When will my premature baby reach development milestones?

The BabyCenter Editorial Team

Whether a baby is premature or not, there's no way to predict exactly when she'll hit milestones. Instead, there's a "range of normal" that spans when most babies accomplish these big developmental goals.
For preemies, many pediatricians recommend using an "adjusted age" to determine this range. Adjusted age helps level the playing field by taking into account just how early your baby was born. After all, had your baby not been premature, she would have had a lot more time in your womb to get ready before she was expected to achieve milestones!
When you use an adjusted age, the range of normal gets shifted. For example, while most full-term babies will sit up between 4 and 7 months, a baby born two months early can be expected to do this between 6 and 9 months.
To find your child's adjusted age, count the number of weeks between her birth date and her due date, and subtract that amount of time from her current age.
For example, if you have a 4-month-old baby who was born 8 weeks early, her adjusted age would be 4 months minus 8 weeks, which comes to about 2 months. At 6 months old, her adjusted age would be 4 months, and at 12 months old, her adjusted age would be 10 months. 
According to Sessions Cole, a pediatrician and director of newborn medicine at St. Louis Children's Hospital, adjusted age may be more accurate for motor milestones (such as rolling over, sitting up, and walking) than for cognitive milestones (such as babbling and imitating sounds).
"Premature babies tend to be less delayed in their cognitive milestones, so the adjusted age may be slightly more helpful for the motor milestones," Cole explains.  "But remember that it's highly individual."
If you're concerned about your baby's development, even after adjusting for age, talk with her doctor. A referral for early intervention services (for children younger than 3) may be in order.
Research has shown that early intervention is extremely helpful. As Cole says, "Premature babies can benefit greatly from these services."
You'll probably find that your child's adjusted age becomes less and less relevant the older she gets. "We can't pinpoint an exact date to stop adjusting, but at some point it will become clear that it doesn't make that much difference – usually around age 2 to 3," says Mia Doron, associate professor of pediatrics at the University of North Carolina and coauthor of Preemies: The Essential Guide for Parents of Premature Babies. 
Some parents find it helpful to consider adjusted age as a child gets older, though – when approaching big life events like starting kindergarten or smaller ones like choosing a cabin at camp.  
If your child seems younger than her peers, you may want to group her with slightly younger kids. "Adjusting for age could still be appropriate" in cases like this, Doron says.
Finally, remember that while milestones are important, they don't provide a complete picture of your child. "Milestones are great for helping to keep track of how a baby is doing – but babies have strengths that milestones can't capture," says Cole. "We shouldn't deny these strengths, even if they aren't exactly 'fitable' into the milestone cubbyholes."
This advice makes good sense for the post-baby years, too. As Jeff Stimpson writes of his 5-year-old son in Alex: The Fathering of a Preemie,"He can do three forty-eight piece puzzles simultaneously. I can't do that."

10 of the Worst Parenting Tips Ever

Every parent has received bad advice at one time or another. Be it child-rearing techniques that seem to stem from the Stone Age or poorly conceived tips from adults who've never actually raised children, most new moms and dads quickly learn the art of nodding politely then changing the subject.

But what about those so-bad-you-stop-what-you're-doing-and-call-your-relatives kind of parenting tips? We're talking about the kind of advice that's so ill-advised you remember and discuss it years later. Do people really still give infants alcohol? Do some parents actually believe that TVs make good babysitters? Yes, they do, which is why we thought it'd be a good idea to make a list of the most misguided parenting tips out there. We'll go over egregious offenders for every age level, and we'll even set the record straight on one controversial practice that's both dangerous and gaining popularity. (Hint: It involves slumbering with a pint-sized partner.)

10: Your Baby Can Just Cry Himself to Sleep

Though your baby probably could cry himself to sleep, you really don't want him to.

When a child younger than six months old cries, it's always for a legitimate reason. Your little one could be telling you he's hungry, tired, needs to be changed or even just wants to cuddle in the only way he knows how. Babies this young haven't yet learned the cause and effect of their actions, so it's impossible to spoil them. The quicker you respond to your little love's cries, the more comforted he will feel. Prompt attention to his needs will decrease his overall anxiety and cause him to realize that he's important and has worth, which is one of the most valuable lessons he'll ever learn.

