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 Premature birth may shake your confidence in the world. It’s natural to have both positive and negative emotions when you have a premature baby. Parents go through many complex feelings, as it is different from what parents-to-be had dreamed or expected about the upcoming baby. 

 However, parents wonder about what happened and what caused the premature delivery. The birth experience may make you feel powerless, unhappy, guilty, worried, or traumatized. There might be Concern, worry, and anxiety that may arise when your infant is admitted to the NICU or a special care nursery (SCN). 

What is premature birth?

 A pregnancy normally lasts about forty weeks. Premature birth occurs when the infant is born more than three weeks before the expected due date. In other terms, a preterm baby is born before the 37th week of pregnancy. 

Premature babies, particularly those born very early, are prone to a variety of medical issues. Prematurity complications can range from mild to severe. However, the earlier the baby is born, the greater the chance of complications. A baby born prematurely is called a preemie.

“An estimated 15 million infants are born each year prematurely (before 37 weeks of pregnancy), which is more than one in ten babies, and unfortunately, the number is growing.”- According to a WHO report.


What causes a preterm birth?

Premature birth can happen for several reasons. Although, majority of preterm births occur without particular reasons; however some are caused through early labor induction or cesarean delivery, whether for medical or non-medical reasons. 

On the other hand, infections, multiple pregnancies, problems in the uterus or cervix, chronic diseases such as diabetes and high blood pressure or a mother has a history of premature birth, etc., are all common reasons for premature delivery; however, in many cases, no cause is discovered. However, in some cases, a genetic issue might also play a big role. 


The basics of premature baby development:

Premature babies, particularly those born extremely early, and are sensitive to several medical issues. Prematurity problems can range from mild to severe. However, the sooner your baby is born, the greater the chance of complications. 

The majority of preemies grow up to be healthy children. By the age of three or so, they are on par with full-term newborns in terms of growth and development. Because your premature baby’s genes are also programmed to develop in a particular way, and it’s naturally going on even if the baby is born early. However, your baby’s early years may be more challenging than those of a full-term infant. Preemies require extra care since they are born before they are ready. They’re more likely to suffer health problems and developmental difficulties during their early year or sometimes afterward. 

Remember, all babies are different, and the way they develop and behave is also different. With preemies, the differences also depend on when they were born. For instance, a preterm infant born at 37th week is likely to behave differently from a baby born at 26 weeks who has already faced several medical problems by the time she reaches 37 weeks. It may take longer for a baby born at 26 weeks to gain weight, learn to feed, and enter the social environment.

Therefore, doctors divide preemies (premature babies) into groups depending on how old babies are at birth:


  • Born between 34-36 weeks of pregnancy is known as Late Preterm. 
  • Born between 32-34 weeks of pregnancy is known as Moderately Preterm.  
  • Born at less than 32 weeks of pregnancy is known as Very Preterm.
  • Born at or before 25 weeks of pregnancy is known as Extremely Preterm.
  • Born between 23-24 weeks of pregnancy is known as Micro-preemies.


Development Milestone

Here are the week-by-week changes that you may watch and expect in your preemie during his or her time in hospital. 


25-26 Week Baby

A baby born at or before 25 weeks of gestation is known as extremely preterm. Your preterm baby has a far better chance of surviving than ever before. A newborn has the highest chance of survival in a neonatal intensive care unit (NICU) with an experienced staff.  

A baby in the womb at 26 weeks is around 35 cm long and weighs about 760 gm. Usually, premature newborns are small for their age. However, a baby delivered at 26 weeks would most likely fit into her father’s hand comfortably. The only goal 23-24 weeks baby is to grow, sleep, and most importantly, to become medically stable.

23-26 week old baby may open his eyes occasionally; however, he is unable to focus. His body’s processes may be stressed by light or other visual stimuli. Therefore, the baby’s nurse may cover the incubator and dim the lights of Intensive Care Units at night. Twitches, jerks, and startles are common in your baby’s movements. She still lacks a muscular tone and is unable to curl up. Hence, the baby will be placed in a curled-up posture, with material to support her body and keep her warm. This allows her to maintain her energy levels. 

