Development of a premature baby up to one year old by month. How should he be cared for?

Child's weight

If the baby does not have serious health problems, then when he reaches a weight of 1800-2000 g, he can be discharged home.
It is best to purchase scales for newborns in advance to monitor weight gain once every 1-2 weeks (but not every day). On average, daily weight gain should be 15-30g per kg per day. This is especially important for children who do not breastfeed well. In the case of normal nutrition, low gains may indicate anemia or digestive problems

As the baby gets older, weekly increases decrease.

Weight, height and head circumference chart

Age in the chart is counted in weeks from conception (up to 40 weeks), and then from birth in months, as for children born at full term. The thick black line indicates the average value. The dark area around the line indicates values ​​close to the average. The dot-dash line indicates the boundaries of the norm. But even when going beyond these boundaries, it is necessary to take into account the child’s individual data: his state of health, nutritional habits and the doctor’s opinion.

Physical development of a child up to one year old

Children of different groups develop according to a schedule drawn up for them. Optimal weight and height gain for each of them:

• IV (up to 1 kg). In the first weeks, weight increases by 180 g and height by 3.9 cm. Then, every month, the child gains 450-600 g and grows by 2-3.7 cm.
• III (up to 1.5 kg). Initially, the weight increases by 190 g, height - by 3.7 cm. Then the monthly weight gain is about 600 g, in six months - 800-950 g. The increase in height reaches its peak at 8 weeks with a value of 4.2 cm, gradually decreasing to 0.6-1.2 cm.
• II (up to 2 kg). After birth, weight increases by 190 g, height - by 3.8 cm. Then weight gain ranges from 400 to 900 g, and height - from 1 to 3.8 cm.
• I (up to 2.5 kg). In the 1st month, weight increases by 300 g, height - by 3.7 cm. In six months, weight constantly increases by 700-900 g, and height by 2.5-3.5 cm. After that, the monthly increase is reduced to 400 g and 1.5 cm.

Over time, all premature babies catch up with their peers weighing from 8 to 12 kg.

Premature birth - what is it?

Childbirth before 38 weeks is considered premature. Reasons for giving birth earlier than expected include:

• Stressful situations of a pregnant woman; Fetal development abnormalities; Anomalies in the development of the genital organs in a pregnant woman; Multiple pregnancy; Intrauterine infection; Severe viral and infectious pathologies suffered by the pregnant woman.

During childbirth, a resuscitation island is set up near the woman in labor to provide emergency assistance to the baby in case of asphyxia. A baby born before 38 weeks is considered premature. From the first minutes of birth, the baby, depending on the degree of prematurity, is placed in an incubator or heated crib (Baby Term).

Conditions necessary for nursing premature babies

The child’s body is very weak and cannot adapt to environmental conditions. The main problem of premature babies is the body's lack of ability to maintain a constant body temperature. Their body thermoregulation is impaired. The incubator has all the conditions for the normal development of the child:

At the time of birth, premature babies have underdeveloped respiratory organs. To prepare the baby's lungs to work in environmental conditions, injections are indicated for the pregnant woman before delivery.

If a child was born early, doctors do everything to care for him.

There is a myth that premature girls are stronger than boys. This statement is not true. It all depends on the baby’s weight at birth, the course of pregnancy and the individual characteristics of the baby’s body.

If a premature baby is born, the main thing is not to panic. Medicine has stepped forward in this regard. The latest equipment allows you to care for children with very low weight.

Pediatricians monitor that the child gains weight evenly. Every morning, the mother weighs the child and records the increase in grams in a special journal. As soon as the increase stabilizes, the long-awaited discharge home awaits you. As a rule, this occurs by 1 month of the child’s life.

Full-term babies begin to smile at 1 month. Don't expect such achievements from your baby. You will see your first smile at 2–3 months. The mother must understand that all periods of development in her baby will occur later.

Development of premature babies up to one year, by month

What a premature baby can do by month:

At 2 - 3 months - recognizes mother, responds with a smile; At 4 months - reaches out to the rattle and tries to hold it; At 6–8 months – sits independently; At 8 – 10 months – begins to crawl; At 10 – 12 months – stands and walks on a support; 12 – 15 months – takes first steps.

All children are individual, and these are only statistical data. There are cases where premature babies took their first steps at 11 months and by the age of 1 year they had already caught up with their full-term peers.

Table weight and height: physical development of a premature baby by month

A premature baby gains more weight and height than a full-term baby. A small increase is observed only in the first month of life. Since the physiological weight loss in the first day is great. Monthly weight gain depends on the degree of prematurity of the baby. The data can be seen in a comparative table, which shows that the weight of a premature baby by the age of 1 year increases by 5–7 times. Let us remind you that a full-term baby’s weight increases 3 times by the year.

There are also distinctive features in feeding. A premature baby feeds 7–8 times, that is, every 2–3 hours.

A child born prematurely is under close supervision of a neurologist and pediatrician. Every month, a neurologist examines the baby and, if necessary, prescribes medications.

The development of premature babies up to one year old, reviewed by month

And in raising a premature baby, it is important to show patience and attention. By the age of 2, you will not see the difference between a full-term baby and a premature one. Doctors say that babies born prematurely are much hardier and healthier than full-term babies.

These are also children who are gifted and intellectually developed

Doctors say that children born prematurely are much hardier and healthier than full-term ones. These are also children who are gifted and intellectually developed.

What can he do? or developing the skills of a premature baby.

