Child development: Premature babies

Welcoming a premature baby into the world can be both a joyful and challenging experience for parents. About 8% of babies born in Australia are premature, meaning they were born before 37 weeks gestation.  

Most premature babies will thrive as they grow, but some babies can have added challenges with areas of development caused by their early arrival into the world. Below, you can read about childhood development considerations when your baby is born prematurely, and how you can support their growth. 

Understanding premature birth

Most premature babies are born between 32 and 36 weeks of gestation. Some babies born before 32 weeks can have immediate challenges with their health because their bodies are not as developed. Things like breathing and eating can be especially difficult, and your baby will probably need extra support from a medical team in the Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN).  

NICU and SCN can be an emotionally taxing period for parents as they recover from childbirth and adapt to a different start to their parenting journey. The doctors and nurses looking after your baby in NICU and SCN will not only support your baby, but they can supply support to you as parents and provide important education on your child’s individual development and how you can help them to grow strong. 

 

Growth and development challenges for premature birth

Premature babies are more likely to be delayed in meeting their growth and developmental milestones compared to full-term babies. The earlier your baby is born, the greater the challenge, as they have had to adjust to the outside world before they were ready.  

All babies born in Australia can see their local child and family health nurse for free. Visits are usually arranged at key developmental stages from birth until they start school. Child and family health services help to pick up on any issues your child might be having and arrange support. 

Developmental disability

Most premature babies will eventually catch up in their development, but some may face mild disabilities depending on the reason for their premature birth and any added complications that might have happened during birth. Developmental disabilities related to premature birth can include: 

  • cerebral palsy 
  • visual or hearing difficulties 
  • learning delays 
  • gross and fine motor skill difficulties 
  • speech development delays. 

Language development

While premature babies typically follow a similar language development path to full-term babies, their language development can be delayed. Delays in language development can be an indicator of early hearing, cognitive, or learning issues. 

Physical disability

Premature babies will usually have a lower birth weight. It might take them a little while to physically catch up in weight and height compared to babies born at term. Some may experience minor difficulties in fine motor skills, coordination and planning of movement, matching what they see to their movement, and responding physically to sensory stimuli.  

Dental health

Dental problems can be an issue with premature babies, including issues with tooth enamel, delayed teething or tooth eruption, and differences in the shape and structure of their mouth. Your baby’s doctor might recommend seeing a paediatric dentist around the age of 12 months, or when their first tooth arrives. 

Sensory development

Most premature babies will have typical hearing, vision, and sensory awareness, but they are at a higher risk of developing hearing loss and visual impairments as they grow. These issues are usually picked up and addressed early through routine screening and assessments. 

Learning and social-emotional development

Social and emotional development can vary for premature babies, considering any other complications or challenges with their birth. They might also experience difficulties with learning and concentration. 

Premature babies can behave a bit differently to other babies in their first year, seeming more irritable and less engaged. This can be very stressful for parents especially when comparing baby behaviour and milestones in social situations. It’s important to keep checking in with your baby’s doctor about any concerns you might have. 

Corrected age and milestones

The growth and development of premature babies will look a little different, depending on how early they were born. Their growth and development progress is based on their corrected age, which helps check their progress and identify concerns more accurately. 

Corrected age = time since your baby was born - number of weeks or months they were early. 

Example: a baby was born 16 weeks ago. They were born at 29 weeks gestation, which is 11 weeks early. Their corrected age is 5 weeks old. 

Being positive about milestones

Developmental milestones are a common source of anxiety for parents. While they help track how your child is growing, they are broad guidelines and will be slightly different for every baby. Every child develops at their own pace, and not reaching a milestone on time doesn't necessarily indicate a problem. 

Comparison is the thief of joy and a source of unneeded stress. Try reframing milestone windows as a way to help you: 

  • encourage or boost certain areas of your baby’s development  
  • adapt your baby’s environment for stimulation and safety 
  • identify potential delays early, which helps to bring your child up to speed. 

A quick guide to milestones by corrected age

Milestones are a guide. Remember every child is different. Speak to your child’s doctor or your local child and family health nurse if you are worried about your premature baby’s development. 

1 to 2 months corrected

  • Smiling 
  • Making eye contact 
  • Basic limb movements 
  • Vocalising and cooing 
  • Responding to sounds and voices 
  • Starting to engage with immediate surroundings. 

4 months corrected

  • Laughter and more vocalisations 
  • Head control gets better 
  • Grasping objects 
  • Exploring by touch and bringing things to the mouth 
  • Building strength through tummy time  
  • Starting to sit up with support. 

6 months corrected

  • Sitting with support 
  • Rolling over, left to right and front to back 
  • Reaching for objects 
  • Head control gets even better 
  • Starting to hold their bodyweight on their legs, with support 
  • Vocalisations and interactions get more advanced and personal. 

9 months corrected

  • Babbling with various sounds – da, ba, and ma are common 
  • Sitting on their own without support 
  • Crawling or pulling themselves along the floor 
  • Recognising familiar faces and names 
  • Walking with support 
  • Fine motor skills like pulling and pincer grip are developing. 

1 year corrected

  • Pulling up on objects to a standing position 
  • Cruising around furniture 
  • Fine motor skills develop like grasping a spoon and moving it to the mouth 
  • Anxiety or fear around strangers develops 
  • Enjoying picture books and interactive play 
  • Developing language skills and showing independence.