By Chris Woolston, M.S.
Premature babies often start life behind the curve. They are generally smaller than full-term babies, and their bodies may be less developed. From the very beginning, their parents watch them anxiously for signs of progress. They want their babies to grow larger and stronger, and the little ones usually oblige. According to a report from the American Academy of Family Physicians, most premature babies eventually "catch up" to other children -- usually by the time they're a year old. Nobody could tell they were born too early.
Nonetheless, if your baby was born prematurely, don't take his progress for granted. He'll need regular checkups so his doctor can track his development and spot any problems as quickly as possible. You can do your part by encouraging your baby's physical and mental growth every step of the way.
Sizing up the future
There's a reason doctors weigh and measure babies at every appointment. A baby's size is a strong indicator of his development and overall health. In general, premature babies grow more slowly at first than full-term babies. So, although doctors use the same growth charts for preemies as they do for babies born on or near their regular due date, they interpret the results differently. As long as your baby is growing as expected, there's no cause for alarm.
Your baby may seem small for his age, but he has plenty of time to make up ground. "It's amazing how fast these babies often grow -- they are behind in their size in the beginning, but they tend to catch up surprisingly quickly," says Michael Potter, MD, an attending physician at UCSF Medical Center.
According to a report in American Family Physician, most premature infants go through a growth spurt before their third birthday. By the time the spurt is over, they may very well have reached their "natural size" -- the size they would have been if they weren't premature.
A study published in the July 2003 issue of the journal Pediatrics provides an interesting glimpse into the future of premature babies. The study of 103 boys and 92 girls who were born in the late 1970s found that premature girls were just as tall as other girls by age 20. Premature boys, in contrast, were about an inch shorter on average than other boys. Interestingly, boys who were born prematurely were about half as likely as other boys to be overweight at age 20. For girls, prematurity didn't seem to have much effect on the risk of obesity.
Some premature babies have an especially hard time catching up. As reported in an article on For Parents of Preemies, a Web site run by the University of Wisconsin, stunted growth is most common among babies who weighed less than 2 1/2 pounds at birth, were small for their gestational age (their age since conception) at birth, and suffered a long illness, or who were slow to gain weight in the hospital nursery.
Hitting the milestones
Every parent waits eagerly for that first smile, that first step, that first word. As you watch for your baby's milestones, adjust your expectations to take into account the date he SHOULD have been born. To take an example, if he was born two months prematurely, he should be about two months behind schedule. When he's 4-months-old, you should expect to see the skills of a 2-month-old, such as cooing, smiling, and showing an interest in the world. Likewise, he should be able to sit up on his own by the time he's 11-months-old, something most babies master by 9 months.
A baby's development shouldn't be a spectator sport. Throughout your baby's first years, you can actively help him learn and grow. The "For Parents of Preemies" Web site provides many suggestions for encouraging development. For instance, in the first month past a baby's due date, you can sing and talk to your baby in a low voice, rock him slowly, and give him plenty of cuddles. By his fourth month, you can play pat-a-cake and help him play with his toys.
As you watch your baby develop, remember that all babies follow their own schedule. It's impossible to say for sure how quickly your baby will grow or when he'll feel like saying his first word or taking his first step. All you can do is make the journey as smooth -- and fun -- as possible.
American Academy of Family Physicians. Caring for Your Premature Baby. http://www.aafp.org/afp/2007/1015/p1165.html
Hack, M. et al. Growth of very low birthweight infants to age 20 years. Pediatrics. July 2003. 112(1): 30-38.
American Academy of Pediatrics, HealthyChildren.org. Preemie. http://www.healthychildren.org/English/ages-stages/baby/preemie/Pages/default.aspx
Trachtenbarg, DE and Golemon, TB. Care of the premature infant: Part I. Monitoring growth and development. http://www.aafp.org/afp/980501ap/trachten.html