Do Premature Babies Hit Milestones Later?

Reviewed on 6/10/2021

premature babies
Considering their gestational age, premature babies may be hitting all milestones on time for their “corrected” age. Most babies catch up developmentally by age 2.

In a sense, premature babies do hit milestones later than full-term babies. But here’s the catch. Considering their gestational age, a premature baby may be hitting all milestones on time for their “corrected” age.

What does “corrected” age mean? Well, a preterm baby is born less than 37 weeks into their gestation, meaning they’re spending less time inside their mother’s uterus as compared to a full-term baby. So let’s say your baby is born 4 weeks before your due date and is now 8 weeks old. Your baby's corrected age is actually 4 weeks since the 4 weeks your baby should have spent in your uterus is subtracted from the 8 weeks. 

So your baby at the corrected age of 4 weeks may be doing the same things a 4-week-old full-term baby is doing. You can’t expect your baby to do the same things an 8-week-old full-term baby is doing because they aren’t the same age developmentally. 

Premature development is complex, but most kids catch up in due time. By the time premature children are 2 years old, 85% of them will have caught up on their milestones without having to recalculate their corrected ages. 

However, if you have concerns about your child not hitting their milestones, talk to your pediatrician.

What complications may premature babies face in the hospital?

Premature babies often have extended stays in the neonatal intensive care unit (NICU). Some may have serious complications that need short-term monitoring and treatment and others need lifelong rehabilitation and management.

What are common development delays for premature babies?

Although birth weight and short gestational age seem to correlate with infant development, each premature baby will develop at its own pace. Common developmental delays that a preemie may experience include the following:

  • Inability to breathe, suck and swallow simultaneously: They may require the insertion of a nasogastric feeding tube for nutritional support.
  • Jaundice. Babies born before 35 weeks of gestation are more likely to have prolonged jaundice compared to full-term infants. Jaundice causes yellow skin and eyes and may result in brain damage due to the buildup of bilirubin in the baby’s bloodstream.
  • Anemia: Preterm babies are more apt to have anemia, a red blood cell deficiency.
  • Respiratory issues: Preemies with severe respiratory developmental issues may need assistance breathing due to underdeveloped lungs.
  • Motor skills. Motor skills, such as holding the head up or crawling, may come slower for preemies than they would to a full-term child.
  • Difficulty flexing muscles: A premature baby tends to hold arms and legs straight, whereas a full-term baby keeps their arms and legs flexed. Preemies may have a difficult time flexing underdeveloped muscles because they did not spend sufficient time tightly folded inside the mother’s womb.

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What can a pediatrician recommend for premature babies?

Many premature babies don't need special therapy or treatment. But because preemies are at increased risk for developmental delays, your doctor may suggest ways to boost their progress.

Physical therapy

  • Physical therapy can help the baby improve their gross motor skills and learn better ways to move their body. 
  • This often means improving muscle tone. Problems with muscle tone are fairly common among preemies because the parts of the nervous system that control muscles are not well developed.
  • However, physiotherapy is only recommended if there is a severe developmental delay.

Speech therapy

  • Speech therapy can help with feeding difficulties, which are common among preemies because the muscles needed to suck, swallow and eventually chew have not had enough time to develop and a preemie's brain isn't yet able to coordinate these muscles.
  • Speech therapy can also help the child use their mouth, lips, and tongue to communicate more easily.
  • Depending on the baby's age, a therapist may work with them on talking, responding, and expressing their needs.

Occupational therapy

  • Depending on the child's strengths and needs, the occupational therapist may help them learn to play with toys, develop their feeding skills, improve their fine motor skills, or manage sensory inputs, such as touch, sounds, and lights.

What can parents do to help their premature baby’s development?

Interacting with your baby when they are awake and giving them plenty of time and opportunity to rest means you are on the right track to helping your baby develop properly. With time, your baby should eventually catch up to their peers.

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References
D'Angelo Friedman J. Your Premature Baby: Milestones for the First 18 Months. WebMD. https://www.webmd.com/parenting/baby/features/premature-milestones#1

Raising Children Network (Australia). Premature Baby Development Concerns. https://raisingchildren.net.au/newborns/premature-babies/development/premature-development-concerns

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