9: Don't Swaddle Your Baby

People have been swaddling babes throughout history, and while the process of restricting infants' movements with a tightly pulled blanket may seem unnecessary and even cruel to adult eyes, babies actually find it comforting.

Studies have shown that swaddling reduces crying, lowers anxious babies' breathing and heart rates, and allows infants to sleep longer, with fewer interruptions. The technique has even been shown to reduce the risk of sudden infant death syndrome (SIDS) for babies sleeping on their backs. What's more, any parent who practices swaddling can tell you that it makes little ones feel better. It has a naturally calming, almost sedative effect, which can be just as much of a relief for sleep-deprived parents as it is for fussy babies.

8: Rub Whiskey on Teething Babies' Gums

Whiskey may have worked wonders when horses were the dominant mode of transportation, but with today's advancements in science and technology, we don't have to give our babies hard liquor to soothe their aching gums. Admittedly, giving your baby the equivalent of a nip or two may ease his teething pain. Unfortunately, it could also be fatal. Even in small doses, alcohol can be poisonous to infants. As much as a teaspoon of brandy or whiskey could be enough to intoxicate a baby, and it can also cause hypoglycemia, seizures and respiratory failure. So, make sure your tot stays off the sauce, OK?

There are plenty of effective methods to ease your little one's agitation. Try giving him a wet, frozen washcloth; frozen teething toys; or just rubbing a clean, whiskey-free finger across his gums. Of course, distraction works, too, so maybe just a little bit of extra one-on-one time or a few more minutes of cuddling before bed may be all your baby needs to rest easier at night.

7: Sharing a Bed With Your Child Is Perfectly Safe

Sleeping near each other is fine, but there's a big difference between sharing slumber space with your little one and sharing a bed. Co-sleeping, which is the term used for parents sleeping within arm's reach of their children, is healthy, safe and encouraged by the American Academy of Pediatrics (AAP) for infants, especially during the first year of life. Co-sleepers maintain their own individual sleeping spaces by using extensions that connect to the bed or a nearby cradle or bassinet. Sleeping in such close quarters makes for easier, less disturbing feedings; strengthens bonding and allows babies to fall asleep more easily.

Conversely, bed sharing occurs when parents sleep in the same bed with their baby. It may seem like a small difference, but because adult beds aren't built with infant safety in mind, bed sharing has been proven to increase the chance of sudden infant death syndrome (SIDS). Soft mattresses, pillows, blankets, loose headboards and an easier ability for the baby to transition from sleeping on his back to a prone position have all been shown to pose an increased risk for SIDS, and the AAP lists bed sharing as a significant hazard for slumbering babes.

6: Let Your Toddler Discover His Own Interests

Playing with crayons may be more stimulating than practicing the alphabet, but just as every artist needs to know how to spell and sign his name, every child needs a little guidance -- especially at home.

Sure, your kid's habit of uninterrupted floor wandering may teach him that the cat is soft and Daddy's shoes smell funny, but if left completely to his own devices, he may also find a wall socket.

Let your kid be himself and discover the world on his own terms, but don't be afraid to step and take charge in when necessary.

5: Don't Punish Your Child

During an interview with Style magazine, Jada Pinkett Smith discussed her and hubby Will Smith's philosophy on disciplining their children. She said, "We don't have rules. We come up with agreements." While we're happy the Fresh Prince and his family have found a way to successfully negotiate bedtimes and curfews, most of us (and our children) need a few concrete rules.

No parent wants to be the bad guy, and frankly, punishing your kid is never an enjoyable experience. But children need to understand that actions have consequences, and sometimes negotiations just aren't going to cut it. You never have to resort to corporal punishment, and often talking about an issue may be enough to drive your point home. But, if you want to put an end to bad or dangerous behavior, sometimes you're going to need more than a persuasive argument. Taking away computer privileges or grounding a kid sends a message.

4: Why Pay a Babysitter When You Have a TV?

A surprisingly large number of parents think the TV set is an acceptable alternative to a living, breathing childcare provider.

It's not so shocking when you think about it in terms of dollar signs. The boob tube is captivating for young kids, and floating a cable bill is much cheaper than paying for a babysitter to watch your little one after school during the work week.

No matter how tight your budget may be, there are other options. Regardless of where you live, there are after-school programs that are both safe and affordable. If you're unsure about where to start looking, ask your child's teacher for advice, or contact your local YMCA.