Very often parents of premature babies ask me - what will happen to him next? Relatives and friends add fuel to the fire by telling scary stories about profound mental retardation and severe disability of such children. But this is not true - extreme prematurity does not mean at all that the child will become disabled or develop abnormally. Of course, they are different, different requirements are placed on them, but this does not mean that such children are defective. To dispel doubts, let's talk about the peculiarities of the development of skills of premature babies, about their neuropsychic development and the characteristics that you, parents, need to know. What is their difference? Basic skills and age-related skills (holding the head, crawling, sitting, standing and others) Most premature babies are born at a later date than full-term babies. Premature babies later begin to focus on visual and auditory stimuli, later hold their heads, later begin to walk, smile, recognize surrounding faces, laugh, roll over, sit, stand, walk, purposefully move their arms, and speak. The lag in psychomotor development depends on how premature the baby is. If the baby is born after 32 weeks, the baby’s skills will develop later by about 1-1.5 months; if born before 30-31 weeks, they will all slow down by about 3-4 months. By the end of the first year of life, most children with short periods of prematurity catch up with their peers, and by 2-3 years, very premature babies born weighing 500 grams or even less are compared with them. In children who are ill for a long time, children with developmental defects or in the absence of the necessary care, the lag in neuropsychic development is more pronounced. To monitor the neuropsychic development of a premature baby, especially with a body weight of up to 2500 g, special indicators of the neuropsychic development of premature infants are used children of the first year of life. Typically, all values ​​are indicated in comparison with age for full-term babies and the limits of fluctuations are indicated when a new sign may appear in a premature baby, depending on body weight at birth. what can we do? I will dwell in more detail on the exact timing of the appearance of skills, so that it is easier for you to navigate whether there is a problem or everything is fine with you. A delay of more than a month behind the established deadlines will be considered abnormal. A baby with a body weight of less than 1500 grams fixes his gaze, smiles for the first time, makes attempts to hold his head while lying on his stomach at the age of 2-4 months; children weighing 1500-1700 grams master these same skills in 2-3 months, with a weight of 1701-2000 gram - at the age of 1-2.5 months, and babies 2000-2500 grams - at 1-2 months of life. The baby tries to follow and listen to you, quickly answers you with a smile - with a body weight of less than 1500 grams at the age of 4-6 months, these Children weighing 1500-1700 grams master the same skills in 3.5-4.5 months, those weighing 1701-2000 grams - at the age of 3-5 months, and babies weighing 2000-2500 grams - at 2-3 months of age. Your baby concentrates visually, listens , perks up when you appear, accidentally bumps into a toy hanging over his chest, holds his head well and focuses his gaze on the adult, being on his hands in a vertical position, rests his legs, and begins to walk. These skills are formed with a body weight of less than 1500 grams at the age of 4-6.5 months, children with a weight of 1500-1700 grams master these same skills in 4-6 months, with a weight of 1701-2000 grams - at the age of 4-5 months, and babies 2000-2500 grams - at 3-4 months of life. The child finds an invisible source of sound, laughs loudly, grabs a suspended toy, gurgles - with a body weight of less than 1500 grams at the age of 6 months, children weighing 1500-1700 grams master these same skills 5-6 months, with a weight of 1701-2000 grams - at the age of 5-6 months, and babies 2000-2500 grams - at 4.5 months of age. Your baby can distinguish the tone of speech addressed to him, distinguish strangers from loved ones, clearly take a toy from the hands of adults, can turn on his stomach, stand steadily with support, and walk for a long time. This is acquired with a body weight of less than 1500 grams at the age of 6.5-7.5 months; children weighing 1500-1700 grams master these same skills in 6-7 months, with a weight of 1701-2000 grams - at the age of 6-6.5 months, and babies 2000-2500 grams - at 5.5-6 months of life. The baby can freely take toys from different positions, can roll over from his stomach to his back, crawl, begins to babble, can eat from a spoon and remove food with his lips - with a body weight of less than 1500 grams at age 7.5-8.5 months, children weighing 1500-1700 grams master these same skills at 7-8 months, those weighing 1701-2000 grams at the age of 6.5-7 months, and babies weighing 2000-2500 grams at 6-7 months of age. The baby has learned to crawl well, babbles for a long time, when asked “Where?”, finds an object located in the same place - with a body weight of less than 1500 grams at the age of 9-11 months, children weighing 1500-1700 grams master these same skills 8.5-10 months, with a weight of 1701-2000 grams - at the age of 8-9 months, and babies 2000-2500 grams - at 7.5-8.5 months of life. The child plays with toys for a long time, sits down and stands up, holding on to the barrier, steps over, pronounces syllables loudly and repeatedly, performs “okay”, “give me a hand”, “goodbye”, eats bread himself, pours from a cup held by an adult - with a body weight of less than 1500 grams at the age of 9.5-12 months, the same children weighing 1500-1700 grams master skills at 9.5-12 months, those weighing 1701-2000 grams at the age of 9-10 months, and babies weighing 2000-2500 grams at 8.5-10 months of age. Acts with objects in different ways: rolls, takes out, walks, slightly holding on, repeats various syllables after adults, knows his name, when asked “where?”, finds an object in different places, shows the skill of neatness - with a body weight of less than 1500 grams at the age of 11.5-13 months, these Children with a weight of 1500-1700 grams master the same skills at 11-12 months, with a weight of 1701-2000 grams - at the age of 10.5-11 months, and babies with a weight of 2000-2500 grams - at 8.5-10 months of life. The baby opens, puts in a toy, climbs onto a high surface and gets off it, at the request of “give”, gives familiar objects - with a body weight of less than 1500 grams at the age of 12.5-14 months, children with a weight of 1500-1700 grams master these same skills at 12-13 months, with a weight of 1701-2000 grams - at the age of 11.5-12 months, and babies 2000-2500 grams - at 10-11 months of life. The baby puts on the cubes, removes the ring from the pyramid with a large hole, stands independently, uses the first symbols: aw-aw , kitty-kis - with a body weight of less than 1500 grams at the age of 13.5-14.5 months, children with a weight of 1500-1700 grams master these same skills at 11.5-12.5 months, with a weight of 1701-2000 grams - at the age of 11-12 months, and babies 2000-2500 grams - at 11-12 months of life. Begins to walk independently, has a vocabulary of about 10 simple words, upon request performs actions: shake Lala, where are the eyes, etc. - the baby acquires these skills with a body weight of less than 1500 grams at the age of 14 -16 months, children weighing 1500-1700 grams master these same skills at 12-15 months, those weighing 1701-2000 grams at the age of 12-13 months, and babies weighing 2000-2500 grams at 13-13 months of age. How can you find out when there are problems? When assessing the development of a premature baby, the actual level of development is compared, what he can confidently do from the proposed skills for today, and this is compared with normative indicators at a given age. This is how the child’s individual rate of maturation is determined (slow, normal, accelerated, mosaic). Problems are considered to be a slowdown in skill development for 1-2 months, and for more than 2-3 skill lines. Of course, it is absolutely wrong to level a baby. who was born at term with a baby who was born weighing less than a kilogram - they will be very different in development. But in order to know the basic patterns and be able to understand in time that something is going wrong, doctors are developing many schemes for assessing the development of a child’s skills. His abilities are assessed, making sure to adjust for the degree of prematurity. That is, how many weeks will he rush into the world, this is usually 40 weeks minus the due date. With age, the level of mental development of a premature baby changes and approaches the normal level, as a result of which maintaining the initial correction loses its meaning, and to assess the level of development at the age of 12-14 months, focusing on the standards for ordinary healthy full-term babies becomes optimal. If developmental problems arise - or you are concerned about the lack of a particular skill, do not hesitate - contact your pediatrician or neurologist. The doctor will evaluate the baby using a special in-depth scale and will say for sure whether the baby has problems or not. Then treatment, if necessary, will be correct and timely. what difficulties might there be? Psychological rehabilitation of a premature infant is usually based, first of all, on warm emotional contacts and a favorable mode of obtaining auditory and motor experience, creating a feeling of psychological comfort and helping the child cope with the effects of external and internal stress. You need to talk to them, carry them in your arms, pressing them to your stomach, do gymnastics, developmental techniques, and walk a lot. This is especially important for very premature babies, because in the first years of life such children are noticeably behind the norm. Unfortunately, it happens that prematurity is accompanied by damage to the nervous tissue, which can cause some consequences. The lower the birth weight, the more significant the impairment. Most intellectual disabilities last a lifetime. In all cases, the initial manifestations of mental disorders relate to the vegetative-instinctive sphere, sensory development (sense organs), motor skills, emotional sphere, communication, cognitive development, social behavior and the formation of prototypes of self-awareness. In the structure of mental disorders at an early age in premature infants, the most common behavioral and emotional disorders, psychological development disorders and organic mental disorders occur. Among behavioral and emotional deviations in children, pathological habitual actions in the form of nail biting, finger sucking and pacifiers predominate. Organic mental disorders (epilepsy, seizures) are much less common in such children. Behavioral and character defects in prematurely born children in preschool age are the most common reason for parents turning to a psychiatrist. In preschoolers, these are disorders of appetite, sleep, sleepwalking, pathological habits, emotional lability, fears, disruption of adaptation in a team. However, this does not mean at all that your child will be like this - work started on time leads to full development and the baby will grow up healthy. You just need more strength, perseverance and patience in studying and developing abilities, and you will need more careful care for your child. Children born very prematurely have a fairly low level of development in childhood. Speech and sensory development especially suffers; in older age, thinking, attention, and memory suffer. Only 35% of children who are premature are ready to enter school, 9% are not ready, the rest are conditionally ready. The main psychological signs in these children are anxiety, insecurity, difficulties in communication, conflict, and hostility. What will these kids need? The first is your love, affection, care and attention - this is 90% of success in treatment, nursing and full development. The rest is the help of doctors - pediatrician, neurologist, psychologist, other specialists, if necessary. Medicine has made great strides forward - we can help babies weighing half a kilo, but!!!! Only a mother’s love works miracles, it lifts hopelessly sick people out of bed, it inspires faith and hope that everything will be fine. Love your baby, tell him about your love, cry and laugh together, always be present and your baby will grow up to be a strong and healthy boy or girl!

