Questions about preemie and growth

• By dharrington05
• Posted April 29, 2008 at 7:06 am
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15 pounds at 8 months sounds like he is really on the road! My 24 weeker is 18 lbs at 15 months so Donenick sounds like he is doing just fine. As for tummy time? Just keep trying. When he is able to roll over on his own, he will enjoy it more. Josh hated tummy time too but now that he can roll back and forth he likes it better. He will crawl in his own time. Josh is still not crawling at 15 months (11 months adjusted) but I have no fear that he is going to catch up. Good luck to you.

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• By funkyme
• Posted April 29, 2008 at 7:16 am
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Hi,
My preemiew was born at 28 wks, 1lb 1oz and 12.5 inches. She will be 11 mos old on May 9. She now weighs 12 lbs and is 26.5 inches tall. She is doing exceptionally well. she was in the NICU for 72 days, no ventilation, no support - just feed and grow. She is meeting all her developmental targets and so fer has been cleared for pretty much all anticipated issues.

My problem with her was exactly that she would not eat enough - so, to my thinking, wasn't gaining enough weight. Unlike your son, she does sleep good - we put her down at 8 pm. Most days she makes it t 5 am, sometimes wakes up at 12 midnight for a feed. She has somewhere between 3-4 oz, ralely 5 per 3-4 hrs. My daughter has consistently been following the under 3rd percentile curve. In fact, the ped predicted at her 6 mos check up (she was 10 lbs then) that she will be close to 11 lbs by the time she comes in for her 9 mos check up. That's exactly where she was!! Weight gain/not per se does not necessarily mean your child is doing great/not. As long as he is following his curve (need not be on the normal curves yet) - he will be fine. Second, everytime I really stuff my baby with solids (she doesn't like drinking out of a bottle) she sleeps much longer - can go upto 3.5 hr naps, then be woken up to eat and back to bed again. The nurse explained me that they will not wake up as long as their bellies are full. Putting that logic to work, I try feeding her cereal and some solids for her 8 pm 'snack' before she goes to bed for night. Those nights she sleeps right through - others when I let her go with milk alone, she will be up in 5 hrs or so. Also, do tire him out a bit more while playing with him - he will eat better and sleep better too. Finally, my daughter sleeps much better ever since I moved her crib out of my room into her own room. She put up a big fight at first, but has adapted quite well. Now I simply lay her down in her crib for naps and walk out the room. Earlier we had to quieten the house, hold her and walk around with her - rock her to sleep only for her to wake up within 40 minutes, or right away if I dared to lay her down. It was exhausting - for us and her too. Geting her into a healthy sleep pattern has definitely helped with her eating too!! Hope that helps

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• By KC92872
• Posted April 29, 2008 at 9:13 am
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Hi,

Thanks for your replies. I agree with the fact just because they are gaining weight doesn't mean everything. Even though Domenick is gaining weight I am still terrified that he will have other delays but I have EI working with him and hopes they will help. The doctors say he is doing great and he is a pretty energentic ball of enery and pretty stubborn when he doesnt get his way. He is meeting all his milestones, EI says he still has time to learn to crawl that he is not behind on that yet. I keep at it every chance I get, he is on his belly. As far as the sleep issue. He has been sleeping in his crib since he was home from the hospital. He just isnt a good sleeper. I load him up with food before he goes down and once he wakes up the first time, he gets another bottle. His formula is added calorie so it is thicker than regular formula and should fill his belly. The pediatrician says he should be going at least 4 hours at a time before he needs to eat again. She keeps telling me to let him cry and walk away that he needs to soothe himself. I still swaddle him because he wont sleep at all unless he is swaddled. We are going to a sleep specialist on May 28th to see if they have any suggestions. I wish he would be a better sleeper because I think that does help them grow better.

What formula does your daughter use and is it added calorie?

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• By katek
• Posted April 29, 2008 at 11:28 am
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Will Domenick spend time on his tummy in a reclined position when he is on your chest? Even if he is on your chest with you leaning back but not completely flat, he will begin to develop the appropriate arm/chest muscles needed for crawling.

My son Henry hated, hated, hated tummy time. He would tolerate it for a couple seconds but then would roll over onto his back. We spent a lot of time with him on our chests. We would slowly lean a little further back over the course of several weeks, so that it would be more of a challenge for his arm/chest muscles. I don't think that we ever made it to completely flat on our backs.

When we did put him on his tummy, we'd try to entice him with toys to grab. That would work for a couple seconds. We did that throughout the day.

Also, we'd put him at the end of our bed facing the edge. We'd sit on the floor and make faces at him to distract him while he was on his stomach. 30 seconds here. 30 seconds there.

