Preemie Development Milestones: What to Expect

The birth of a premature baby can undoubtedly cause a significant change in plans for you and your family. The early birth of your little one requires a lot of adjustments. If your bundle of joy arrived earlier than expected, it’s important to have realistic expectations as your preemie grows, develops, and prepares for the trip home.

If your baby is born before 37 weeks of pregnancy, it is considered premature.¹ Because your baby is growing and developing outside the protective environment of the amniotic sac, he or she may require more support and medical care than babies born closer to him Due Date. Different terms are used to differentiate the degree of premature birth:⁵

• Late premature babies are born between 34 and 36 weeks of pregnancy.⁵ Most babies born prematurely fall into this category.⁴
• Moderately premature babies are born between 32 and 34 weeks of pregnancy.
• Very premature babies are born at less than 32 weeks of gestation.
• Extremely premature babies are born at 25 weeks of pregnancy or less.⁵

In addition to the gestational age classification, there are special weight categories used to classify the weight of a premature baby:¹⁷

• Low birth weight means a baby weighs less than 2,500 grams or 5 pounds, 8 ounces.
• Very low birth weight means a baby weighs less than 1,500 grams or 3 pounds 5 ounces.
• Extremely low birth weight means a baby weighs less than 1,000 grams or 2 pounds 3 ounces. These babies are also called micro-preemies.⁶

Very premature babies are very fragile and have the highest risk of complications.²

The adjusted age is calculated by subtracting the number of weeks your baby was born earlier from the actual age. If your baby is now 4 months old and was born two months (8 weeks) earlier, the adjusted age is 2 months.^8th If you compare a 4-month-old baby born at 40 weeks of pregnancy with your premature baby, you may notice a difference Development skills. For example, this may not be the case with your baby smiling to get your attention as this ability usually only appears after 4 months.¹²

All babies develop at their own pace; However, if your baby is premature, the adjusted age will give you a more realistic idea of ​​when he or she will reach certain developmental milestones in the first two years.⁹ During this time, most premature babies experience catch-up growth.¹⁰ If your baby doesn’t seem to be reaching certain milestones by the age of two, his doctor may refer him to specialists where he can receive additional support.⁹

Growth charts are tools health care providers use to assess trends in your baby’s weight, length, and head circumference over time. This will help them identify any discrepancies in your child’s expected growth.¹⁸

The World Health Organization (WHO) growth chart. is used for babies born at term Fenton growth chart is used for premature babies. Both include weight, length and head circumference measurements, but the WHO growth chart measures in monthly increments while the Fenton growth chart measures in weeks. The Fenton growth chart starts at 22 weeks and ends at 50 weeks. Once your baby reaches the adjusted age of 40 weeks, both charts can be used to track their growth. After your baby reaches the Fenton growth chart, their adjusted age should be used to record their growth on the WHO growth chart until age 2.¹⁰

Whether your premature baby grows slower depends on the severity of the medical complications he or she is facing. Early birth does not necessarily result in slower growth because your baby’s development occurs as if it were a growing fetus. What can cause slower growth are health complications such as breathing problems, problems gaining weight, and difficulty learning to feed.^11.14

If your baby is born prematurely, there are several preemie milestones to watch out for as they grow and develop.

At 26 weeks, your baby may open his eyes regularly, but slowly OverstimulationWhile they sleep and grow, their environment is darkened with an incubator cover.¹¹ Nutrition and hydration are provided through intravenous fluids. For reliable and stable access, a tiny IV (intravenous) tube is inserted into a vein at the best possible location. This can happen on your baby’s hand, foot, scalp, or even through the skin Umbilical cord stump. These intravenous fluids support your premature baby’s growth until the medical team determines he or she is ready for full feeding.¹³

They will likely suffer from prematurity apnea, which means they pause between breaths because the part of their brain responsible for triggering breaths is not yet fully developed. This will lessen as he gets older, and your baby’s doctors will make sure he grows out of it before he goes home. Your baby can hear your voice and sounds around him because his ears are fully developed. Your skin is not yet fully developed and is very sensitive. The NICU staff Learn how to touch your baby to avoid overstimulation.¹¹

Your baby will be able to blink and his eyebrows and eyelashes will begin to develop. You may even see how they react when they hear your voice during times of alertness. They practice sucking, but it will take a while before they can take food with their mouth. This happens when they can coordinate sucking, swallowing and breathing.¹¹ When the medical team determines they are ready, they will be fed through a nasogastric or nasogastric tube that is inserted into their nose or mouth and runs down the esophagus and stomach.¹³ If your premature baby is medically stable enough, you may be able to hold him or her on your chest skin to skinalso called kangaroo care.¹¹

At 28 to 30 weeks, your baby’s muscle tone increases and he moves his arms and legs more often. They may also close their eyes when reacting to bright light. Singing or talking to your baby during periods of wakefulness is a great way to bond because your voice is familiar to him. The rooting reflex may begin to develop, causing your baby to turn his mouth toward a pacifier or touch his cheek with a finger. This reflex helps your baby find food sources when he or she is ready to breastfeed or bottle feed.¹¹

Between weeks 30 and 33, you may notice that your premature baby’s movements become smoother as the strength increases. Your sleep rhythm becomes more regular and alternates between deep sleep and awake phases. Your baby may also focus on your face and respond more clearly to your voice. You can also start calm down by bringing their hands to their mouths.¹¹

At 33 to 36 weeks, your baby develops clear activity states such as deep sleep, active sleep, calm alertness, and active alertness. Telling your baby what you are about to do can help her be better prepared Diaper change.¹¹ They may also be able to be gradually moved from the incubator to an open crib as long as they can maintain a normal body temperature. This ability depends on their weight and gestational age.¹⁵ Your coordination of sucking, swallowing, and breathing may be sufficient to begin feeding. Your baby’s medical team will determine if he or she is ready. Oral feeding is started gradually as your baby needs to use up additional energy.¹⁴

Once your premature baby reaches 37 weeks of pregnancy, taking her home may be on the horizon. The medical team will ensure they are fully ready Baby in the neonatal intensive care unit achieved all discharge goals. Depending on the facility, this may include tests such as a hearing test and a car seat test. For this test, your baby will sit in their car seat while their vital signs are assessed to make sure they can tolerate sitting there for the ride home. Education for parents, e.g. B. Cardiopulmonary resuscitation (CPR) Training, administration of medication or, if necessary, use of home medical equipment are also offered.¹⁶

If your baby is born prematurely, it’s important to know that he or she may have some early childhood challenges to overcome. It can be tempting to compare your baby’s developmental achievements (e.g Roll over, while sitting, crawletc.) to others of the same chronological age as they grow older. But be realistic and think about the adjusted age. Remember that every baby, whether born early or a few days before their due date, is on a unique journey towards their developmental milestones. When your little one is ready, the celebration will be extra sweet!