Restorative procedures

In the first year of life, the child’s body has great potential to restore damaged or delayed functions of organs and systems. This is largely facilitated by individual developmental and strengthening activities, including games, gymnastics, and massage.

Classic massage is performed using traditional baby massage techniques. In the first months of life, the skin of premature babies is thin and dry. In this regard, a massage session should begin with gentle techniques (stroking), gradually moving to more intense ones (gentle vibration, light rubbing, patting, kneading). The duration of each technique is up to 2 minutes.

Stroking massage helps relax muscles. It starts from 1-1.5 months of life, especially if the baby has increased muscle tone. Later, other massage techniques are used: light rubbing, kneading, effleurage and passive exercises with their gradual complication. These massage and gymnastics techniques for children with a birth weight of less than 1500 g can be used only from 6 months, and for children born with a birth weight of more than 2000 g - from 2-3 months. After 7-9 months, more complex exercises are performed with the child, such as turning from the stomach to the back (rotations), crawling, getting on all fours, sitting down, standing on your feet (dancing).

Parents are recommended to learn how to perform various classical massage techniques themselves, since this procedure is best done at home. Massage and gymnastics techniques can be learned in the room for raising a healthy child at children's clinics with the help of a specially trained nurse, or, in the absence of one, a visiting nurse.

Acupressure is also used. It consists of pressing one or two fingers on certain reflexogenic zones. Strong and short pressure helps to increase the tone of a certain muscle group, and soft and longer pressure leads to a weakening of muscle tension. However, if anyone can easily master the techniques of classical massage, acupressure should be carried out by a specialist or one of the parents who has completed a full course of special training.

Placing a premature baby on his stomach helps strengthen the muscles of the neck, limbs, abdomen, and back. This placement can begin from the first days after birth, for example before feeding, for 2-3 minutes, first 1-2 times, then 3-4 times a day.

Important hardening procedures are daily bathing of the child, air baths, rational thermal regime and walks in the open air.

Walks in winter begin at the age of two months at an air temperature of at least –8-10°C, starting from 15 minutes. and up to 1-2 hours a day; In summer you can walk with your baby for a longer time.

When bathing premature babies, the water temperature should be at least 37°C. The first time bathing is carried out under a reflector. To achieve a calming, relaxing effect, you can add herbs to the bath, for example, valerian root, sage, motherwort, St. John's wort, mint, chamomile, oregano, and hops.

