Preemie Development

WHAT CAN I EXPECT FOR MY PREEMIE’S GROWTH AND DEVELOPMENT?

Parents of infants born prematurely often receive reassurances that preemies may develop differently from babies born at full-term. Although many premature babies “catch up” with full-term babies in growth and development by age 3, the first few years may demonstrate noticeable differences in certain milestones and targets. The following guides provide insight how to follow your baby’s progress and work with different specialist teams to provide your preemie with the support that he or she needs.

FACTORS AFFECTING PREEMIE GROWTH
DEVELOPMENTAL MILESTONES

FACTORS AFFECTING PREEMIE GROWTH

What Factors Affect Preemie Growth and Development?

The first factor that affects growth and development is how early the baby arrived. In other words, the greater the prematurity, the more likely the need for special care and early intervention for growth and development.

A full-term baby is born at about 40 weeks. Babies born prematurely can be grouped in one of four categories:

Late preterm – Born between 34 weeks and fewer than 37 weeks
Moderately preterm – Born between 32 weeks and 34 weeks
Very preterm – Fewer than 32 weeks
Extremely preterm – 25 weeks or below

Other factors that affect growth and development include low birth weight, health conditions like infections or organ problems at birth, or length of time spent in a neonatal intensive care unit (NICU).

DEVELOPMENTAL MILESTONES

How Do I Look for Developmental Milestones in Preemies?

Since preemies may need extra time and care, you should avoid immediately comparing a preemie to full-term babies. Instead, you will need to calculate the preemie’s corrected or adjusted age. You can do so by subtracting the weeks (or months) of prematurity from the child’s chronological age in weeks (or months). For example, if an infant is 16 weeks (4 months) but born 8 weeks prematurely, the child would have a corrected or adjusted age of 8 weeks (2 months).

After determining your baby’s corrected or adjusted age, you can then review some of the general corrected or adjusted age milestones for preemies:

Example Preemie Developmental Milestones

(Corrected/Adjusted Ages Below)

2 Months (8 Weeks)

Moves hands and legs
Keeps hands open much of the time
Lifts head and chest during tummy time
Begins to try to control head (still needs head support at this age)
Begins to hold objects in hands
Responsive to sounds (such as turning head at the sound of a favorite toy or rattle)
Begins to make cooing noises
Cries to express needs; develops different cries to indicate different needs
Focuses eyes on person or object; can follow movement with eyes
Makes eye contact and smiles
Begins to recognize parent or primary caregiver

4 Months (16 Weeks)

Brings hands to mouth
Can push up on arms during tummy time; makes crawling motion during tummy time
Reaches for desired objects
Turns head at the sound of familiar voices
Begins to laugh or squeal
Combines coos into double sounds (such as goo-goo)
Begins to grasp objects
Expresses excitement with toys
Begins to become interactive with parent or caregiver
Shows interest in mirrors
Gains the ability to self-soothe

6 Months

Puts weight on feet when held standing up; recognition of lower body
Can sit independently
Bangs or shakes objects
Switch objects from one hand to another; increased hand-eye coordination
Begins to roll from tummy to back
Watches cause-and-effect with toys and objects (for example, seeing if a toy can light up)
Looks toward toys that drop out of line of sight
Notices if parent or caregiver is absent
Reacts differently to strangers
Can express emotions like happiness or excitement

9 Months

Picks up objects between thumb and forefinger
Crawls and moves along furniture to move about
Pulls to a stand
Begins to recognize familiar words (name, phrases like “go bye-bye”)
Combines consonant and vowels (“mama” and “dada”)
Attempts to imitate sounds and movements
Examines objects closely (turning them upside down, etc)
Tries to hold bottle and pick up finger foods
Resists removal of favorite toy
Enjoys playing peek-a-boo or clapping hands
Clings to parents or caregiver around strangers

12 Months (1 Year)

Stands alone
Takes steps
Begins to turn pages of a book
Attempts to put objects into containers
Combines movements (reaching for object) with words (saying the object’s name)
Pauses when told to stop doing something
Begins to associate “mama” and “dada” with parents
Gives object when asked
Attempts to drink from cup and help with getting dressed
Prefers to be with parent or caregiver
Able to play with other children

As you enjoy your child’s progress, keep up with scheduled appointments and speak with your pediatrician about any concerns. For example, you may have questions about how your baby communicates, whether your baby uses enough large or small muscles, and whether your baby has stand-out strengths or specific weaknesses to address. While it is great to keep a journal and take notes of your child’s progress, do not get too sidetracked by specific milestones. Instead, talk to your physician about special services and early childhood intervention (ECI) programs at the Warren Center.

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