Some of the milestones and challenges your preemie will face in the big world beyond the hospital doors.

Life outside the NICU can be a big change from the small, enclosed bubble of incubators and friendly nurses.  What basic adjustments will parents of preemies have to make in the first few weeks, months, and years of their preemie’s life?  Read a comprehensive overview of the general development of premature children once they’ve left the hospital floor.

What Milestones Are Preemies Expected to Achieve?

Because your child was born early, they weren’t quite ready for the hard work of growing and changing outside the womb.  As a result, your preemie may be slow to pass some of the milestones you’d expect from a full term infant.  This is normal and should not be cause for alarm.  Your neonatologist will craft a schedule of scaled-back milestones that your preemie should be hitting based on their “adjusted age for prematurity.”

While every preemie’s milestones will differ based on how early they were born, any conditions they have, and any treatments they are given, some basic milestones that most preemies will hit a month or two after birth are:

  • Responds to stimulation such as lights and sounds, like looking at the source of a noise
  • Cries when frustrated, hungry, or tired
  • Can make a few different sounds
  • Basic motor control, such as moving their hands and legs actively
  •  Keeping their hands open most of the time
  •  Lifting their head and chest during tummy time, even if they still require a little bit of support
  • Attempts to holds objects
  • Can follow a parent’s hand or toy with their eyes and hold eye contact
  • Can tolerate or enjoy basic social interaction with a parent and will react positively to attention, smiles, and playtime

What Can I do to help my Preemie Hit their Milestones?

  • Cuddle your child with long sessions of kangaroo care.  The warmth and comfort will encourage them to socialize and eat more frequently, which will help them gain weight more quickly.
  • Encourage tummy time every day.  Begin by positioning your baby on their tummy while kangarooing.  Once they are a bit stronger and can lift their heads by themselves, transition to a flat, stable surface like the floor.  Go slow. Preemies need to strengthen their neck muscles at their own pace.
  • Once your child can look at you and track your facial movements, play with them by moving brightly colored toys across their range of vision.  They should be able to follow the toys with their eyes.  This will encourage brain development and teach them how to socially interact.
  • Limit distractions like loud background noises, frequent visitors, and an unsteady routine for the first few weeks at home.  Your preemie needs a little time to adjust to the normalcy of everyday life outside the NICU.

What Challenges Can I Expect My Baby To Face after we Leave?

  • Becoming exhausted from activity much sooner than a full-term infant, and requiring additional rest.
  • Taking a longer time to learn the differences between day and night and falling into a regular sleeping routine.
  • Needing to wait an additional few months before they start to eat solid foods.
  • Entering waking and sleep cycles frequently and without much warning
  • Experiencing difficulty interacting with adults, such as meeting and keeping eye contact
  • Becoming easily annoyed or over-stimulated by noise, light, movement, and too many activities at once.
  • Rejecting touching or try to kick off blankets, swaddles, or clothing.
  • Disliking bathing
  • Becoming frustrated, withdrawn, or impossible to calm down when overly stimulated.

How Can I Make Life Outside the NICU Bearable?

The most important thing you need to remember as a preemie parent: don’t be afraid to ask for support.  You don’t have to go through this alone; in fact, it’s far better for you and your child if you get help when you need it.

Babies expend energy by fussing and crying.  Since your baby needs to gain weight quickly, keeping them calm is important.  Preemies who can’t be soothed may experience slower growth rates.  If you have trouble calming your baby after a crying episode, speak with your physician or a fellow preemie parent, or find a parent group near to your location.  You are not a bad caregiver if your baby isn’t responding to your soothing methods!  Even full-term parents have difficulties adjusting to their newborn.  Group support is a vital resource for overworked, overstressed preemie parents.

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