The recipe for preparing such a bath: pour 1 teaspoon of each herb into 1 liter of boiling water in a thermos. Leave for 4 hours. Strain. Use 0.5 liters of infusion in a baby bath, adding water at a temperature of 37°C. The duration of the procedure is 10 minutes for 25 days. After the procedure, do not rinse the child with water, but pat dry with a towel.

Degrees of prematurity

Prematurity is differentiated based on when and at what weight the baby was born. The presence of delays in the development of certain organs and systems is also taken into account.

There are several degrees of prematurity:

1. 1st degree - the baby was born at 35-37 weeks weighing 2-2.5 kg.
2. 2nd degree - the child is born weighing from 1.5 to 2 kg at 32-34 weeks of pregnancy.
3. 3rd degree - the weight of the premature baby at birth at 29-31 weeks of gestation is from 1 to 1.5 kg.
4. 4th degree – children born weighing up to 1 kg and up to 29 weeks of pregnancy.

Please note: the physical condition of premature infants will approach normal at the age of 12 months; a delay before this period is considered normal.

The development of a premature baby after birth is influenced by many factors:

• nutrition;
• high-quality, proper and regular child care;
• understanding of parents and their adequate attitude to the problem of the birth of a premature baby;
• social status of the family itself.

To ensure the full development of such children, it is necessary to carefully care for them and pay attention to the work of each system and organ. It is worth considering that children born before 30 weeks are 3-4 months behind their peers in development, so they learn all the necessary skills a little later.

Developmental level of a premature baby at 1 month

During this month, the baby will gain very little weight due to an underdeveloped swallowing reflex and sluggish sucking activity. That is why nutrition is often supplied through a tube.

During this period, there is a very high risk of infectious diseases that cause serious complications, so it is very important to protect the child. There is also pronounced instability of the nervous system, which persists for up to 4 months.

From birth it is necessary to maintain vocal and tactile contact with the baby. He should feel his mother's voice, smell her, feel the warmth of her body. If possible, you should ensure that he stays in his mother’s arms for as long as possible.

Level of development of a premature baby at 2 months

The child becomes stronger and begins to gain weight better. Positive weight gain in the 2nd month is the main criterion for the healthy development of a premature baby.

By the second month of the baby's life, it is allowed to lay him on his stomach. But the baby still does not know how to hold his head in this position on his own, like his full-term peers.

A well-developed sucking-swallowing reflex also becomes noticeable. But during natural breastfeeding, 2-month-old premature babies quickly become tired, so they need to be supplemented with expressed milk. It is important to consider that the interval between feedings will be less than 3 hours.

How does a premature baby develop at 3 months?

At this age, the baby is already trying to fix his gaze on his mother’s face and raise his head on his own. It is necessary to provide him with adequate sleep and food. In the 3rd month of life, the grasping reflex begins to form, the baby actively reacts to tactile contact, and facial reactions appear.

During this period, the weight of the child increases 1.5-2 times. Auditory and visual attention begins to develop more actively. It is necessary to closely monitor the physiological state of the child. It is important not to overcool it and not to overheat it. Between feedings, the premature baby sleeps most of the time, so the period of wakefulness is short.

You should not forget about frequent changes in body position. It is better if the light source is dim rather than bright; with it, the non-born will feel more comfortable.

What should a premature baby be able to do at 4 months?

The baby learns to confidently raise and hold his head. He tries to make sounds, grab a toy with his palm, and fixes his gaze on an object or face more confidently.

It is likely that muscle tone will increase, which can be easily corrected with the help of special gymnastics and massage for premature babies. Air baths and water procedures are very useful.

How does a premature baby develop at 5 months?

Now the baby can independently hold a rattle in his hand or grab a hanging toy with his hand.

He smiles often and takes an interest in everything that surrounds him. He reacts much better to light and sound, turning his head in its direction.

Also, at the 5th month, premature babies begin to walk.

Sixth month of life of a premature baby

Now the baby’s weight is 2-2.5 times greater than at birth. The baby is trying to roll over onto his stomach from his back.

The psycho-emotional development of the premature baby also accelerates. Not all children, but most of them, can already distinguish their own people from strangers. When communicating with them, they perk up, become active, walk around, move their arms and legs.

With the child's armpits supporting him, he tries to rest his feet on the surface.

Development of a premature baby at 7 months

The baby's activity is becoming more and more, he already knows how to roll over onto his stomach from his back and vice versa. May make first attempts to crawl on its bellies.

At 7 months old, your baby is already confidently holding a toy in his hand. If a baby is born at 35 weeks, his first teeth may begin to erupt.

What can a premature baby do at 8 months?

Starting at this age, the baby shows interest in communicating with others, and not just in what he himself does. He likes verbal contact with others (reading fairy tales, singing songs, changing the intonation of words, etc.).

The child’s movements become more skillful and confident. He tries to stand on all fours on his own, knows how to swing and sit.

The baby understands and knows some objects well and can show them if asked. Starting at 8 months, a premature baby learns to eat from a spoon.

How does a baby develop at 9 months?

The first attempts to crawl appear, and the child sits much more confidently . He constantly needs the attention of his family, as the need for communication increases even more than before.

At this time, he most often pronounces the first words in the form of separate syllables. The child already plays independently with toys . He makes attempts to stand up, holding on to something, but sits down from a position standing on his side, while leaning on his hand.

While eating, he can put a piece of food into his mouth himself. Babies born at 32-33 weeks of gestation may have their first teeth.

10th month: what a premature baby can do

At the 10th month of life, a premature baby can already stand and does it quite confidently. But still, to get on his feet, he needs support.

Important: you don’t need to overdo it and force your baby to stand if he doesn’t want to. Doctors do not recommend doing this for both full-term and premature babies.

Holding onto a support, the baby can move around, but still prefers crawling. Shows great interest in objects that move and make sounds. The child already knows his name and reacts to it. Those born before the 31st week of pregnancy may start cutting their first teeth.

