Whether a baby is premature or not, there’s no way to predict exactly when she’ll hit milestones. Instead, there’s a “range of normal” that spans when most babies accomplish these big developmental goals.
For preemies, many pediatricians recommend using an “adjusted age” to determine this range. Adjusted age helps level the playing field by taking into account just how early your baby was born. After all, had your baby not been premature, she would have had a lot more time in your womb to get ready before she was expected to achieve milestones!
When you use an adjusted age, the range of normal gets shifted. For example, while most full-term babies will sit up between 4 and 7 months, a baby born two months early can be expected to do this between 6 and 9 months.
To find your child’s adjusted age, count the number of weeks between her birth date and her due date, and subtract that amount of time from her current age.
For example, if you have a 4-month-old baby who was born 8 weeks early, her adjusted age would be 4 months minus 8 weeks, which comes to about 2 months. At 6 months old, her adjusted age would be 4 months, and at 12 months old, her adjusted age would be 10 months. Find out more about your premature baby’s adjusted age.
According to Sessions Cole, a pediatrician and director of newborn medicine at St. Louis Children’s Hospital, adjusted age may be more accurate for motor milestones (such as rolling over, sitting up, and walking) than for cognitive milestones (such as babbling and imitating sounds).
“Premature babies tend to be less delayed in their cognitive milestones, so the adjusted age may be slightly more helpful for the motor milestones,” Cole explains. “But remember that it’s highly individual.”
If you’re concerned about your baby’s development, even after adjusting for age, talk with her doctor. A referral for early intervention services (for children younger than 3) may be in order.
Research has shown that early intervention is extremely helpful. As Cole says, “Premature babies can benefit greatly from these services.”
You’ll probably find that your child’s adjusted age becomes less and less relevant the older she gets. “We can’t pinpoint an exact date to stop adjusting, but at some point it will become clear that it doesn’t make that much difference – usually around age 2 to 3,” says Mia Doron, associate professor of pediatrics at the University of North Carolina and coauthor of Preemies: The Essential Guide for Parents of Premature Babies.
Some parents find it helpful to consider adjusted age as a child gets older, though – when approaching big life events like starting kindergarten or smaller ones like choosing a cabin at camp.
If your child seems younger than her peers, you may want to group her with slightly younger kids. “Adjusting for age could still be appropriate” in cases like this, Doron says.
Finally, remember that while milestones are important, they don’t provide a complete picture of your child. “Milestones are great for helping to keep track of how a baby is doing – but babies have strengths that milestones can’t capture,” says Cole. “We shouldn’t deny these strengths, even if they aren’t exactly ‘fitable’ into the milestone cubbyholes.”
This advice makes good sense for the post-baby years, too. As Jeff Stimpson writes of his 5-year-old son in Alex: The Fathering of a Preemie,”He can do three forty-eight piece puzzles simultaneously. I can’t do that.”
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