3: Anything Your Child Does Is Good Enough

In today's era of trophies for the losing team, it's important for kids to learn how and when to push themselves to do better. Shakespeare didn't pen "Romeo and Juliet" the first time he picked up an inked quill -- it takes time todevelop skills and talents. Rewarding your child for mediocre achievements gives the impression that OK is good enough.

Now, we're not saying that you should constantly find fault in your kid's work -- we're just pointing out that if your child is practicing writing sentences but neglects to include verbs, you might want to show him how much those action words can improve his prose. Adjectives and adverbs, however, can wait for another day.

2: It's Your Job to Make Sure Your Kid Gets Good Grades

Your job as a parent is to help your child reach adulthood and become the best person he can be -- that's it. If your studious little scholar's path includes getting straight A's, that's wonderful, but grades aren't everything. Not every kid is capable of making the honor roll, and there's nothing wrong with that. Everyone has different strengths, and while grades are important, they shouldn't be the entire focus of your child's (or your) existence. Childhood is over all too quickly, so make sure your kid has time to relax and enjoy himself. He can study anytime, but that lazy Sunday afternoon won't last forever.

1: Just Let Him Charge Those College Expenses

We all need to pay our way, but not with credit cards. And we certainly don't advocate that your child charge his way through the college years.

Even when your kid heads off to seek a higher education, he's still, well, a kid. He may be old enough to drive, vote and join the military, but chances are he's not mature enough to charge his expenses for the next four (or more) years at college. Open lines of credit are almost never a good idea for college students, and no matter what his major is, it probably won't help him handle the mountain of debt he'd accumulate while earning his degree.

Scholarships and student loans are a great way to pick up the expenses you're not able to cover, and if money is still tight, he could always attend a local university and (gasp) continue to live with you until he graduates and finds a job. It's a scary prospect, we know, but it's not nearly as frightening as your baby still paying off his college credit card debt when he has babies of his own.

How do I choose the best food for my baby?

You'll find quite an array of baby food on the supermarket shelf — from simple veggies and fruits to fancy mixed dinners — so it's no surprise that you're wondering which to choose.

Many baby food jars are labeled according to a baby's stage of development, with stage 1 for babies who are just starting solids and stages 2 and 3 for babies and toddlers with more experience (and solids!) under their belts. If your baby's a beginner, stick with stage 1, which is pureed to a thick liquid. Stage 2 has a thicker consistency, and stage 3 has chunks in it.

Check the expiration date on the jar label and make sure the vacuum seal is intact: The center of the lid should be slightly indented. When you open the jar at mealtime, listen for the whooshing sound and watch the center of the lid pop up. (It's a good idea to wipe the cap clean before opening the jar, too.)

When it comes to ingredients, you don't have to worry much about salt because it's no longer added to most commercial baby food. But do avoid food with added sugar and modified food starch, which are just empty calories.

Buy simple, one-ingredient baby food — rather than combinations — until you know your baby can tolerate each of the components. Introduce peas before peas and potatoes, for example.

Should I buy organic baby food or use organic food when making my own baby food?

Just don't skimp on fruits and veggies in an effort to reduce your baby's exposure to pesticides. You might consider buying organic produce for the "dirty dozen" — the fruits and vegetables that typically contain the highest levels of pesticides: celery, peaches, strawberries, apples, blueberries, nectarines, bell peppers, spinach, cherries, kale/collard greens, potatoes, and imported grapes.

Just don't skimp on fruits and veggies in an effort to reduce your baby's exposure to pesticides. You might consider buying organic produce for the "dirty dozen" — the fruits and vegetables that typically contain the highest levels of pesticides: celery, peaches, strawberries, apples, blueberries, nectarines, bell peppers, spinach, cherries, kale/collard greens, potatoes, and imported grapes.

Many parents prefer organic baby food, despite the higher cost, because they want to give their baby food that's free of pesticides and other chemicals. But other parents trust that commercial products meet the minimum requirements set by the Environmental Protection Agency for their baby's safety. This is an issue you'll have to decide based on your family's beliefs and budget.

What kind of water should I use to prepare baby formula?

