How do I calculate my preemie’s milestones?

For premature babies, each achievement is special.

If you’re wondering whether your preemie will reach her milestones, such as walking and teething, at the same time as other children, read on.

As parents, we know that babies all develop at their own speed when it comes to reaching important milestones, but for preemies, each achievement is a little more special. According to the American Academy of Pediatrics (AAP), considered to be one of the world’s authorities on childcare and development, if your baby was born early, she has two important days. The day she was born is her official date of birth, but her estimated date of birth is equally as important, and it’s the difference between these two dates that provides you with her corrected or adjusted age. This adjusted age will give you a better idea of developmental ages and stages in her first two years.

Your preemie’s adjusted age

If your baby is 16 weeks old but was born six weeks early, you need to subtract six from 16, which gives you an adjusted age of 10 weeks. It’s, therefore, reasonable for her to achieve milestones suitable for a baby of 10 weeks (or two and a half months), rather than 16 weeks (or four months). It’s important to make sure she continuously moves forward in her development and progresses, such as moving from rolling to sitting, to pulling herself up, to standing, etc. If you’re concerned she’s not reaching her milestones in her adjusted capacity, speak to your paediatrician or caregiver, as your preemie may require additional therapeutic support.

When will your premmie learn to walk?

There are a number of factors to take into consideration, the experts say. This includes how prem your baby was, how long she was required to stay in NICU, and what measures were taken at this time. A prem baby, who had a limited and uneventful time in NICU, and has had no health problems linked to her premature birth, should learn to walk according to the standard milestones at her adjusted age. Full-term babies are usually able to stand up supported by a parent or a piece of furniture between the ages of six to nine months. (Remember that this will be the adjusted age, so a baby born six weeks early, will reach these milestones around seven months to 10 months old). By the age of 12 months adjusted, she should be able to pull up on furniture into a standing position and walk when supported by you. By 18 months adjusted, she should be walking on her own with no support, and her heels flat. It’s important to make sure you take into consideration your baby’s adjusted or corrected age.

Challenges prem babies face

The more prem your baby, the more severe her complications or the more invasive her treatment, can impact and delay her milestones. If your baby has experienced any of the following, she may be delayed in her walking:

  • Born earlier than 27 weeks
  • A birth weight of less than 750g
  • Chronic lung disease
  • Weak muscle tone
  • Frequent hospitalisations
  • Additional or significant home medical support.

Enamel Hypoplasia

The Academy of General Dentistry reports that 70% of prem babies will have a problem with their teeth, known as enamel hypoplasia. This means the baby teeth appear brownish, less smooth and appear to be softer and more prone to decay or chipping. Unfortunately, this is only picked up around six months of age when your baby’s first tooth erupts. The Academy of General Dentistry recommends prem babies see a dentist when that first tooth comes through, to prevent further complications. The experts also share that prem babies may have delays in both their baby teeth and even their permanent adult teeth coming through. Baby teeth commonly erupt between six and 12 months of age, however, again it’s important to bear in mind that this is your baby’s adjusted, or corrected age, and not her real or birth age. Back teeth tend to come through anytime between 18 and 24 months. Teeth and bones need calcium to form and strengthen, and your baby gets most of this calcium intake during the last trimester of pregnancy. Research reveals that this may be one of the reasons why teeth come through slower in preemies and why they are more prone to cavities. Research has also found that extended intubation and inadequate early nutrition are both contributing factors of delayed tooth eruption.