Understanding Premature Baby Milestones: How Parents Can Track Growth and Development After NICU Discharge — says Dr. Sunil Pawar

Is your little one’s birth an early arrival? It would be nothing short of exciting to take your baby finally home from the Neonatal Intensive Care Unit (NICU). Although, the journey ahead can be confusing. From understanding how to feed them, measuring their weight gain, to evaluating their growth and progress, parents often have several questions.

Every premature baby needs their own time and pace to grow. As parents, you should ensure that their progress is not being compared with other babies. Here are some essential factors to consider so you can track your little one’s growth at home.

Corrected Age

Premature babies need some extra time to catch up. To assess their growth during the first two years, an adjust age calculation is used. This is called corrected age. Take your baby’s actual age and subtract the number of weeks your baby was preterm. For some extremely preterm babies, doctors may advise using this calculation for a longer period.  

Motor Skills

  • Look for improving head control and spontaneous movements.  
  • Observe if they are reaching for objects, rolling and eventually sitting.  
  • Persistent stiffness, unusual floppiness or unequal movements require medical attention. 

Feeding and Weight Gain

  • Monitor feeding effectiveness by observing the latch, swallowing rhythm, duration, and post-feed mood.  
  • Milk intake, wet nappies and weight gain are other ways to understand if your baby is feeding well.  
  • Some babies need specialised formula to add those extra calories they need for their growth as prescribed.  

Social and Cognitive Age Development

  • Observe how your baby responds to familiar voices. 
  • Notice how their eye contact, smiles, and interest in faces are changing or improving. 
  • See if their interaction increases with time.   

Never Ignore these Red Flags

  • Continuous feeding difficulties or choking during feeds  
  • Not gaining weight or not showing responsiveness 
  • They show strange movements  
  • They may lose some skills they learned earlier 
  • If your baby has breathing difficulty take them to the doctor immediately. Blue or grey lips, seizures, severe dullness, or fever are also some symptoms that needs urgent care.  

Create a Supportive Environment at Home

  • Talk, sing, and involve in gentle play with your baby frequently. 
  • Skin-to-skin contact plays a major role in their growth.  
  • Making them sleep on their back will ensure they are safe at all times.  
  • Washing your hands and maintaining hygiene is significant.  
  • Keep them away and never expose them to smoke from tobacco.  
  • Ensure your baby is not around sick people as much as possible.   
  • Frequently lay down your baby on their stomach, but only when they are awake and monitored.  
  • Remember that your baby’s emotional wellness comes first. In case you need support, take help from professionals.  

Follow-up After Discharge

  • The first paediatric review is mentioned in the discharge summary and it’s often within a few days. Schedule your appointments accordingly.  
  • Assess growth, nutrition, development, hearing, vision and immunisation during the later visits.  
  • Depending on your baby’s age, medical history, and developmental progression, follow-ups may involve a neonatologist, developmental paediatrician, physiotherapist, occupational therapist, dietitian or ophthalmologist.  
  • A structured developmental monitoring and follow-up are extremely beneficial for the high-risk babies. This includes assessments during infancy and around two years corrected age. The schedule should be personalised to the baby’s unique needs.