The child is prone to have apnea in most cases, as it is quite common for very preterm infants. Because the part of your baby’s brain that triggers breathing hasn’t fully matured yet, hence, pauses between breaths are common. Your child may need a breathing tube for long-term breathing support. It’s not a major concern as with passing time and medical care; your child will grow out of it. 

Although your baby’s ears and hearing structures are completely developed, he may be sensitive to environmental noises. Your baby may be aware of your presence, but he is unable to respond. Remember, the baby is not yet able to feed on the breast. Since your baby’s skin is delicate and sensitive, she may get distressed by touché. Hence, nurses will generally advise you to ‘comfort hold’ rather than touching your child. 


27-28 Week Baby

27-28 week old babies are no longer considered micro-preemies. Instead, they are known as ‘very premature babies. Moreover, these babies have a survival past birth rate, which is greater than 95%. However, these babies still require special care and need to stay in the INCU for long periods.

At 27-28 weeks, Babies in the womb continue to gain weight and grow. However, if your preterm baby is ill, having body temperature, he may not acquire weight as quickly as a baby in the womb. 

In addition, to protect your baby’s undeveloped intestines from infection, hospitals adopt carefully phased feeding plans, which may delay body fat or weight gain. 

Premature infants weigh around 2 1/2 pounds and are roughly 16 inches long from head to toe by the time they reach 28 weeks. Rapid eye development is taking place. Premature infants born after 27 weeks may blink, and their eyes are no longer fused eyelids, and their eyes can form images at this stage. However, babies are prone to retinopathy of prematurity (ROP) at this age because the retinas are still growing. 

Your preterm baby’s muscular tone is still low. Therefore twitches and tremors are possible. Your baby’s sleep and waking cycles aren’t completely obvious yet, although she may have an active sleep and quiet intervals, as well as extremely brief alert times. Although your baby may open her eyes, she is unlikely to be able to focus or move her eyes together. 

Even if your baby starts sucking, the baby won’t be able to feed on your breast. First, this is because she must be able to suck, swallow, and breathe in the correct order to breastfeed. Second, this is because your baby still has sensitive and fragile skin. However, if the medical condition is stable, your doctor may allow for skin-to-skin contact by doing kangaroo care.

The skin of your infant is still delicate and sensitive. However, if your baby’s medical condition is stable, you may be allowed to begin skin-to-skin contact by doing kangaroo care. 


28-30 Week Baby


At 29 to 30 weeks in the womb, a growing baby matures a lot. Their vital organs are developed well than those of babies born a couple of weeks earlier. However, 27-30 week old baby still requires long NICU stays. When a baby is in the womb, it keeps getting longer and heavier, knows the differences between sound and music, opens and shuts his eyes, grasp with the hands, and even begins to move often. At this age, you need to wait for a bit of time to development of motor skills, as she might stretch or move more actively when the muscles tone gets better.

Premature infants birth weight around 3 pounds and are about 17 inches long at 29-30 weeks and have more fat stored beneath their skin which gives them a look like a real baby. Their eyes can blink now, but they can still have a difficult time with bright light and loud noises. In addition, their deep sleep increases. Aside from all of these external development goals, brain development goes through a time of significant growth. The brain display development begins to look grooved and wrinkled around 29-30 weeks. They’re also ready to start regulating their body temperature. 

The intestines and stomach are getting ready to digest the milk. However, the baby is not yet ready for breastfeeding, but it may begin sucking on a pacifier that helps develop its eating muscles. Moreover, kangaroo care while feeding helps your baby thrive.


31-35 week Baby

A baby’s organs are all developing at this age. 31-32 week old a baby may not require much medical attention or body tension. Your preterm baby’s behavior over time will become smoother and more regulated. Not just that, he will begin to bend the arms and legs independently. By 31-35 weeks, your preemie may be between 18 to 19 inches long and weigh between 3 ½ and 4 pounds. That’s almost compared to equal to full-term babies.