Oddly, by 4-5 months, he would flip over at night and sleep on his stomach at times. I thought that was interesting considering he refused to spend time on his tummy during the day.

By the time he was sitting up by himself (6 months adjusted), we spent a lot of time with him on the floor. We would put him between our legs, with him leaning on one of our legs with his arms. Again, it certainly wasn't as challenging a workout than if he was pushing up with his arms from the tummy position on the floor, but it did work the muscles to some extent (and some is better than none).

Regarding his sleep, it is great that you have found a sleep specialist. I felt that the doctors (peds) that we talked to when Henry first came home didn't take our concerns about sleep seriously. They wrote us off as anxious parents. This was of course very frustrating b/c we knew that his lack of sleep was no where near "normal." Henry didn't sleep well during his last few weeks in the NICU. And when he came home around his due date, he was an insomniac for about 5 weeks. He maybe slept 1-2 hours per day total (10-20 minutes here and there) when he should have been sleeping 16 hours per day. We discovered that Reglan was the cause of his insomnia. We had been at my parents' house and had forgotten to give him his Reglan, resulting in him being much more relaxed. We took him off the Reglan and saw immediate (positive) effects. He didn't really sleep "normally" for another couple weeks, but he eventually did. I hope that the sleep specialist will be able to help you pinpoint the cause of your son's sleep disturbance.

Best wishes,
== Kate

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• By KC92872
• Posted April 29, 2008 at 12:03 pm
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Domenick will go on his tummy and lift himself up so he does have the muscles but he will only stay that way for not even a minute. Today was the first day that he seemed more interested in some toys while on his tummy. So yes I can see that doing it every day is making progress and we have to keep at it. So your son was sitting up on his own at 6 months?? That is wonderful. Domenick will be 8 months next week and he is just starting to sit up but he needs someone to sit there in case he falls over but he is getting it. How much does your son weigh now? I know every kid is different and I know he will eventually get these things because he has no disabilities to prevent him from sitting up and crawling and all that but it is so frustrating because I work so hard with him and then I hear other people with kids 4,5,6 months that say their kids were doing these things so much sooner.

I can't wait for the sleep specialist because it is exhausting to not sleep. My husband works everyday so I am the one who gets up with my son during the week and thank god I dont have to go to work because it is just so tiring!!!
I think that because Domenick spent time in the NICU and the hospital that is the reason for waking up so many times, it is was he was so used to from being in the hospital, could that be a reason?

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• By Archi
• Posted April 29, 2008 at 12:07 pm
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My daughter was born at 34 weeks weighing 4.5 lbs she is 6 months (actual) 4.5 months(adjusted) and weighing 12.5 lbs. She is on 20 cal formula. she hated tummy time intially but now she rolls on her own and like to play while on her tummy. She too had feeding issues but now its getting better.
I think your baby is doing fine with the weight gain .I really can't comment on sleeping coz my baby started sleeping through night( 6-8 hrs) since she was 3.5 months old.
Feel free to write me if you need to know more from me.
archanavangils@yahoo.co.in
best wishes
Archana

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• By DavySopheara
• Posted April 29, 2008 at 1:07 pm
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Hi,

Sounds like Domenick is doing just fine! My son didn't start crawling until he was about 8 months old...and he's a full term baby! Please don't compare him to your friends' babies. Every babies develop differently - preemie or not. He will do it on his own time. Sounds like you are doing everything you can to help him.

I also have a daughter who was born at 25 wk 5/7 days due to my incompetent cervix. Yeah there is such thing! She was 1lb 7oz & 12" long. She was in the NICU for 105 days. She went through a lot including two surgeries to repair the hernia. The first surgery was done before she came home. But two months later, she had to go in again to repair the other side. It was tough for all of us but the future is looking better and better every day. She weighed 18lbs at her one year doctor visit! She has EI every two weeks and her specialist said she is doing great including her fine motor skills. She pulled herself up to stand at 10 months and is furniture walking but has not take the first step yet. Hopefully soon :)

Her naps are short just like your son. It's anywhere from 30 - 60 mins, 3 - 4 times a day. She sleeps through the night when she was around 9 months.

Good luck with Domenick!

~Rav

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• By dauger
• Posted April 29, 2008 at 1:37 pm
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Congrats to you and Domenick and a succesful heart surgery.

He sound like he is doing AWESOME.

My son just turned 3 and was born at 28 weeks 2lbs 6 oz.

He was 17 lbs at age One. On the adjusted chart he was in the high percentile for weight and height. Compared to his premie friends he was small. They weighted 27 lbs but were overweight. By my son's second birthday he was 27 lbs and they had only gained a couple of lbs but grew taller. He was as tall as them and now he is VERY TALL for his age and 32 lbs.

