Developmental milestones and adjusted age for premature babies

November 29, 2018

During the first year of life, a baby grows and learns very quickly. Although babies develop at their own rate, most babies reach developmental milestones (important skills like smiling, rolling over, and sitting up) at around the same age. If your baby was born prematurely (before 37 weeks of pregnancy) this may not be the case — he may need more time to reach his milestones.

How do you track your baby’s development?

By the end of his first month, your baby may keep his hands in tight fists, bring his hands to his face and recognize some sounds. By the end of his third month, you may notice him babbling or grabbing and shaking hand toys. Your baby's health care provider asks you questions about your baby’s development at each well-baby visit. She asks you about the kinds of things your baby is doing, but remember that no two babies are exactly alike. If you think your baby is lagging behind, tell his health care provider. For a list of general developmental milestones, visit our website. Other great places to go for information include the American Academy of Pediatrics and the CDC.

Are developmental milestones the same for premature babies?

If your baby was born prematurely, milestones are evaluated a bit differently. The age at which your baby is expected to reach certain milestones is based on his adjusted age. Adjusted age is based on your baby’s due date. For example, if your baby is 6 months old but was born 2 months early, his adjusted age is 4 months. When evaluating his milestones, your baby’s provider uses your baby’s adjusted age.

Why is adjusted age important when it comes to your baby’s development?

Lots of important things happen to your baby in the last few weeks of pregnancy. Babies born prematurely miss out on important developmental time in the womb and are at higher risk of long-term health problems, like intellectual and developmental disabilities, than babies born full term. That’s why a baby who is 6 months old but was born 2 months early (adjusted age of 4 months) shouldn’t be compared to 6-month-old babies who were born full term. A better comparison is with 4-month-old babies who were born full-term. This way her growth and development are more in line with typical developmental milestones.

As time passes, your baby begins catching up to other babies his age. Some premature babies catch up completely; others may have delays or developmental problems. Talk to your baby’s health care provider about medical services and treatment your baby may need. Depending on your baby’s condition, he may need treatment early on or sometimes not until later in life.

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