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.

Cerebral palsy

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:

  • walking
  • posture
  • learning.

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.

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.

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.

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
  • dietitians
  • neurologists (specialists of the nervous system)
  • geneticists
  • 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:

  • physiotherapist
  • 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.

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.

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.

 

 

Sources

  1. BMJ Best Practice (2011) Premature newborn care, Treatment, Step by step,http://bestpractice.bmj.com/best-practice/monograph/671/treatment/step-b...
  2. BMJ Best Practice (2011) Cerebral palsy, Highlights, Overview, http://bestpractice.bmj.com/best-practice/monograph/674.html
  3. BMJ Group (2011) ADHD: What is it?, BMJ Publishing Group Limited
  4. 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
  5. 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/Publicati...
  6. DirectGov (accessed Sept 2011) Disability rights, Definition of disability under the Disability Discrimmination Act (DDA), http://www.direct.gov.uk/en/disabledpeople/rightsandobligations/disabili...
  7. EMIS (2010) Premature babies and their problems, Patient.co.uk, http://www.patient.co.uk/doctor/Premature-Babies-and-their-Problems.htm
  8. Hack M, Costello DW (2007) Decrease in frequency of cerebral palsy in preterm infants, The Lancet, Vol 369, No 9555, p7-8
  9. Pritchard et al (2009) Early school-based learning difficulties in children born very preterm. Early Human Development; 85 (2009) 215–224
  10. 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
  11. Norman JE, Greer IA (2005) Preterm labour: managing risk in clinical practice, Cambridge University Press
  12. Rennie JA (2005) Roberton’s Textbook of Neonatology (4th edition), London, Churchill Livingstone
  13. Rodrigues MC, et al (2006) Learning difficulties in schoolchildren born with very low birth weight, Journal of Paediatrics, Vol 82, No 1, p6-14
  14. Willacy HMD (2010) Premature Babies and their Problems, Patient Plus, No 1152
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  • Woman with her baby in doctor's office.

    Growth and development after prematurity

    Premature birth can affect the way your child develops. Early intervention is important, so assessments from your healthcare team are crucial in ensuring that your baby gets the right care.

Last reviewed on April 1st, 2012. Next review date April 1st, 2015.

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Comments

  • By Anonymous (not verified) on 17 Dec 2016 - 18:22

    My daughter is 4 and half years old and her weight is 10.5kg. her birth weight was 1.9 kg.she is not growing in height as well as in weight since 1 year.plz advise me.

  • By Midwife @Tommys on 19 Dec 2016 - 09:40

    Hi Kanhaiya. It would be best for you to take your daughter to the health visitor or your GP to check on her weight and height measurements etc. They will be best to assess her and make any necessary referrals if they are concerned her rate of growth.
    Take care.

  • By Midwife @Tommys on 26 Jul 2016 - 16:03

    Hi
    As a Midwife , I cannot give advice regarding this query but would recommend that you contact your GP who can refer you on appropriately. Every child is different and some develop at a slower rate to others , but it would help you if you had reassurance from a specialist in the field, such as a Pediatrician. So have a chat with your GP who should be able to help and refer you on.
    Tommys

  • By Anonymous (not verified) on 23 Jul 2016 - 21:12

    Hi my daughter is of 3 yrs n she can say only few words. She does repeat many words that i say but cant construct a sentence on her own. Please can anyone help me.

  • By Deirdre@Tommy's on 24 May 2016 - 09:17

    Hi, Sorry but we are not able to help here. We have midwives but their expertise is unlikely to cover this query. If you are concerned about your daughter the best thing to do would be to talk again to your doctor or paediatrician.
    Tommy's

  • By Anonymous (not verified) on 23 May 2016 - 16:12

    My baby age is 2 years 9 months still she is not talking and she is looking very lean. But doctor said health wise she is Ok. Please advise how to improve her growth and talking

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