My oldest was a skinny baby toddler/kid also so dont worry too much about weight.

Also for the first 3 years or so ALWAYS adjust his weight. You will find he is doing GREAT on the age appropriate adjusted chart. Never compare to full termers since they have that extra time in utero....

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• By dauger
• Posted April 29, 2008 at 1:37 pm
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Congrats to you and Domenick and a succesful heart surgery.

He sound like he is doing AWESOME.

My son just turned 3 and was born at 28 weeks 2lbs 6 oz.

He was 17 lbs at age One. On the adjusted chart he was in the high percentile for weight and height. Compared to his premie friends he was small. They weighted 27 lbs but were overweight. By my son's second birthday he was 27 lbs and they had only gained a couple of lbs but grew taller. He was as tall as them and now he is VERY TALL for his age and 32 lbs.

My oldest was a skinny baby toddler/kid also so dont worry too much about weight.

Also for the first 3 years or so ALWAYS adjust his weight. You will find he is doing GREAT on the age appropriate adjusted chart. Never compare to full termers since they have that extra time in utero....

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• By katek
• Posted April 29, 2008 at 2:32 pm
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Henry was born at 25 weeks 2 days weighing 1 lb 3.65 ozs. He will be a year old tomorrow. He could sit by himself (without us there to catch him) around 6.5 months adjusted. And then started crawling at 8 months adjusted. He is 8.5 months adjusted now. We have a doctor's appointment on Thursday. I suspect that he's about 18 lbs. His weight gain goes in fits and starts. He isn't a big eater.

Domenick is 8 months or 8 months adjusted? If he is 8 months actual, that puts him at 6.5 months adjusted. In any event, my son's PT says "normally" crawling is anywhere between 6-12 months for full-term babies.

I have done quite a bit of reading on infant development. I have yet to see a study that says that babies who learn to do things "early" are more advanced as children and adults than babies who learn to do things "later" inside the normal range. I have two sisters who were FT babies. One pulled herself up to a stand at 5 months. The other pulled up to a stand at 10-11 months. Both were athletes. Both were honors students. The unfolding of their motors skills as infants didn't seem to have any impact on their future accomplishments.

I know that a lot of parents try to push things along (e.g., feeding preemies solids earlier to "catch up"), but my husband and I have taken the approach that development should be tracked by the adjusted age. Biologically, that's what makes sense to us. In fact, I have heard that it is problematic when parents push kids to things well before they are ready (it frustrates the parents, frustrates the kids). And, I have wondered if that contributes to the self-esteem issues that preemies on average face in comparison to full-term babies.

In addition to knowing that "every child is different," I have also learned that parents and grand parents tend to revise history when it comes to their children's development. For example, according my mom, Henry spoke his first word (poop) back in March (around 6.5 months adjusted); and it just so happened that he did have a soiled diaper at the time. Mind you, we haven't heard it since. But I can give you countless other examples where my mom has exaggerated Henry's accomplishments (because she is a proud grand parent). In fact, when Henry is being evaluated, we try to schedule the evaluations when my mom isn't there. At his first developmental evaluation at 2.5 months adjusted, my mom was giving the developmental coordinator a skewed opinion of where Henry was at. The coordinator would ask something like, "Is Henry making constant sounds? Da, Ba." My mom would jump in and say "Yes, he is. I heard that yesterday." My husband and I spent the time saying, "Ummm...no...we've never heard that" and "No, he isn't doing that yet." We certainly didn't want Henry's situation overstated to the coordinator, because we wanted him to get help if he needed it. My point is that when other people talk about their children and grand children, do take it with a grain of salt, especially if the parents/grand parents are especially proud of their kids (as loving parents usually are). I suspect that preemie parents probably have a better sense than parents of FT babies of when their children have accomplished things, because we come to the table assuming that problems could be there (and therefore we are vigilant in looking for them).

When in doubt, ask for an early intervention evaluation for your peace of mind. If you have any nagging concerns, you might as well have the evaluation done (as worrying certainly isn't going to help you or your baby!). I suspect more often than not, things will be fine. It is also true that parents are the first line of defense for their kids. And if you read this message board a lot, you'll find that there are many, many instances where parents picked up on problems way ahead of the medical establishment.

Best wishes.