Premature development at 11 months

The child can already sit down, stand up, independently and confidently, take a toy with his hand and put it in its place. This is a period of active exploration of the surrounding world, by crawling and standing, holding onto support.

The baby is very active in contact with his family.

12th month of life

Some preemies (not all) may take their first steps at 12 months of age. But it’s too early for them to walk on their own. Around this time, premature babies catch up with their peers in physical development. At the same time, neuropsychic immaturity still remains. The difference will finally disappear by 2-3 years (depending on the degree of prematurity).

Important features of newborn care

When organizing care for a premature baby, it is important to pay attention to a number of factors, including components such as:

• 
  Observation by specialists. The first months after birth, the pediatrician should examine the premature baby every week, from 2 months of age - once every 2 weeks. This regime lasts up to 6 months. Every 3 months it is necessary to consult a neurologist and orthopedist, 2 times a year - a cardiologist, ophthalmologist, endocrinologist, otolaryngologist. Prevention of rickets in the form of vitamin D is carried out from the 2nd week of life.

• Care products. It is very important that they are hypoallergenic and intended specifically for premature babies. This is due to the fact that such children have very sensitive skin, which is easily irritated and inflamed.
• Cloth. It should be made exclusively from natural fabric, without synthetics, not bright colors, appropriately small in size, with seams facing out. Fasteners are only allowed in the form of snaps, not buttons.
• Temperature conditions in the room. The optimal air humidity is no more than 70%, the air temperature range in the room where the premature baby is located is 23-24°C. It is important to prevent the child from becoming hypothermic in the first months.
• Bathing. It is necessary to remember the dangers of sudden temperature changes for such children, so they are bathed in water at 36-37°C, at a room temperature of 25°C. Immediately after bathing, wrap in a preheated warm towel.
• Walks. It is allowed to walk outside in summer with children who weigh more than 2 kg, in winter - 3 kg. This process begins gradually, with 5 minutes a day, and incrementally adds 5 minutes daily. When the walking time reaches 2 hours, it is divided into 2 times and continues to be increased. In winter, you are allowed to go outside at temperatures not lower than -10°C.

In the absence of severe pathologies and proper care, a premature newborn has every chance to catch up with other children in development and grow into a healthy, strong and psychologically mature person.

Chumachenko Olga, pediatrician

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Appearance

A normal pregnancy lasts about 40 weeks. During this time, the baby turns from a small cell into a full-fledged person who can exist independently from his mother.

During this entire period, processes of formation and improvement of all systems necessary for life are ongoing. If birth occurs earlier than the required 38-42 weeks, then the baby does not have time to fully prepare for independent life support outside the mother’s body.

Premature children differ not only from their peers born at term, but also from each other. Different degrees of prematurity have their own characteristics.

Premature baby born at 24-28 weeks:

• Weight less than 1000 g.
• The head is much larger than the chest. The skull has an unusual shape: a high forehead, an elongated nape, large open fontanelles, a very thin neck. The ears are very soft, the cartilage in them is underdeveloped, asymmetry is noticeable, and they are prone to deformation when lying on their side for a long time.
• The legs and arms are very thin, the elbows and knees are sharp.
• The nails do not reach the edges of the fingers, they are very soft.
• The navel is located significantly below the center of the abdomen.
• The genitals are underdeveloped: in girls, the labia majora do not cover the labia minora; in boys, the testicles are not lowered into the scrotum.
• The skin is very thin, wrinkled, flabby. Hyperemia (redness) is very pronounced.
• A network of blood vessels is clearly visible throughout the body; the fat layer is practically absent.
• White fluff is visible on the face, arms, legs, back and stomach.
• Muscle tone is weakly expressed.
• Babies born at 24-26 weeks may not open their eyes in the first few weeks of life.

Premature baby born at 28-32 weeks of gestation

• Outwardly, it is more similar to a normal newborn; the head circumference exceeds the sternum circumference by 2-3 cm.
• On the head there are large open seams and springs of considerable size.
• The ears are soft and easily deformed.
• The navel is located low to the center of the abdomen.
• The genitals are underdeveloped.
• A slight fat layer on the body is noticeable.
• The face, body, arms and legs are covered with white fluff.
• Muscle tone is weak.

Premature baby born at 32-37 weeks

• Body proportions are like those of a normal newborn.
• The skin is pink, there is no fuzz on the face.
• The formed subcutaneous fat layer is noticeable.
• The first curves on the ears are visible.
• Nipples and areola are visible on the body.
• The navel is located closer to the center of the abdomen.

Premature babies are born without completing an important stage of intrauterine development, so they need special care and monitoring of their condition. In most cases, babies have to stay in the maternity hospital in the neonatal department from 7 days to 4 months, depending on the degree of prematurity.

Of course, every mother wants to be home with her baby as soon as possible, but if doctors insist on additional control and stay in a medical facility, you should listen to them.

Features of care at birth

On average, prematurity ranges from 21 to 37 weeks of pregnancy. Depending on the date of birth of the child, his general condition and how far he will lag behind his peers in development at the time of birth depends. But there are some common features that are characteristic of all premature babies.

If a child was born from 21 to 32 weeks of pregnancy, then his developmental delay will be about three months. Whereas babies born later, from 32 to 37 weeks of pregnancy, will be almost fully formed, and their lag will be only one month.

At birth, any child needs affection and warmth, but a premature baby needs this especially acutely, because he must still be inside his mother and feels completely defenseless. It is not recommended to let premature babies out of your arms or feed them artificial formula without a doctor’s prescription. They are also advised to sleep together and have as close physical contact as possible with their mother.

Immediately after birth, the baby will be weighed first. If his weight is less than one and a half kilograms, this indicates that the child needs special care. He will be placed in a special cuvette, where all conditions are created specifically for favorable development and compensation for prematurity. However, after that the baby will pass the critical mark and weigh more than 1700–2 thousand grams, he will be transferred to the mother’s department, where he will be able to enjoy her warmth, care and love.

Keeping the atmosphere at home as close as possible will contribute to a faster recovery of the child after childbirth. The optimal ratio is an air temperature of about 20–22 degrees with a humidity of 50–70%.

