When you have a preemie, things can look quite a bit different, developmentally, as compared to a full term baby. While I am NEVER a fan of comparing babies to one another developmentally, there is one particularly important thing to note when your little bundle of joy made their debut early. Note, this isn’t so you can see how they measure up to the others in the play pen, but so you can provide YOURSELF with realistic expectations of your baby and their progress through their first few years of development.
It takes 40 weeks for babies to fully develop in the womb, which is what your due date was based on when your pregnancy was confirmed. During that time, each one of your baby’s little features, from fingers and toes, to lungs and heart, to their central nervous system and brain have their own prime opportunity for growth. The longer your baby stays in utero, the longer these features and systems have to develop. An early arrival does not mean early development, and even though your baby is living in the outside world, they still have ALL of that developing to do.
Corrected Age: How old your baby is based on a 40 week gestation calendar
Think of this as their “would be” birthday, or their age based on their predicted due date.
Actual Age: How old your baby is based on when they were born.
Here’s an example: Your baby’s due date is June 28th, and they arrived on May 28th (one month early). In July, you would say that your baby is 2 months old (actual age), but their corrected (gestational) age is 1 month old.
In a lot of ways, your baby is ahead of the curve! They’re adapting and learning “outside world” things way ahead of when they normally would, had they stayed tucked in hotel uterus until their due date. The flip side of this coin is, we need to make a few accommodations to give your sweet little miracle some time to catch up, depending on when they made their grand entrance.
Milestone moments, and supporting your baby’s continued development
Here, we will look at your baby’s gestational age, what you can look forward to, and what you can do to support your baby as they continue to progress in the NICU. Already home? Here’s a great reminder of how far your baby has come! Stay tuned for future newsletters, where we will look at ages 0 and beyond!
28 – 30 Weeks Gestation:
Since your baby wasn’t ready to leave the safety and security of your womb yet, containment is especially important right now. Ask your baby’s care team for suggestions on the best positions to help your baby set some boundaries.
Allow your baby to have uninterrupted rest time. Sleep will help them put on weight, as well as recover from any stimulus related stress they may be experiencing. Remember, everything is still brand new, and that can be a bit scary!
Your baby’s nervous system is getting more advanced every day! If you’re able to touch your baby, do so with a firm caress, rather than a soft stroking movement. This will help them differentiate your touch from painful or unfamiliar stimuli.
If you haven’t already, start a journal to record your baby’s NICU journey, so you can keep track of important events.
If you’re able to, pump for your baby. Your milk is specifically designed to provide exactly what your baby needs for optimal growth and development.
31 – 33 Weeks Gestation:
Your baby may be ready to enjoy skin to skin contact with you (also known as Kangaroo Care)! Be sure to ask the care team about what hands-on interaction you can have with your baby at this time. Any snuggles and cuddles you can share with your little one will go a long way towards helping your baby grow and thrive!
Your baby can identify you by your voice, so be sure to read, talk, and sing to your little one whenever you can, in a soft quiet voice of course. Baby’s hearing is still very sensitive. And refer to your baby by their name!
Continue shielding your baby’s eyes from any bright lights
At this point (unless otherwise directed by your care team), use only one form of interaction at a time, like speaking, rocking, or touching, to avoid potential over stimulation.
34 – 36 Weeks Gestation:
Your baby is getting stronger every day, and is starting to get more control over their limbs! Encouraging them to move their arms and legs closer to their face and abdomen will help them stay organized and content.
Continue skin to skin contact whenever possible, which will not only strengthen your bond, but has been shown to help stabilize your baby’s heart rate, oxygen levels, and general sense of contentment and organization.
Your baby’s senses are getting more acute, but they still need special comfort and care, so continue shielding their eyes from bright lights, and using your “library voice” whenever talking, singing, and reading to your baby. Avoid any perfumes, scented skin care products, and especially interaction with thirdhand smoke, or chemical smells.
36 – 38 Weeks Gestation:
If you haven’t already, it may be almost time to go home! Be sure to visit with your care team about the safest way to use any equipment you have, such as your car seat, tummy time mats, and carriers / infant wraps once you get home.
Your baby is about to transition to their own bed! Be sure to discuss safe sleep techniques with your care team BEFORE leaving the hospital.
Your baby should be getting much better at feeding now! It’s a good idea to visit with the lactation consultant before you go home, so they can get you set up for success on your own, and answer any last questions you may have. Not breastfeeding? Schedule some time with the NICU dietitian so they can walk you through your baby’s specific feeding needs.
If you haven’t already, it’s time to pick your baby’s pediatrician! They’re have their first checkup soon after discharge!
One of the *many* important things to remember about the journey you and your baby are on together, is that everything takes time…sometimes, more than you think. The information provided above is a guideline. Just like full term babies, not all preemies are on the same schedule. Yesterday your baby may have been feeding like a champ, and today they may not be. It doesn’t mean they are facing a setback, it might just mean that eating is hard work, and they’re tired! Be patient with your baby, and be patient with yourself. Not every day will be one to celebrate, and not all progress will be seen immediately. If you can be flexible with your expectations throughout the process, you will better set yourself up for success in a stressful situation.
Just remember to try and savor these moments like you would any other, because before long, your baby will be asking for car keys, and you’ll be asking where the time has gone!
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