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• By KC92872
• Posted April 29, 2008 at 6:09 pm
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Domenick is 6.5 months adjusted. I agree that he should always be evaluated at his adjusted age. For whatever reason his pediatrican doesn't. She evalutes him at his actual age and therefore is always pushing for the cathc up weight. I have done some research and found a doctor that is a pcp/pediatrician but he specializes in developmental issues. I finally was able to get an appointment on May 29th so if all goes well then I will be changing Domenicks pediatrican to him.
He was born with some hearing loss on his left side so there will be that concearn for speech and language until he can talk so I think that this new doctor might be a good choice.
It is very encouraging to read all the posts on this board, I am not necessarily comparing Domenick to these different kids but it gives me a sense what to expect. I am a first time mom and not alot of experience with kids before this so this has really been a wake up call having my first child be a preemie and have a big hole in his heart. You don't think your first child you will be in the NICU making decisions on open heart surgery and things like that.


KC

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• By funkyme
• Posted April 30, 2008 at 5:48 am
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Hello, my daughter is having 24 cal enfacare. She is tiny and her intake of formula is kinda low. She came home on 26 cal, we switched to 24 when she started solids.

Another thing on the sleeping issue - I do massage my daughter every day for atleast 15 minutes. In Jan I switched to evening massage - before bedtime. She loves it and I guess it helps her sleep through the night. She used to hate tummy time too - massaging her back (while on her tummy on the floor) was an excellent way to give her tummy time. I would position a favorite rattle just out of her reach and she would strech to reach for it. It did great for strengthening her back.
You should certainly change your pediatrician. Anyone who insists on pushing you to do stuff when comparing him to full term babies definitely does not understand prematurity. Having said that, I do believe it is important for parents to keep sight of where the child should be so benefits of EI can be maximised. Keep up the good work and remember sometimes these little guys just don't have the strength yet to do what they could be doing - don't let it discourage you and just know that your baby is really strong to be where he is now!!

You can email me at nidhimehrotra@hotmail.com if you have any other questions.

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• By katek
• Posted April 30, 2008 at 8:21 am
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In their charts, doctors always write things down by the birth age. I suspect that's in part due to the fact that "due dates" are determined by the mother's memory of when her last period was prior to getting pregnant (and memories are often hazy). The birth age, however, is something that isn't disputed or subject to conjecture.

Also, a lot of doctors are simply ignorant of preemie issues, and they have trouble conceptualizing "adjusted age." Frankly, I have been shocked at how poorly read a lot of doctors are. They often don't keep up with the literature in their own fields and don't seem to be very informed about development. And they rarely spend more than 20 minutes with their patients (hard to really get a sense of a child in such a short period of time). That's so great that you may have found a PCP that specializes in development! How rare! Hope that goes well! Sounds very promising.

Our experience has been that Early Invention people do monitor things by "adjusted age" BUT they follow birth age when they do the testing. The bottom line is that preemies should be tracked by adjusted age, but to get funded, it isn't enough to say that a child is a preemie (and hence significantly more at risk for a host of issues). To justify what they do, therefore, the EI people compare babies to their chronological age. The preemies almost always come up short. Hence, they are given funding for developmental therapists.

Let me second nidhim's suggestion about infant massage. We had a massage therapist visit us twice to train us in infant massage. The first time Henry had a really good massage (the massage therapist showed us on a doll while I mimicked her movements on Henry), he slept 12 hours straight. I think that it helped transition him into regular sleeping. His nanny who comes 32 hours a week has an associates degree in massage therapy and gives him massages twice a week.

Please keep us posted on how the sleep clinic goes and how the developmental PCP visit goes.

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• By KC92872
• Posted April 30, 2008 at 9:37 am
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I will keep ypu posted on how the sleep specialist goes and how this new PCP goes once I meet with them and thanks for the advice on the massage. Our OT EI person was doing massage for a while so I may ask her to show me some techniques and try that.

KC

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• By erikar
• Posted April 30, 2008 at 10:59 am
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15lbs @ 8 months is WONDERFUL.
I will be happy if my 26 weeker born at 14 oz. (now 6.5 months old) will be 10 lbs by 8 months, so please count your blessings and try to relax. As far as development, all you can do is work with all the EI people to give your son the best chance. You shouldn't regret being too stuck on that and not allowing yourself to enjoy all the time with him!

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• By OrionsMommy
• Posted April 30, 2008 at 7:01 pm
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Hi!

Orion was born at 31 weeks and is now 13 months old today. He just now began to sit on his own and though his is not crawling he loves to stand and "army" crawl around on the floor.
We found that the BUMBO was extremely helpful in teaching him to stay up in the sitting position. He is trying very hard to sit up on his own and can when not completely flat on his back.
Orion did not want to sleep either and we found it helpful to add a small amount of oatmeal or rice cereal to his bottles so that it was heavy in his tummy and allowed him to sleep longer.
I hope that this helps.

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• By treesa
• Posted April 30, 2008 at 9:26 pm
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my oldest son never crawled was not a premie just small 4lbs. mind you but he skipped crawling and that is very common so iw wouldnt be to worried.

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