Behavior and grooming characteristics

How do premature babies develop over the months? The development of babies in the early period of birth differs from the development of babies of the due date. Let's look at how development proceeds month by month

in premature infants:

Monthly crumbs. In the first month of life, babies show virtually no activity. Decreased muscle tone can be caused by poor muscle development and slow weight gain. Feeding is carried out by tube, often with the use of artificial pulmonary ventilation. Two months old. Two-month-old babies gain significant weight and height, but their body is not yet active in movement. Breastfeeding at this stage is the best way to complete feeding. Premature babies, according to Komarovsky, at this age begin to raise their heads.

Three months old. The baby's weight and growth continue to increase. The toddler begins to react to the world around him with sounds. Four months old. Four-month-old babies hold their heads freely and fixate their gaze on individual objects. At the same time, many “walk” and are very active. Every day it is recommended to take such babies out into the fresh air, bathe and massage them.

Breast milk continues to be an important foundation of diet and bonding with mom. Muscle tone begins to appear, preventing the little ones from sleeping peacefully. Five months

Babies begin to smile, hold rattles and turn their heads. The weight of the premature baby by month, as can be seen from the table, increased by more than five hundred grams. Six months. Body weight continues to increase. Little ones begin to distinguish parents from other people, and children from adults. Many children of early development at this age are catching up with their peers.

Seven months. Seven-month-old babies are actively involved in the game. Now the little one is able to roll over freely and without outside help from tummy to back and back. Movements become faster and more controlled.

Eight months. At eight months, babies can not only roll over, but also already show their first attempts to crawl. The monthly development of premature babies shown in the table above shows how much their body weight has increased. Nine months. What time do premature babies start walking? At the age of nine months, babies begin to stand on each leg in turn, making their first attempts to walk. At the same time, they always hold on to surrounding objects. Ten months. At ten months, babies are actively crawling and begin to raise their heads when their name is pronounced. Eleven months. By eleven months, babies are trying to take their first steps. In addition, they actively pronounce various sounds and syllables. One-year-old children. At one year old, babies begin to walk. Of course, not everyone can do this, but many examples have been described in medicine.

Note! In many ways, one-year-old babies correspond to their peers, which is a success of the work of the mother and doctors.

The above table of development by month for premature babies shows that by the year the increase in body weight is not large. Now the main emphasis is on the development of the baby, since its main organs have already been formed. Premature babies are not a death sentence or a disease, but only the provision of greater care and affection.

Features of development of premature babies

Let's look at the development calendar of a premature baby by month.

First month

During the first month, the baby still does not gain weight well, which is associated with underdevelopment of sucking activity. It is difficult for the baby to suck mother's milk, so the mother often has to express it and feed the baby through a special tube. Special attention is paid to the nutrition of a premature baby. At home, the child needs constant care. He should not get sick, so the room should be constantly maintained at a comfortable temperature.

A very premature baby born at 21 weeks or more needs medical supervision in the first month and in the next 3-4 months.

A premature baby is not very active and his muscle tone is weakened. All he can do is breathe on his own and swallow food. Physical contact with mom is very important.

Second month

The sucking reflex is still poorly developed; feeding with expressed milk from a bottle is possible. Nutrition calculations are made according to the child’s weight. Already at two months, doctors advise the mother to lay the baby on her tummy. There is rapid fatigue and frequent sleep. Such babies still cannot hold their heads on their own. Despite the weight gain, the baby is still developmentally delayed and very weak.

Third month

At this age, the child loves most to eat and sleep. In a lying position, you should monitor the rotation of the baby's head - you must definitely lay the child down, turning his head first to the left, then to the right. The baby can already fix his gaze on his mother and tries to raise his head a little. Tries to grab objects in front of him, which is a good sign. Your weight should double by this time.

Fourth month

At 4 months, the child can already hold his head on his own and can make sounds and grab a toy. A massage is recommended to relieve muscle tone and walks in the fresh air. Some children at this age already know how to smile.

Despite its development, the baby still needs breast milk, so it is not worth stopping lactation.

Fifth month

The baby already knows how to hold a toy in his hand. He becomes interested in what surrounds him and knows how to turn his head in the direction of sound. So, a child, hearing his mother’s voice, will immediately turn his head towards him. At this age, the baby has his first conscious smile. The neuropsychological development of a premature baby during this period is very active.

Sixth month

By this time, the premature baby's weight should triple. At 6 months, the baby independently tries to roll over from his back to his tummy. His development differs little from his peers born at term. Many doctors recommend introducing complementary foods at this age. The baby is becoming more and more interested in communicating with adults and monitoring their reactions, playing with toys, and going for walks.

Seventh month

The baby is very active, sociable, already knows how to roll over on his tummy and is trying to crawl. So far this is only possible backwards, or as if dragging yourself forward along the floor with your hands. This means that the baby will soon begin to crawl confidently. Able to independently pick up an object in their hand, they want to learn to eat themselves from a spoon. Some babies are getting their first teeth.

Eighth month

At this age, the premature baby is already trying to sit up on his own. He is very active, constantly on the move, interested in everything, and understands the speech of adults addressed to him. If they ask to show something, they point to that very object. At 8 months, the child is interested in fairy tales, rhymes, nursery rhymes, and likes to look at pictures. Able to get on all fours and swing.

Ninth month

A previously premature baby is no longer different from other babies. He sits, tries to crawl forward on all fours, and really needs communication. Parents should talk to their baby as much as possible, explaining to him all their actions in words. Some children manage to stand up on their own, holding on to support. The child already sleeps less and plays with toys more. You can hear the first syllables: “ma”, “ba”.

Tenth month

The baby stands well on his own, but still loves to crawl. Reacts to its name, as well as to external sounds. Sits confidently, keeping his back straight. At this age, the child is interested in toys. Capable of attracting attention with sounds or colors. The child wants to try adult food, showing interest in it.

