Understanding Preemie Adjusted Age
Understanding Preemie Adjusted Age vs. Actual Age: A Guide for Parents and Our Experiences
Welcoming a preemie newborn into the world is alarming and frightening from the start.
We know this first hand
During and after NICU stay, taking care of your preemie means leaning what your preemie is ready for and what is to come, which is measured by an adjusted age. This can introduce a unique set of challenges and considerations.
An adjusted age can be confusing and cause for pause, but it is a helpful reminder of how unique preemies are to full term babies.
Preemies are different. They have their own set of rules and truly live on their own terms and timeline.
In this blog post, I will explore the difference between preemie adjusted age and actual age and discuss why it matters.
Defining Preemie Adjusted Age:
Preemie adjusted age, also known as corrected age or gestational age, is a term used to describe the age of a premature baby in relation to their due date, rather than their actual birth date.
Let that sink in. Birthdate isn’t important. Due date is.
You may ask, “but my baby is born.. why does an irrelevant due date matter?”
It does. Because that’s the developmental age your baby is.
When babies are born premature (before 37 weeks gestation) they are not skipping the steps of developing in the womb, they are developing outside of the womb at the same rate they would have if they were inside the womb.
Preemie adjusted age is calculated by subtracting the number of weeks or months the baby was born prematurely from their actual age.
Example: My daughter Kaylee Jane was born at almost 32 weeks gestation, which is 2 months early or 8 weeks early.
Here’s the first big realization I had learning adjusted age. Her birthdate chronically she would be 1 month old at 36 weeks gestation. But since she technically shouldn’t have been born yet, with three weeks until due date, any real milestones don’t start until her due date or adjusted age. Actual age 1 month, preemie age 36 weeks.
The impact of this for the past 18 months has been huge. I’ll explain.
Understanding Actual Age: Actual age refers to the baby's age since their birth, measured in days, weeks, months, or years. It is simply the amount of time that has passed since the baby entered the world, regardless of whether they were born prematurely or at full term.
While in the NICU I remember thinking how lucky I was to have this extra time with her, since technically she shouldn’t be born yet, I had two full months of babyhood. But preemies are different. They act less baby and more fetal like, very little and frail, lots of sleep and Preemie newborns exhibit certain differences in behavior compared to full-term newborns. Here are some ways preemie newborns may differ:
Size and appearance: Preemies tend to be smaller and lighter than full-term babies. Their skin may appear thin, transparent, or wrinkled. They may have less body fat, making them appear fragile and delicate.
Sleep patterns: Preemies may have irregular sleep patterns and may sleep for shorter durations. They may be more easily awakened and have trouble settling into deep sleep.
Feeding challenges: Preemies often have difficulty with feeding due to their immature sucking and swallowing reflexes. They may lack coordination between sucking, swallowing, and breathing, leading to challenges in breastfeeding or bottle-feeding. Some preemies may require feeding through a tube initially.
Temperature regulation: Preemies have less body fat and underdeveloped mechanisms for maintaining body temperature. They may struggle to stay warm and require additional measures such as an incubator or special clothing to help regulate their body temperature.
Sensory sensitivity: Preemies may exhibit increased sensitivity to light, noise, and touch. They may become easily overwhelmed by their environment, leading to fussiness or irritability.
Muscle tone and reflexes: Premature babies may have weaker muscle tone and less-developed reflexes compared to full-term newborns. They may exhibit less active movement and have difficulty coordinating their movements.
Respiratory issues: Preemies often have immature lungs and may require assistance with breathing, such as supplemental oxygen or mechanical ventilation. They may also be prone to respiratory infections.
It's important to note that every preemie is unique, and the extent of these differences can vary depending on the gestational age and overall health of the baby. Healthcare professionals specializing in neonatal care closely monitor preemies to ensure their growth, development, and well-being.
Why Preemie Adjusted Age Matters: The reason preemie adjusted age is important is that it helps healthcare professionals, parents, and caregivers evaluate the development and growth of premature babies more accurately. Premature birth disrupts the natural progression of fetal development, and preemies often require additional time to catch up to their full-term counterparts.
Knowing this helps the next part, milestones.
Developmental Milestones and Preemie Adjusted Age: Babies reach various developmental milestones at different ages, such as sitting up, crawling, or saying their first words. For preemies, achieving these milestones might occur later compared to babies born at full term. For us, Kaylee Jane was “late” on every milestone according to the NON adjusted age. At 3 months old she acted like a 1 month old. Again, she was technically 3 months but developmentally 1 month. This absolutely applies to her size and look of her also.
By using preemie adjusted age, healthcare professionals can track a preemie's progress against milestones appropriate for their adjusted age, rather than their actual age.
Medical and Educational Considerations: Preemie adjusted age also has implications in medical settings and educational environments. When assessing a preemie's health or considering intervention or therapy options, medical professionals may refer to the child's adjusted age to ensure appropriate evaluation and treatment. Likewise, when a preemie reaches school age, their adjusted age can be used to determine readiness for academic programs or services.
Adjusting Expectations: Understanding preemie adjusted age can help parents manage their expectations and alleviate concerns. Comparing a preemie's progress to that of a full-term baby can lead to unnecessary worry and stress. By recognizing that premature babies may need additional time to meet certain milestones, parents can focus on celebrating their unique journey and providing the necessary support for their child's development.
Kaylee Jane throughout babyhood was true to her preemie age.
Transitioning to Actual Age: As a preemie grows and develops, the significance of preemie adjusted age gradually diminishes. By around two to three years old, most preemies have caught up to their full-term peers, and the distinction between adjusted age and actual age becomes less relevant. At this point, parents can rely on their child's actual age for developmental tracking and comparisons.
Conclusion: Preemie adjusted age is a valuable tool for assessing the growth and development of premature babies in relation to their due date. It provides a more accurate framework for understanding a preemie's progress and helps parents, healthcare professionals, and educators make informed decisions about their care. By acknowledging and embracing the concept of preemie adjusted age, parents can support their child's unique journey and provide the appropriate resources to help them thrive.
