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.
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).
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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Services include speech, occupational and physical therapy; developmental services; and nutrition as well as family education and support.
