Health problems and disability
Premature babies are more susceptible to certain health problems than term babies, so your healthcare team will take special care when assessing your child's development.
Hearing and vision problems
Premature babies are more likely than their term peers to develop hearing or sight problems. They are also more likely to develop retinopathy of prematurity, which can impair sight, but this can often be prevented if caught early on. Other common sight problems include squints and refractive errors.
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This is a group of conditions that affect movement and co-ordination. It affects about one in 400 children and is more common among babies born prematurely, with those born earliest being at highest risk.
Symptoms of cerebral palsy
The symptoms of cerebral palsy can range from severe to very mild, and include difficulties with:
Help for children with cerebral palsy
The condition is managed with support from a range of therapies, including physiotherapy and occupational therapy, and with medication to help with stiff muscles, and sometimes surgery. Find out more at SCOPE or call 0808 800 3333.
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Learning problems caused by prematurity
Although some children born prematurely do exceptionally well at school, a premature baby is statistically more likely to develop problems with learning that could require extra support at school. The later the baby is born, the milder the difficulty tends to be. Children who have intrauterine growth restriction/fetal growth restriction (FGR) seem to have a lower IQ than other children. Researchers have found that preterm children were lagging behind their peers at school and experiencing difficulties in a number of curriculum areas at age six. There does seem to be some association between learning difficulties and very low birthweight.
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Behavioural difficulties associated with premature birth
Studies have found higher levels of conditions such as attention deficit hyperactivity disorder (ADHD) among babies born prematurely. They are more likely to be less organised and have a shorter attention span. Children who were more premature are not necessarily the worse affected. Although higher levels of emotional, attention and peer problems have been reported into their teens, studies have not shown signs of more serious conduct disorders, delinquency, drug use or depression.
Attention deficit hyperactivity disorder (ADHD)
This disorder affects the way people behave. ADHD does not affect people's intelligence, but may cause learning difficulties. An estimated three to nine percent of school-aged children in the UK are affected by ADHD.
The symptoms of attention deficit hyperactivity disorder (ADHD) are:
- restlessness and fidgeting
- a short attention span
- impulsive behaviour.
Once the disorder is identified, it can be managed with therapies and medication. Find out more at ADDISS or call 020 8952 2800.
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Health experts who may treat your child
If your child is referred to a specialist as a result of delayed milestones, you may suddenly find yourself inundated with appointments, as paediatricians will often refer your child for a broad range of assessments, to make sure that nothing is missed. These might include:
- hearing and vision experts
- neurologists (specialists of the nervous system)
- other specialists, depending on whether your child has a specific condition.
Your child may also be seen by members of the community team, such as a:
- occupational therapist
- speech therapist
- early years team.
These experts will assess whether any therapies could help your child progress towards the developmental targets.
After this initial spate of appointments, treatment will usually become focused on the specific areas needing support, and the process should settle down into a planned course of treatment or therapy.
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Disability and premature birth
Disability is a scary word – especially if someone uses it about your child. There is still a stigma around disability, but this is almost always among people who are ignorant of the facts.
The government defines disability as 'a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities'. In practice, this can range from something like asthma to problems with walking, developmental delay or subtle behavioural problems. Many forms of disability are not immediately obvious.
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Prematurity doesn't affect happiness
The good news is that when asked to rate their quality of life or self-esteem, young adults who were born very prematurely do not score very differently from those born at term.
Doctors measure your child's progress in terms of clinical outcomes, but in fact this is only a small part of the full picture of your child's life, challenges and triumphs. In other words, premature birth may mean that your child has to work harder than others to develop some skills, but it does not need to affect his capacity for happiness.
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In this section
Taking your baby home:
You can also read about
The following organisations can give you more information about the topics covered in this section.
BMJ Best Practice (2011) Premature newborn care, Treatment, Step by step, http://bestpractice.bmj.com/best-practice/monograph/671/treatment/step-by-step.html
BMJ Best Practice (2011) Cerebral palsy, Highlights, Overview, http://bestpractice.bmj.com/best-practice/monograph/674.html
BMJ Group (2011) ADHD: What is it?, BMJ Publishing Group Limited
Cooke RW (2006) Are there critical periods for brain growth in children born preterm?, Archives of Disease in Childhood, Fetal and Neonatal Edition, Vol 91, No 1, p17-20
DH (accessed Sept 2011) National Service Framework for Children, Young People and Maternity Services: Standard 8, 4,http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/Browsable/DH_4869232
DirectGov (accessed Sept 2011) Disability rights, Definition of disability under the Disability Discrimmination Act (DDA), http://www.direct.gov.uk/en/disabledpeople/rightsandobligations/disabilityrights/dg_4001069
EMIS (2010) Premature babies and their problems, Patient.co.uk, http://www.patient.co.uk/doctor/Premature-Babies-and-their-Problems.htm
Hack M, Costello DW (2007) Decrease in frequency of cerebral palsy in preterm infants, The Lancet, Vol 369, No 9555, p7-8
Pritchard et al (2009) Early school-based learning difficulties in children born very preterm. Early Human Development; 85 (2009) 215–224
Larroque B, Ancel PY, Marret S, et al (2008) Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): a longitudinal cohort study, The Lancet, Vol 371, No 9615, p813-20
Norman JE, Greer IA (2005) Preterm labour: managing risk in clinical practice, Cambridge University Press
Rennie JA (2005) Roberton’s Textbook of Neonatology (4th edition), London, Churchill Livingstone
Rodrigues MC, et al (2006) Learning difficulties in schoolchildren born with very low birth weight, Journal of Paediatrics, Vol 82, No 1, p6-14
Willacy HMD (2010) Premature Babies and their Problems, Patient Plus, No 1152