When a baby arrives early, a family is launched into a period of unimaginable stress and fear and information overload. Once that precious baby arrives home and the dust begins to settle, many parents are left with questions about their little one's development. One of the more frequent questions I'm asked is:
Is my preemie delayed with baby milestones?
One key to understanding your preemie's development is understanding adjusted age. Sometimes this very important piece of information isn't explained clearly to parents or may have been explained during a time when a family was too overwhelmed to process it. So let's talk about adjusted age and why it matters for babies born prematurely.
What Is Adjusted Age?
Adjusted age (also called Corrected Age, Corrected Gestational Age or Corrected Postmenstrual Age) is the age that a baby would be if he had been born at full term.
To figure out your baby's adjusted age, subtract how many weeks early your baby arrived from how old he is now. If your little one was born at 32 weeks (or 8 weeks early) and is now 16 weeks old, his adjusted age would be 8 weeks.
Those weeks after a preemie is born but before his due date are weeks spent completing the development that should have happened in the womb and aren't the same as the the first weeks of life for a full-term newborn. For that reason, from a developmental perspective it's important to adjust age to get a more realistic estimation of when your little one will reach milestones.
While other 16 week babies might be starting to grab at their feet, lift up onto forearms in Tummy Time or even roll, your little one might still be working on the 2 month milestones of holding his head in the middle of his body, smiling and making smoother movements with his arms and legs.
While there is no definitive rule for adjusting age, many developmental professionals recommend considering adjusted age until the age of two. And many recommend using adjusted age even for "late preterm infants" - those born at 34 weeks to 37 weeks. These "just a little early" babies often avoid some of the more serious health concerns and prolonged NICU stays of more significant prematurity. However, research indicates that they are at risk for developmental delays and challenges compared to full-term infants and therefore should be closely monitored and their prematurity considered when looking at development.
A Delicate Balance
As a pediatric Occupational Therapist, I see a delicate balance play out with premature infants. Understanding and using adjusted age is very important and can be reassuring for parents who might see their baby not meeting milestones as anticipated or like their friends' babies.
BUT it's also important to (lovingly and supportively) remember that premature babies are at increased risk for developmental concerns and often benefit from professional support and intervention. Research is also beginning to show us that premature infants aren't just playing catchup in their develop. The ways in which their sensory and motor systems acquire new skills appears to be different. Continued research is essential for gaining a better understanding of how preemies learn and catch up to their peers so that both parents and professionals can best help them on that journey.
The bottom line is - if after considering the adjusted age of your premature baby you still have developmental concerns about your preemie (or any baby), discuss them with your child's healthcare provider. If you feel your concerns are brushed aside or that you have questions unanswered, push for clarity. Ask another professional. Advocate for your child.
It can be very difficult to know, "Am I just worrying too much?" or, "Is there really something going on with my little one?" Listen to your gut, ask questions, ask more questions, get the support YOU need so that you can best support your baby.