Why Considering Adjusted Age Is Important for Premature Babies' Milestones

I want to share something important about prematurity that a lot of people do not realize. Early birth does not fast-track a baby’s brain development. It doesn’t fast-track anything for that matter. If anything, it can slow down development.

Premature babies are given two different ages. They have an actual age based on the day they were born, and they also have an adjusted age based on when they would have been full-term. To find a premature baby’s adjusted age, subtract the amount of weeks the baby was premature from their actual age. For instance, a “preemie” born at 32 weeks might have an actual age of 4 months, which would make their adjusted age 2 months.

Considering adjusted age is an absolute necessity for tracking premature babies’ development, especially for when you will start breastfeeding or bottle feeding. You don’t typically see a premature baby bottle feeding or breastfeeding right away because the suck and swallow reflexes don’t come until around 34 weeks gestation. Babies born prior to that week of pregnancy don’t have the capacity to do so because they are technically “supposed” to be in the womb still.

This is the same for other developmental milestones. If a baby born at 28 weeks is now 3 months old, you can’t expect them to do what a full-term 3-month-old can do because their brain is now developmentally similar to that of a full-term newborn baby. I’m not saying they won’t advance or cannot advance ahead of schedule, but it’s important to remember your baby’s adjusted age and give your child grace. After all, your premature baby may have gone through a lot just to be born, so try not to compare your baby to full-term babies with the same actual age.

When recognizing adjusted age really becomes important is when it’s time to introduce your baby to solids. Babies have to be able to do certain things before they can start eating solid food. According to the American Academy of Pediatrics, babies who are ready to start eating solids should be able to sit by themselves in high chairs or infant seats, be able to coordinate their heads, necks, and hands, and be able to move food from a spoon into their mouths and down their throats. Babies should also be around 6 months of age prior to introducing solids.

Let’s go back to the 28-weeker preemie example. When a baby born at 28 weeks has an actual age of 6 months old, they are only 3 months old adjusted. A 24-weeker would only be 2 months adjusted when they reach an actual age of 6 months old. Would you start your 2-month-old baby on solids? A lot of doctors tell parents of premature babies to start solids at an actual age of 6 months. But adjusted age matters when you have a premature baby — especially when their premature birth slows their development. Nearly every age-based milestone for premature babies — except for vaccinations — goes by adjusted age.

You will not adjust your premature baby’s age forever. Many preemies will be the same size as their full-term peers by age 2. Some may also have caught up developmentally at that age, but typically, premature babies’ development evens out around 3 years old. You are the best advocate for your preemie. If you’re a new parent, know that this is one of the struggles premature babies can face.