What do the neonatal therapists do with my baby in the NICU?

Neonatal therapists play a key role in supporting the development, comfort, and feeding skills of babies in the NICU. The team usually includes occupational therapists (OTs), physical therapists (PTs), and speech-language pathologists (SLPs)—each with specialized training in premature and medically fragile infants.

Here’s what they do:

⭐ 1. Support Neurodevelopment

Neonatal therapists help protect and optimize brain development during a period when the NICU environment can be stressful.

They work on:

• Promoting optimal positioning (flexed, midline, contained)

• Providing developmentally supportive handling

• Reducing sensory overload from noise, light, and procedures

• Encouraging regulated, calm states to support growth and sleep

⭐ 2. Positioning & Motor Development (OT/PT)

They assess and support:

• Muscle tone and movement patterns

• Head shaping (helping prevent plagiocephaly)

• Midline orientation and flexion

• Early motor skills appropriate for gestational age

They teach parents safe, developmentally appropriate ways to:

• Hold their baby

• Provide tummy time when medically ready

• Support early movement and bonding

⭐ 3. Feeding Readiness & Feeding Skills (SLP/OT)

Feeding is one of the most complex tasks for preterm babies. Therapists support:

• Feeding readiness cues (state regulation, rooting, organization)

• Oral-motor development (sucking, swallowing, breathing coordination)

• Safe bottle-feeding techniques (pacing, nipple selection, positioning)

• Transition to breastfeeding, including:

  • Pre-feeding at the breast

  • Helping optimize latch and positioning

  • Collaborating with lactation consultants

⭐ 4. Sensory Development

Premature babies missed weeks or months of in-utero sensory experiences. Therapists help provide appropriate, soothing sensory input such as:

• Gentle touch and containment

• Skin-to-skin/kangaroo care coaching

• Vestibular and proprioceptive support

They avoid overstimulation and help babies learn to self-regulate.

⭐ 5. Support for Babies With Complex Needs

Neonatal therapists also work with babies with:

• BPD

• HIE

• IVH or PVL

• Congenital anomalies (e.g., CDH, TEF, CHD)

• Neuromuscular concerns

• Genetic syndromes

They adapt care plans to each baby’s unique clinical needs.

⭐ 6. Parent Coaching & Education

A huge part of their role is empowering parents. They teach:

• How to read stress and stability cues

• When and how to interact with the baby

• Safe ways to do kangaroo care

• Developmentally supportive care at home

• How to continue feeding or therapy techniques after discharge