Your baby can have coordinated sleep. Your baby likes cuddling or talking and initiates eye contact at this age. Premature babies born at 33-34 weeks are also called “moderately preterm babies.” Despite their growing size, 33-34 week olds are still underdeveloped and may require a couple of weeks in the NICU and daily care. By this age, premature infants are virtually completely formed. 33-34 weeker most facilitates with bones are fully developed, their fingernails have grown to the tips of their fingers, and their testicles have begun to descend into the scrotum in boys. 


36 weeks and beyond

Your kid is getting close to the time when he was supposed to be born or actual birth time. Even when he reaches 37 weeks, he isn’t exactly a full-term baby. Your baby’s movements are now more flexible, and she can bend her arms and legs more easily. Her muscular tone is better, and she can move her head from side to side. 

“Late preterm newborns” are premature babies born at 35 to 36 weeks gestation. These infants are around 20 inches long and typically weigh between 5 1/2 and 6 pounds. Although 35-36 week olds appear to be full-term babies, they are still preterm and may experience challenging time and prematurity-related issues. Because their lungs won’t be fully formed for another couple of weeks, and they might not have enough fat or strength to have properly breastfed or bottle-feed. It’s critical to continue to protect their sleep and time in the NICU until they’re all ready to go home. 

Your kid may be ready to leave the hospital before his due date only if your kid hasn’t undergone surgery or has been sick, as it may take longer. Before you can take your baby home, the hospital will check the development preemies premature, like health, growth, and development goals for her. These might include gaining weight gradually, eating from your breast or a bottle at all feeds, and not experiencing any apnea issues or breathing rate stable skin. However, the respiratory system does not fully mature until the last weeks of pregnancy, and antibodies are only just beginning to transfer from mother to child, so their immune health is still a little impaired. Late preterm newborns have development by age like other normal children.

Don’t get too worked up overachieving milestones. Because no baby, whether full-term or preterm, grows on a strict timetable. It’s typically not a cause for Concern if your child misses or delays developmental milestones because babies have a different preterm birth story. Hence, consult your pediatrician for your concerns. They can acknowledge your concerns and talk about ways to help your kid’s development.

On the other hand, rather than sticking to specific milestones or targets, focus on your baby’s progress. Look at the bright side they are making. For example, all babies babble before they learn to speak the first word. Likewise, they will shuffle and stand before they learn to walk. Hence, as long as your baby is moving slowly or steadily forward in their development, that’s what is essential.  

People Also Ask:

When do preterm newborns catch up with their peers in terms of development?

The sooner a child is born, the longer it may take for her to catch up, although most babies do. For example, a baby delivered at 36 weeks may not be caught up by six months, but it might be within the range by 12 months. The same way a baby born at 26 may not catch up until they don’t reach the age of 2-3 years.


How premature birth affects parents?

Premature birth affects parents deeply as they have not expected it. Because prematurely born babies are more likely to suffer health issues at birth time and later in life than those born later. Premature newborns are more likely to suffer long-term intellectual and developmental issues, as well as problems with their lungs, brain, eyes, and other organs. 


How to help your premature baby grow?

Your care for preemies helps your child to achieve developmental milestones. Like breastfeed your baby, care to bond, massage your baby, skin-to-skin contact, or care for baby health. Visit the doctor regularly for a development check. Your preemie needs your extra time until they reach 10-18 months.


How do you assess a premature baby?

Your doctor will guide you about your premature baby. First, however, we have summarized some possible tests for your preemie, which include: Blood tests, ultrasound scan, fluid input and output, breathing and heart rate monitoring, and eye exam.

When do preemies smile?

We don’t think anything is cuter in this world than a smiling baby. Typically, newborns begin smiling between the ages of 6 and 12 months, although you may detect a smile or smirk shortly after birth these early grin is known as ‘reflex smile’. In the womb, also babies begin to smile reflexively and continue to do so as infants.


Premature babies’ development varies so drastically from child to child.   So, rather than sticking to specific milestones or targets, focus on your baby’s progress. If your child is moving steadily forward in their development that’s what is crucial. Babies will be caught up within 12 months, or even before they reach their second or third year. It’s essential to visit the doctor regularly for a development check. Because no baby on their own grows on a strict timetable, don’t get too worked up over your child missing milestones because they will catch up eventually.


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