Growth and development for premature babies

Babies who are born early are known as premature or preterm babies. They are more likely not to meet their growth and development milestones. The earlier in pregnancy your baby is born, the more difficulties they might have.

Your baby may need to spend time in a special care (SCN) or intensive care nursery (NICU).

There are categories which depend on when your baby was born.

• extremely preterm — born before 28 weeks pregnancy
• very preterm — born between 28- and 32-weeks pregnancy
• late preterm — born between 32- and 36-weeks pregnancy

Premature babies can face more challenges than babies born at full-term (at least 37 weeks). This is because they've had less time to grow and develop in your uterus. They may also need to stay in hospital longer.

Babies born before 32 weeks of pregnancy may also face more problems with their:

• health
• growth
• development

Contact with your skin is very important to help you bond with your baby. You may like to try kangaroo care.

Giving your premature baby a massage can help them put on weight. It also encourages relaxation and sleep.

You can support your baby's development by playing with them. You can try:

• making eye contact, smiling and talking softly
• singing to them
• talk or make sounds
• giving them toys to look at and hold — especially rattles, picture books and toys with different textures and colours
• reading to them

It's important to give your baby tummy time. This helps them learn to control their head. Always watch your baby during tummy time.

If you are concerned about your baby's development, contact your doctor or child and family nurse.

If your baby is born early, they can have a range of health problems. These problems may be more severe or milder depending on how early your baby was born.

Lung problems — a premature baby's lungs are small and immature. Your baby may need some help with their breathing.

Heart problems — premature babies may have problems with low blood pressure after birth.

Feeding difficulties — premature babies can't suck from your breast as well as full-term babies. You can give your baby expressed breast milk through a tube. Your health team will help you do this.

Infection — premature babies have an immature immune system. They are at risk of blood and bowel infections.

Jaundice — 8 in 10 premature babies get jaundice. Jaundice is when your baby's liver hasn't developed enough to clear waste products.

Brain problems — some premature babies get brain damage due to problems with oxygen reaching their brain. There is also a chance that they may have an intraventricular haemorrhage (brain bleed).

Eye problems — some babies get retinopathy (the blood vessels in the back of their eyes grow too fast).

When should my baby have their vaccinations?

If your baby is well, they should have their vaccinations according to the National Immunisation Program schedule for their age.

Premature babies usually react well to vaccinations.

Being premature means their immune system is less developed. Your baby may be at higher risk of some vaccine-preventable illnesses.

Your baby might need an extra dose of some vaccines. This is to give them the best protection from the disease. Your doctor will talk about this with you.

Most premature babies go on to develop like babies born at term. But the earlier that your premature baby was born, the more likely it is that they'll face problems in their development.

Some conditions related to premature birth are:

• cerebral palsy
• difficulties with vision or hearing
• learning delays
• autism
• attention deficit hyperactivity disorder (ADHD)
• difficulties or delays with gross motor and fine motor skills
• speech problems

You might notice some of these when your child is a baby or a toddler. Other issues may not show up until they go to school or not at all.

It's not expected that a premature baby will be at the same developmental stage as a baby born at term. This is because premature babies need some time to catch up, particularly in the early months after their birth.

Most babies that are born prematurely don't have serious disabilities later in life.

It's helpful to know which developmental milestones your baby should be reaching at their corrected age.

You'll be able to tell if your baby is reaching the developmental milestones for their age.

Remember that each baby develops in their own way, and there is a range of what's normal.

Your baby can usually start solids at a corrected age of 3 months. It's important to start solids by 7 months chronological age to balance:

• your baby's chances of developing allergies
• their willingness to try new foods
• their chance of getting anaemia

The exact timing will depend on:

• how early your baby was born
• how they are developing
• their readiness to start solids

Speak to your doctor or child health nurse for advice on when to start offering solid foods to your baby.

Signs that your baby is ready to start solids

Your baby is ready to start solids if:

• they can sit supported on your lap or in a highchair
• can hold their head in one position
• they often put hands or toys in their mouth
• they lean toward food and open their mouth when you offer food

Try offering your baby a variety of healthy foods.

Premature babies grow differently to babies who are born at term.

Your baby's growth will depend on their:

• gestational age
• birth weight
• ethnicity

Your baby will be measured against their corrected age. This happens until they are 2 years of age or have caught up.

All children in Australia can see a child and family health nurse for free. Your child health nurse will weigh and measure your baby.

These visits are timed at important stages in your child's development, from birth until they start school.

This helps find issues as early as possible so your baby can be offered treatment and support.

Babies born before 32 weeks

If your baby was born before 32 weeks, they have a higher chance of growth and development delays.

Your baby should be offered specific follow up care after they leave the hospital.

At a minimum you should see your doctor or child health nurse at:

• 1 week after discharge (corrected age)
• 6 weeks after discharge (corrected age)
• 3-4 months (corrected age)
• 8-9 months corrected age)
• 12 months (corrected age)
• 18 months (corrected age)
• 2 years (corrected age)
• 4-5 years (corrected age)

Your doctor will refer your baby to other healthcare professionals for any health concerns. Depending on your baby, these may include:

• early childhood intervention
• a paediatrician (Opens in new tab) (children's doctor)
• a physiotherapist (Opens in new tab)
• an occupational therapist (Opens in new tab)
• a speech therapist (Opens in new tab)

A growth chart is a graph that shows how your baby is growing over time, compared to other children.

Each time your baby is weighed and measured, a mark is made on the chart. These marks are compared to the curved lines on the chart. The lines on the chart represent the usual growth pattern.

There are growth charts for:

• weight
• height
• head circumference (the measurement around your baby's head)

There are different charts for male and female babies.

If you need support, visit the Miracle Babies Foundation (Opens in new tab) or call their NurtureLine (Opens in new tab) on 1300 622 243.

The Life's Little Treasures Foundation (Opens in new tab) also has information and support — you can call them on 1300 697 736.

You can also call the Preterm Infants Parents Association (Opens in new tab) on 1300 773 672.

The Royal Women's Hospital (Opens in new tab) has information on premature babies, including in languages other than English.

The Australian Breastfeeding Association (Opens in new tab) can offer advice and support on feeding your baby on 1800 686 268.