Practical advice for new parents

Preemie Development

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Babies who are born before the 37th week of pregnancy are considered premature. In the United States, about one in every eight births is pre-term, and many of these occur weeks and sometimes months before the optimal due date of 40 weeks. This rate has increased by over 20% since the early 1980's. Pre-term births have a variety of causes. For some women, poor lifestyle decisions during pregnancy such as smoking, alcohol usage, improper nutrition, or stress can lead to an unexpectedly early birth. In other cases, It is caused by unavoidable conditions such as hormonal imbalances, infections, chronic illnesses, or abnormalities of the uterus. As well, woman who are carrying multiple fetuses or are younger than 19 or over 35 years of age are at a greater risk of delivering a baby before the due date. Preemie babies often have a host of medical conditions and delayed development issues.

Fortunately, more than 90% of preemie babies who are born after 26 weeks of pregnancy have a good chance of surviving. They often will begin their lives in the natal intensive care unit (NICU) of the hospital where they will be monitored closely. Frequently they are incubated and fed through a feeding tube. Because a preemie baby's organs are not as developed as a full-term baby, a variety of health problems can occur but not necessarily so. The most common complications are jaundice, anemia, low blood pressure, respiratory distress, and apnea where a baby can stop breathing. In a large number of preemies, these conditions can be treated effectively. Generally, the earlier a baby is born, the more likely he or she will have complications associated with pre-term delivery.

Most preemie babies quickly respond to proper care and are released from the hospital around their actual due date or when they can feed and breath on their own without medical assistance and have reached at least 4 ½ lbs or 2kg in weight. Despite this, many preemies require special care and attention after leaving the hospital and extra attention will be paid to a preemie's development and growth for at least the first two years of life.

During these crucial years, a preemie's development will be charted by his/her due date rather than by birth date. Thus, if a baby is 12 weeks old but was born at 32 weeks of gestation, he/she would have been born 8 weeks before full term. Therefore, his/her developmental age is determined to be that of a 4 week-old baby. Because of this adjusted age, most preemie babies reach developmental milestones, such as smiling, sitting up, and eating sold foods at ages later than full-term babies.

Parents of preemie babies frequently become frustrated or dismayed when their child is not developing at the same rate as a full-term baby. Other parents who unwittingly discuss their children's normal developmental progress often fuel this concern. As well, family members and friends who are not educated on the challenges of preemie development can further create undue stress if they express unwarranted concern about a baby's slower than average growth and development. This is something that the parents of a premature baby need to keep in mind at all times. Preemie development is not the same as a full term baby, and parents shouldn't use other (full-term) babies as development yardsticks for their own baby.

Parents can expect that their pediatrician will give close attention to their preemie's development over the course of the first two years. At each check-up special attention will be paid to the baby's reflexes, muscle tone, motor skills, behavior, sensory responses, and speech development to ensure that the preemie's development is progressing at a healthy rate. If there is cause for concern, a doctor may refer the baby to a developmental specialist who can provide specialized care to prevent any long-term disabilities from occurring.

The good news is that in the vast majority of cases, premature babies do catch up in height, weight, and development within a couple of years. This is particularly true when parents work in conjunction with doctors and specialists to keep good track of developmental progressions or deficits. Besides watching for the expected milestones such as walking and talking, parents need to pay close attention to potential hearing or vision difficulties and possible learning disabilities and behavioral issues once the child begins school. Early medical intervention is the key to successful treatment of any of these problems. As the baby grows and gets older, the noticeable difference in development between the preemie and full-term babies will become less noticeable.

Remember, it's not so important how quickly a preemie baby reaches each milestone, but rather that they get to each milestone in the first place.