Eleventh month

The child is still actively crawling, some children are already trying to take their first steps. At this age, the baby is interested in toys that can move, as well as various pyramids and cubes. He loves to communicate with loved ones. New words and sounds appear in speech.

Twelfth month

At one year it is no longer possible to say that this child was previously premature, since his development corresponds to the norms. Doctors note that physical development in premature babies is faster than mental development, which is again the norm. Movements may be uncoordinated, however, this does not prevent children from being inquisitive and very active.

Above we talked about how premature babies grow. Month-by-month development clearly shows that by one year these children are catching up with their peers, and may even be ahead of them physically. Yes, premature babies can be more emotionally unstable and whiny. Speech develops more slowly and it is more difficult for them to remember new material. But with the right support from parents, it will be easier for such a child to adapt to the world around him. The main thing is patience and calmness, as well as attention to your baby.

How to help a prematurely born baby develop fully?

In order for the development of a premature baby to occur according to the norms, it is necessary to take intensive care of it. Tactile contact with mother is especially important for such children; it has a good effect on the nervous system. It is necessary to maintain a suitable temperature in the room and dress babies according to the weather. Their thermoregulation system still does not work well, and their sweat glands are not yet functioning. To protect them from respiratory diseases, it is worth limiting their social circle in the first months.

It is important to provide good nutrition for the newborn, because he needs to rapidly increase his weight and height. The best food for a premature baby is breast milk

It's easier to digest. In addition to providing nutrients, breast milk helps develop immunity, protecting the baby. It can be difficult for a mother to establish lactation, especially when the baby is so weak that he cannot suckle, or is in the intensive care unit. But there are many examples that regular pumping helps produce milk in sufficient quantities. If desired, it will be possible to achieve long-term feeding, which is so necessary for the baby. Special supplements may also be needed to ensure that the newborn receives all the necessary vitamins and minerals.

Parents must help the child develop normally. The following conditions contribute to this.

Long walks in the fresh air. If the weather permits, it is recommended to spend at least 3 hours outside. Massage. It is necessary to carry out massage and gymnastics on your own daily, and contact professionals every 2 months

It is especially important to do this during the first year. Spend a lot of time with the baby: talk, sing songs and recite poems, pick him up more often and lay him on his stomach. Follow the doctor’s recommendations: undergo examinations on time, take prescribed medications if necessary.

Even with the fourth degree of prematurity, newborns have a good chance of full development, although they will first have to stay in the hospital. It takes up to a year for the functioning of all organs and systems to normalize. Gradually, the kids recover, gain weight and catch up with other children.

Premature babies have a special development by month, different from the development of nine-month-old babies. Therefore, they need to select special formulas, clothes, diapers, taking into account the anatomical and physiological characteristics of the premature baby.

Development of a premature baby by month

In the first year of his life, a child gains a certain number of grams every month. The rate of increase depends on at what stage of pregnancy the baby was born. We have provided information in two tables, for the first and second half of life.

First half year table

Second half table

First month. The first month is the most difficult for a little person born ahead of schedule. At this time, the child most likely still cannot eat on his own, which is why he is sent to a special department. There he will be fed through a special tube so that he can gain weight. Such children show minimal activity and sleep almost all the time.

Second month. The baby has gotten a little stronger and is already trying to show more physical activity. He raises his head from the lying position and sucks the breast more actively. If he is bottle-fed because he has not breastfed before, then it’s time to introduce him to breastfeeding, since it is much healthier and will provide the baby with all the necessary elements for rapid growth and development.

Third month. This month marks the beginning of the most active development of the child.

• He begins to catch up with his peers in growth and development.
• The baby is actively gaining the required body weight. On average, his weight should double since he was born this month.
• His physical activity is increasing every day.

Very soon the child will no longer differ in any way from his full-term peers.

Fourth month. The baby makes new discoveries every day. This month his capabilities will increase.

• Usually the baby can already raise his head a little and hold it in this state for some time.
• The children begin to hum and make characteristic sounds of contentment, similar to some kind of monologue with their mother.
• The child can already concentrate on one toy for a longer time.
• His nervous system is also developing this month, and muscle tone may appear.

Mandatory daily procedures include massage and swimming. Long walks in the fresh air will help strengthen your immune system.

Fifth month. This month, the baby makes his first social feats; he learns to communicate with the closest family members and especially with his mother. Often he reacts to her appearance with a smile. And if before it was just a reflexive unconscious manifestation of sympathy. Now this is a completely social gesture that helps the child determine where his own people are and where strangers are, expressing his love. And also the muscular system does not lag behind the pace of development. It may well be that your baby will make his first feat, happily taking the toy from you, holding it tightly in his hand.

What measures to take?

Premature birth can occur for various reasons, many of which cannot be controlled, but there are still several rules for parents who want to take care of the health of their unborn baby.

1. Check with a doctor
   . Ideally, this should be done before conception, for both women and men. Even if everything seems to be in order, it’s worth being safe. After all, various infections can harm the baby in the womb.
2. Register for consultation in
   a timely manner and talk to your doctor about all your diseases.
3. You should avoid direct contact with sick people
   during pregnancy so as not to endanger the fetus.
4. Avoid stressful situations
   throughout pregnancy. If a woman has a very stressful job, it is worth consulting a doctor about taking sedatives.
5. Avoid strenuous physical activity
   and never lift heavy objects. If a woman wants to keep herself in shape, she should do only those exercises that are recommended for pregnant women, and only under supervision, for example, sign up for a fitness class for expectant mothers. It would be better if the trainer draws up an individual program, taking into account the duration of pregnancy and the doctor’s instructions.
6. It’s also worth watching your diet
   to ensure your baby gets enough nutrients.

First of all, you need to consult a doctor, because each situation is unique in its own way and requires an individual approach.

When a premature baby with a deep degree of immaturity is born, the process of nursing it takes many weeks, and sometimes months. You need to be mentally prepared for this. After all, this is a miracle: such a baby was born alive and is fighting for his right to be in this world. All you have to do is wait until he is next to you. Everyone has their own path, but three stages are clearly visible in it.

