Thursday, July 24, 2014

Adjusting for prematurity

When my babies were born at 35&4, I had heard the term "adjusting for prematurity" a lot. My attitude towards it: "awww hell no!" especially when my girls came out screaming and pink and healthy and needed no NICU time.

This attitude continued for a while. At our 3 month check up, they were 5% weight ... unless we adjusted, in which case they were 85% weight. But I did not want to adjust. So I went home with babies on the 5th percentile line.

When both of my daughters rolled over at exactly the 4 month mark, I sent an email with the video I captured saying "don't you label me a preemie!" (our pediatrician had told me at the 3 month check up that most babies roll at or by 4 months but she didn't expect ours to because they were a month early).

But then I started paying attention to two friends who had more-than-full-term babies. One was born at 41 weeks and the other at 42 weeks.

Those babies had FIVE and SIX extra weeks of womb time than my girls. And you know what, they are more advanced than my girls. Not my adjusted girls. But my born-at-35&4 girls.

When I was in hospital waiting to deliver, everyone kept saying (even my OB) "every extra day in the womb means you skip 2 NICU days." Why? Well, babies belong in the womb until at least 40 weeks and they develop faster in their natural habitat. So if they come early - even 4 weeks early and pink and screaming and healthy - they have still missed out on some key womb time.

It's why my babies had trouble nursing - they had not learned the important suck-swallow-breathe mechanism that comes ... wait for it ... in the last month of gestation.

It's why my babies came out with a layer of thick dark hair all over them. That stuff sheds off ... wait for it ... in the last month-plus of gestation.

I have come to think about it this way: if I was told I had a biology course from September to May and that I would have a final exam on all material covered in those months, but then I was out sick the whole month of May, well, I would not have as much information or knowledge as someone who was in school the month of May. I'm not dumber. I just missed some key learning time. And, likely, it would take me more time to try to learn the stuff on my own than by being taught it in a classroom of peers. The metaphor kind of falls apart at the "of peers" statement except that I did carry twins. Ha!

Anyway, I am now totally ok with adjusting. My girls are still hitting most milestones right when a full term baby hits them, but I don't expect them to, and I certainly do not expect them to be where my friends' 41 and 42 week babies are (one is standing on her own at 11 months and about to walk).

That's all!


  1. Yes, I was told the same with the age adjusted and since I wasn't due until this coming Sunday Little E is still at a minus in age...blah blah blah. Whatever. She is gaining weight and wiggling all over the place with trying to lift her own head up, startling at sounds and even trying to roll over already. I can see how it might affect really preemie babies but my little girl is doing just fine too. I'm patient and will watch her grow on her own schedule.

  2. Beyond the premie thing, each child is different. Even a full term baby can be 'behind' in something. Yes, it's much more common in multiples and premies. In fact, most women I know who have multiples (usually born early) are experiencing at least a bit of a lag in development. Eventually they will catch-up, but it will take a little while.
    My son, was born 2.5 weeks early. Not huge, but still made a difference. He did not catch on to eating for 3 months and it was super frustrating. He was at least 2 months behind in walking. Most other things he has done "on time", but it goes to show that most likely had he stayed put till 40+ weeks, he would have at least had a better shot at feeding correctly.

  3. Babies vary so widely, but even more so for preemies I guess. I think it's okay for you to think either way, whatever works for you!

  4. I've never had a problem with adjusting for my preemie babies. It helps me to know where they "should" be developmentally, although each baby is definitely different. Anyone with multiples can attest to that! Looking at my twins, you would never guess they were preemies at all, and they are mostly on track anyway. I'm glad your girls are doing so well!