with them. Thus the nervous system can slowly experience that relaxation and safety are also possible.
* Mulkey, S. & du Plessis, A. (2018). Autonomous nervous system development and its impact on neuropsychiatric outcome
**Mary E. Coughlin (2014). Transformative nursing in the NICU