Fourth month of life

Many parents today are interested in how quickly premature babies bounce back. Monthly development, weight, height of the baby - these are the main questions. A four-month premature baby can already lift and hold his head independently. Also, at this time the baby learns to fix his gaze and begins to make sounds reminiscent of buzzing. The child’s daily routine must include gymnastics, walks, bathing and massage.

It is especially important during this period not to stop breastfeeding. After all, he needs contact with his mother and healthy nutrients.

Muscle tone may also increase at this age. As a result, the child will have difficulty settling down and waking up.

Exact table for boys and girls by month

This table provides general statistics. Each child is individual. And compliance with standards also occurs individually. Don’t be upset if the baby “puts aside” some element: with the care and love of his parents, he will succeed.

1 month

A very difficult period in the life of the baby and the whole family. For normal weight gain, it is necessary to establish feeding (breastfeeding or bottle-feeding). The baby is easily vulnerable: it needs to be protected from drafts and infections. To maintain the baby's health, you must avoid inviting visitors.

2 months

The baby has grown and become stronger. But while eating he gets tired quickly. Weight gain occurs at a rapid pace. To develop muscles and fight gases, it is recommended to lay the baby on his tummy.

3 months

The baby responds to the touch. He eats and gains weight. Stops his gaze on mommy's face. Tries to grab objects. It is important to monitor the position of the baby's head to prevent the formation of torticollis.

4 months

Increases muscle tone. The baby can grab and hold the rattle. He's already holding his head and babbling. To consolidate the result, you need to do gymnastics and massage.

5 months

Sound and visual skills are improved. The baby looks for sources of sounds with its eyes, monitors the movement of objects, and develops its speech apparatus. Confidently holds the toy in his hand.

6 months

Weight increased 3 times. The baby shows animation when close people appear: it moves its arms and legs. Pushes off with legs from a horizontal surface with support under the arms. The baby requires care like a regular (full-term) baby.

7 months

The baby learns to roll over from its back to its stomach, moves on its tummy (crawls). Some premature babies are teething.

8 months

He tries to sit up himself. Swings on all fours. Begins to strive for communication. During this period, educational games are very useful: songs, nursery rhymes, “Magpie-Crow”.

9 months

He sits for a long time and begins to crawl. Willingly communicates with family members. Begins to pronounce the first syllables.

10 months

Recognizes his name. Walks holding onto support. Loves to crawl. Watches the movement of objects with interest.

11 months

Loves to communicate with others. Actively plays with cubes, pyramids, balls, and musical instruments. He gets up, sits down, walks, leaning on the handrails of the crib.

12 months

Some babies take their first steps independently. This suggests that they have physically caught up with their full-term peers. But neuropsychic processes will return to normal only by 2-3 years. These are normal indicators.

Causes

Factors that cause premature birth are:

• Neglect of medical support during pregnancy.
• Presence of bad habits in a pregnant woman.
• Insufficient or unbalanced nutrition of a woman during pregnancy.
• The age of the expectant mother or expectant father is less than 18 and more than 35 years old.
• Working as a pregnant woman in hazardous conditions.
• Low pregnancy weight (less than 48 kg).
• The expectant mother lives in poor living conditions.
• Gestation in an unfavorable psychological environment.

• Abortion in the past.
• .
• The occurrence of gestosis during pregnancy.
• Premature.
• Short interval between births (less than two years have passed since the previous birth).
• Incompatibility of the blood of the baby and mother according to the Rh factor.
• Gynecological inflammatory diseases in the mother.
• Malformations of the female genital organs.
• Extragenital diseases in a pregnant woman, for example, hypertension, pyelonephritis or diabetes.
• Operations and injuries in the expectant mother.
• Acute infections during pregnancy.
• Genetic or chromosomal diseases in the fetus.
• Infection of an infant during intrauterine development.
• Severe developmental defects of the baby.

How to care for a premature baby

Children born prematurely are very sensitive to the environment. In their place of permanent residence, air humidity should be from 50% to 70%, and the air temperature should be 23-24 degrees. For bathing, it is recommended to use water at least 36 degrees, and then wrap the baby in a warm towel. Walk for 15-20 minutes a day during sunny, dry weather.

The most important thing in the life of a premature baby is the care of parents and regular supervision by specialists. Compliance with all recommendations will ensure the child’s full development at the physical and psycho-emotional level.

How to breastfeed correctly?

Breastfeeding premature babies is often not possible immediately after birth. The baby is examined for the presence of Rh conflict with the mother, and only after that a verdict is made: can or cannot be fed with milk. During these studies or while the baby is in an incubator and does not consume much food, mother's milk may simply disappear. To prevent this from happening, it is necessary to pump every couple of hours, stimulating the production of food for the baby. The same pumping is done when the baby has not yet learned to suck and cannot stimulate the breast on his own.

If the baby is in the same room with his mother, the woman is advised to hold him in her arms more often so that the body temperature is stable. But this is not the only reason. The closer and more established the contact, the faster the baby will begin to latch onto the breast on its own.

Under no circumstances should you be forced to take the breast; the baby will simply refuse and begin to be capricious. On average, one feeding takes from half an hour to an hour, since premature babies are very weak, they will get tired and take food with rest breaks.

If during one feeding the baby did not eat the required amount (this is clearly visible if you feed not by breast, but with a syringe or spoon), then at the next feeding you should try to give the child a little more, but not twice as much! If the baby still does not eat the norm and refuses supplements, doctors will be forced to force-feed the baby using a tube. It is necessary for the child to gain weight faster, catching up with his peers.

When feeding, it is important to choose a comfortable position not only for the mother, but also for the baby. In order for the baby's head to fit more tightly to the breast, which makes sucking easier and reduces the pressure of milk, you need to lean back a little

With this position, the baby swallows less air.

A reminder for feeding premature babies: these babies have a weakened chin and lip area; while sucking, the baby may accidentally release the breast. To prevent this from happening, you need to help him. The mother's index finger should lie on one cheek, and the thumb on the other. Use your middle or ring finger to support your chin.