Your Preemie: The First Twelve Months

The first year with your preemie often involves juggling many check-ups and appointments. Because our babies’ brains and bodies are so plastic, early intervention is a critical tool for supporting preemies. Premature babies are always evaluated based on their ‘adjusted’ age rather than their actual age. This means that if your baby was born at 32 weeks, when they are two months old (8 weeks) they are evaluated as a newborn.

Dr. Yasmin Lyons is a pediatrician who has worked extensively with preemies. She emphasizes that: “Often the baby is doing what is completely normal for their corrected age, and it’s important for parents not to compare the progress with that made by other babies.” You’ll quickly decide who to talk to about your baby being a preemie. Margie, a mother of a preemie born at twenty weeks, told me: “I just always gave the adjusted age of my preemie because I just didn’t want to have to have the whole conversation with strangers."

As parents of preemies, we start feeling more confident when we see our baby eating and reaching textbook milestones. This can vary dramatically depending on how premature our baby is. In other words, a “30-weeker” will have a very different roadmap in the first year then a “34-weeker.” Hospital preemie clinics can be a good resource for reassurance. Premature baby clinics in addition to a pediatric neurologist often include an occupational therapist and a physical therapist, allowing a more thorough evaluation of the premature infant. Susan, a mother of a 33 week preemie, told me: “I was worried because Isabel wasn’t holding her bottle. The neurologist at the preemie clinic told me, ‘Oh she can totally do it, she is just choosing not to!’ I was so relieved that she was on track and making her own decisions!”

The most important thing to understand is that your preemie will always be evaluated at their ‘adjusted’ age, allowing an equal playing field in the evaluation. Based on adjusted age, your doctor will be looking for the following things:

At three months: Gross motor skills: open hands, some holding/grasping, some neck control, visual tracking (i.e., following an object or person with their eyes), cooing vowel sounds, smiling.

 

At six months: Gross motor: rolling over, head control, pushing with their legs while you are holding them, spinning on their stomach, holding toys and shaking, bringing toys to their mouth, lots of prolonged eye contact, engaged with those around them.

9-12 months: Gross motor skills: “the army crawl” (pulling themselves forward on their tummy), sitting up on their own, holding and shaking toys, pulling upright. Language progresses to consonants and vowel sounds strung together, with a few words identified. Smiling and laughter is a regular part of your life.

As a general rule, pediatricians give premature babies a wide margin to be reaching targets based on how premature they were. Variations within a twelve week range can be normal, yet with good intervention concerning physical, occupational, and speech therapy, almost all premature babies are deemed “done” with being “premature” by 24 months!