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premature
baby development
When reading this information, remember to
use your baby's corrected age. To do this, subtract how many
months premature your baby was from how many months old your
baby is now. For example, a four month old baby who was two
months premature has a corrected age of only two months. When
watching your baby's development, use the corrected age. The
areas of development include the following skills: cognitive
(thinking and playing skills), communication skills, gross
and fine motor skills (baby movement and use of hands), social
skills and feeding skills.
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There
are two ways to live your life. One is as though nothing is
a miracle, the other as if everything is.
Albert Einstein (former preemie)
birth
to 3 months corrected age
0-2 months corrected age:
·
Follows with eyes; sees best at a distance of 8-12 inches;
makes eye contact; looks at faces.
·
Responds to sound; cries to make needs known.
·Lifts
head momentarily when positioned on tummy; moves both arms
and both legs; hands are usually fisted or balled up with
occasional opening.
·Enjoys
when you talk; sing, read to them and hold them.
·
More awake and alert times throughout the day.
2-3 months corrected age:
·
Starts to follow faces and objects with eyes; shows interest
in seeing different things and hearing different sounds.
·
Starts to smile; coos and gurgles; enjoys interaction and
is more alert.
·
Shows some head control sitting in your lap or positioned
on their tummy; kicks with both legs; holds onto rattle or
your finger when placed in their hand; sometimes is able to
bring hands together or bring hands to mouth
·
Breast milk or formula is the only food your baby needs still;
do not give water or cereal, including cereal in the bottle
unless your doctor has told you to.
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3
to 6 months corrected age
3-4 months corrected age:
·
Begins to enjoy and explore toys by mouthing, waving and shaking
them; begins to swipe at or reach for toys and rattles.
·
Follows with eyes side to side and up and down; turns to sounds
and voices; good eye contact.
· Has
different sounds or cries for different reasons (wet, hungry,
wants to be picked up, tired, etc.); smiling, cooing and squealing.
·
Holds head steady; on tummy, can lift head and
prop self up on arms; more controlled movements of arms and
legs; notices their hands; plays with hands together; brings
hands to mouth to chew or suck on fist.
· Prefers
family members over strangers.
· Do
not begin solids until recommended by your doctor.
5-6 months corrected age:
·
Plays with toys and rattles or interacts with
people for longer periods of time; bangs toys and mouths toys
as a form of exploration.
· Looks
for objects or people that move out of sight and reponds by
crying, looking, or reaching; realizes their actions and movements
cause something to happen; and will repeat it because it is
enjoyable; likes to see self in mirror.
·
Begins to babble; laughs; smiles in response
to attention; may begin to answer back with sounds or smile;
makes more of a variety of sounds.
·
Rolls from tummy to back; kicks legs with back-and-forth
movement; sits with support; holds steady and looks around in
different positions; when supported, should be able to stand
putting weight on both legs with feet flat against the floor.
·
May start to fuss or cry with strangers; likes
company of family but will play alone for brief periods of time.
· Check
with your doctor on when to start solids.
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ask
the doctor & safety tips for your baby
Use a car seat appropriate for your infant's
weight and age which provides posture support. Make sure to
read car seat instructions completely and the section on child
restraints in the Owners Manual of your car. If you have questions,
check with your local fire or police departments for car seat
safety checks.
Use safety gates on all stairwells and rooms where a child could
get hurt.
Use anti-scald devices for faucets, showers, tubs or set temperature
of hot water heater to 120 degrees Fahrenheit to prevent burns.
Use the heart rate and respiratory monitors as instructed. Do
not hesitate to ask questions.
Use smoke detectors.
Use carbon monoxide detectors if your home is heated with natural
gas or oil or you have an attached garage. Use them near sleeping
areas of your home.
To prevent infection, remember to wash hands before holding
or handling baby.
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positioning
and handling your preemie
How you hold or lay your baby down is important,
especially for prematurely born babies. To encourage good
muscle development, babies should be positioned in a flexed
or bent position: arms and legs are bent and near the body
and the body is in a curled or rounded position rather than
flat or straight. The reason this is so important for babies
born prematurely is that they "missed out" on most
of the flexed positioning that normally happens in the last
part of a full-term pregnancy.
Please
check with your doctor on appropriate positions for your baby!
positioning
Prone: While awake, place
your baby on tummy with head to one side with rolled blankets
to encourage legs tucked toward tummy and arms bent up near
the face. This positioning can be quite comforting and encourages
the flexed position. This is also a good position to strengthen
the muscles needed for good head control and crawling. Remember:
All babies should be placed on their backs during sleep, unless
specifically informed otherwise by the baby's doctor.
Sidelying: Place your baby on their side
with body curled inward. Legs are tucked
up towards tummy and heands and arms should be together and
up near face so that your baby can put their hands to mouth
for comfort. To maintain this position, you can use a rolled
blanket or small stuffed toy for your baby to curl around.
You can put a toy or rattle in front of their hands so that
they can reach toward the toy.
