A member of the healthcare team will usually visit you at home within the first few days of leaving the baby unit. They will weigh your baby and check that you are settling in well together at home.
How might premature birth affect my baby’s development?
Most premature babies develop as expected and have healthy childhoods. But there is a higher chance of premature babies developing a long-term illness or disability compared with babies born at full-term. Babies born before 32 weeks are especially at risk because they have had less time to develop in the womb. Babies born with severe complications, such as a brain injury or infection, also have a higher risk.
You can speak to your health visitor or GP if you’re worried that your baby isn’t reaching their milestones, such as rolling over or crawling.
How will my premature baby’s development be checked?
All babies have routine clinic appointments to monitor their development. Some premature babies have extra appointments so that any possible problems are picked up early.
The healthcare team will use your baby’s developmental age to assess their growth and development in the first 2 years.
Using your baby’s corrected age
Reaching developmental milestones may take a little longer for premature babies by comparison with babies born at full term. This is because they are younger. Your baby will be assessed according to their ‘corrected age’. This is your baby’s age from your due date, rather than the day they were born.
After the age of 2, your child will have the same checks as other children their age. If your baby was born before 28 weeks, they will be offered an extra check when they are 4 years old.
At your clinic appointments, the healthcare team may measure and weigh your baby. They may ask you how well your baby is feeding and what they’re doing. For example, whether they are rolling over or sitting up, depending on their age. They will also ask if you have any questions or concerns about your baby’s growth or development.
If your baby needs support or further tests, they may be referred to a specialist. Specialist services, such as physiotherapy, speech therapy and support from a dietitian are often co-ordinated so you can see more than 1 specialist in a single clinic visit.
You should also be offered emotional support to help you and your family cope with the effects of having a premature baby.
The NHS website has more information about the development checks offered to all babies.
Understanding your baby's growth chart
Before you leave hospital, the healthcare team will give you a Personal Child Health Record, which is also called the 'red book'. This has growth charts to plot your baby's growth and compare it with the average growth for their age.
If your baby was born before 32 weeks, their growth will be plotted in the low-birthweight chart. Babies born at 32–37 weeks are plotted in the preterm chart until 2 weeks after their estimated due date. After that, they are plotted in the main charts using their corrected age, which is measured from your due date rather than their birth date.
How do centile charts work?
The centile charts in your baby’s red book show how quickly your baby is growing and how their size compares with children of the same age. For example, if your baby's length is in the fifth centile, it means they are the fifth longest out of 100 babies of the same age. There are separate charts for girls and boys, as boys tend to be heavier.
Your baby's measurements for their height and weight should be on similar centiles. If they’re very different from each other, this may show that your baby is overweight or underweight. The healthcare team may recommend changing how often and how much you feed them.
Your baby’s weight or length centile may change as they get older, but they usually only go up or down 1 centile. Speak to your health visitor if your baby’s measurements vary more than this.
Rather than 'targets' to be measured, it's more helpful to view milestones as signals that some premature babies might need extra help. Throughout your child's early life, the healthcare team will observe their development and measure their progress against milestones.
These are usually carefully worked out targets based on the average age at which children tend to develop certain skills. For example, 8–18 months is the average age when a child will start trying to walk on their own. The milestones have been designed to help professionals spot problems early. Remember that term babies may not meet development milestones either so try not to worry too much.
Try to avoid comparing your child to others
It's easy to become very focused on comparing your child with other children. Some parents find themselves thinking of milestones as 'targets' that indicate the success or failure of their child. But try to keep in mind that all babies are different and will develop at their own pace, no matter when they were born. Not reaching a milestone doesn’t necessarily mean that there is a problem.
Using milestones positively
You can use milestones positively in different ways:
- to encourage your baby's development – for example, if you know that babies can start to roll over from about 2 months, you might notice them trying to flip themselves over and you can give them a helping hand
- to keep your baby safe, by being aware of what they are and not able to do
- to spot whether your little one could be falling behind – if there may be a problem in a particular area, you can seek advice more quickly.