Supine: It is important for your baby to
spend time lying on their back to wiggle and move. Use of
car seats or infant seats are also appropriate for flexed
playtime. Offering toys within reach and within sight will
encourage reaching and grasping.
Handling:
Handling is any movement requiring touch: holding, diapering,
dressing, etc. Handling is an important way that your baby
learns about the world. When you are turning or picking up
your baby, keep the arms and legs close to the body. MOving
the body, arms and legs as a secure package is less stressful
to your baby than allowing arms and legs to dangle. Handle
your baby slowly and gently with a firm but gentle touch.
Do not make any sudden movements while holding your baby and
NEVER SHAKE YOUR BABY! Shaking a baby can cause permanent
brain damage or even death. Touch and handling should be comforting
to your baby and will increase your bond with your baby. Enjoy
one another!
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I
am ready to play
Understanding what your baby is telling you...
I am ready to play or interact with you when...
·
My eyes are open and I am alert
· I look at you
· My
face, arms and legs are relaxed
· I
make comfort noises like cooing and vocalizing
· I
reach toward you, clasp my hands together, or suck on my fist
or fingers
· I
respond to your voice or smile
I am ready for a break when...
· I
turn my head or eyes away from you
· I
frown, grimace, hiccup, fuss, grunt, spit up, or sneeze
· I
arch my back and neck, and push away
· I
stiffen my arms or legs or increase movements of my arms and
legs
You can help me calm down or get ready
to play by...
· Holding
me with my arms and legs tucked in or close to my body
· Slowing
down the pace of the activity or stopping one activity. Some
premature babies can only cope with one activity at a time.
You might stop talking, rock more slowly, look away from your
baby briefly or just hold a rattle for your baby to see rather
instead of shaking it.
· If
I am showing you I am not ready, give me quiet
time and try again later.
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to questions-
emotional
responses of parents
What are some common feelings of parents
of premature babies?
I feel guilty that I did something to cause my baby
to be premature. This is a common reaction. Mothers
who get excellent prenatal care, and who watch their diet
and neither smoke nor drink alcohol while they are pregnant,
may still have premature babies. Find out if the doctors know
what caused your baby to be premature. In most cases the cause
will be something that was out of your control.
I worry that I don't feel more love for my baby.
Many parents of premature babies fear that their baby will
die and therefore don't allow themselves to bond with their
baby. If you find you are continuing to have problems loving
your baby once you are home, please talk to a health care
professional (this can be a physician, developmental specialist,
social worker, etc.).
I am grieving. Parents create many hopes
and dreams for their baby before they are born. Having a premature
baby often shatters those dreams and parents may experience
a sense of loss. Support from others can help you work through
these feelings.
I am worried that my baby will not know that I am
their parent. This is a normal concern. However,
babies learn to tell the difference between their parents
and other people at a very early age.
What are the stages a parent goes through in adjusting
to having a premature baby?
Shock- During this stage it is difficult
to think clearly or remember what people have told you. Keep
a family member or friend close by to help you sort through
all of the information. Takign notes of what your doctors
and nurses are telling you and writing down your questions
as a reminder may be very helpful.
Denial- Not wanting to believe what is happening
is real. Wanting proof that what your doctors and nurses are
saying is really true. Sometimes seeing your baby, looking
at x-rays or other indicators of "proof" makes the
situation more believable.
Grief and Sadness-Grieving the loss of a happy, healthy
delivery or baby. Feeling sad for yourself and your baby.
Anger and Guilt- You wonder why this happened
to you or what you did wrong. Since you can't be angry with
your baby, it is common to direct your anger toward your partner,
friends, or relatives.
How long do these feelings last?
·
Parents experience all different types of feelings
and work through them at their own pace.
What happens later?
Adjusting-facing the facts that you did not have
a normal delivery and are able to start to move on and focus
on your baby.
Giving up the fear of death- this fear will decrease
as your baby becomes healthier.
Understanding your baby- talk to the nurses,
doctors and other health care professionals about what your
baby can or should be doing so you have realistic expectations.
Focus on what is going well with your baby.
Increasing your involvement- become more
active in the care of your baby, talk to the nurses or doctors
about what you can do for your baby.
What can I do to help myself?
Learn more about the emotions you are feeling.
Talk to someone. You might benefit from a
support group.
Find out about your baby's health problems.
Ask lots of questions. The more you understand, the better
you can work to help your baby progress.
Get involved in the care of your baby as
early as possible.
Appreciate that having a premature baby is
likely to be the biggest life stress that you have encountered.
Don't hesitate to get help or counseling if you are having
a hard time working through your feelings.
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parent-to-parent support
Family Support Specialists at Help Me
Grow can give support to parents of premature infants.
Call Help Me Grow at 216-736-4300
MetroHealth Preemie Workshops/ Support
Group:
Offered periodically on a variety of topics. Open to all parents.
Call Sue Masevice, EI Coordinator at 216-778-5554 for more information.
The March of Dimes offers both online family
support as well as NICU family support. Go to http://www.shareyourstory.org/
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