The American Dental Association recommends not using water that contains high levels of fluoride when mixing powdered or concentrated baby formula. Too much fluoride puts your baby at risk for enamel fluorosis, a condition that develops while the teeth are forming in the gums. It's not a disease, but it can result in faint white lines or white spots or areas on the permanent teeth.If you're on a public water system, check with your local water utility. If your tap water is fluoridated or has substantial natural fluoride (0.7 mg/L or higher), consider using a low-fluoride alternative water source.

If you choose tap water, use the cold-water faucet and allow the water to run for a few minutes before you use it. This reduces the chance of lead and other mineral contamination.

If your baby's healthcare provider or local health department has advised you to boil the water you use for formula, be sure to bring the water to a rolling boil. Boil it for about one minute, and then allow the water to cool before using. Don't boil the water more than once or for too long, since that can increase the concentration of impurities.

If your water supply comes from a well, have the water tested to make sure it's safe before using it for your baby. Well water could contain a high level of nitrates, for example. Boiling well water doesn't assure that the water will be good for your baby — in fact, boiling the water would make the nitrates more concentrated.

Bottled water known to be low in fluoride is labeled as purified, deionized, demineralized, distilled, or prepared by reverse osmosis. Most grocery stores sell these types of low-fluoride water. You may even see water specifically labeled for formula use. (By law, bottled water must meet the FDA's Standard of Water Quality, which is at least as stringent as the EPA's standards for tap water.)Some home water treatment systems remove fluoride, too.

Tips For Infant Health Care

If you had thought that taking care of a baby was only about feeding him/her at the right times and changing a few diapers, it’s high time you took a broader perspective! As a responsible parent, you need to ensure the overall well-being of your little darling. An infant, of course, will not be able to express his/her discomforts/needs verbally – and it is up to you to gauge the same, and provide the right health care for him/her. Over here, we will be discussing on a few pertinent health care tips for babies:

• Get your infant vaccinated – Get in touch with a qualified medical health care service provider, and find out about the vaccines your kids require. Take him/her along for the vaccinations at a local medical center. That would keep the little one safe from serious health problems in future.
• Take care while bathing a baby – No; bathing a baby boy/girl is not only about cute water ducks and lots of soap bubbles! Use good quality baby oils, soaps and shampoos, to keep the skin and hair of the kid nice and healthy. Make sure that the bathtub you are using has high sides – so that there is no risk of the infant toppling over. Never let your kid catch a nasty cold – by prolonging the bathing session beyond the necessary time.
• Make sure that the child is sleeping enough – If your baby is sleeping lots – that’s a healthy sign. Find out the number of hours of sleep that a baby requires, and make sure that your kid is getting the same every day. Insomnia in a baby can make it restless, and prone to other serious health problems.
• Check the body temperature of the kid – Find out if your baby is suffering from fever, by using a reliable thermometer to gauge its body temperature. If yes, contact a child care expert immediately. You will never be able to find out if it’s only a case of common cold, or whether the elevated temperature is a result of food poisoning, diarrhea, or other causes. Why take a chance?
• Do not keep electric wires, coins or other small pieces within easy reach – If you are a first-time parent, you might not be aware of this – but little kids have a tendency to put everything to their mouth. Do not keep coins, pins, or other such small items lying about, which can choke a baby. Keeping electric wires or switches within the reach of children is also a strict ‘no-no’. Your infant might start playing with the wires, with disastrous consequences!
• Keep infants away from direct sunlight – Except for maybe a few hours in a day, do not keep your baby exposed to harsh sunrays. Don’t assume that you can apply sunscreen lotions on an infant’s skin, and keep his/her cot in bright sunshine. Such sunscreens generally have chemical ingredients, which can cause more harm than good – particularly if your child is less than six months old.
• Spend adequate time with your kid – Do not let professional commitments or daily household chores prevent you from spending the requisite amount of time with your baby. Play interesting, entertaining games with him/her, and decorate his/her cot nicely. If you are with your child for long enough, you will also be able to detect symptoms of ill-health quickly.

Have the contact details of a noted child health care service professional close at hand, who can be called upon during emergencies. Take good care of your li’l child – and make your home come alive with baby laughter!

10 Baby Care Tips

Congratulations! A baby is sure to light up any home, but knowing how best to accommodate your new son or daughter is key to a happy transition. Sure, your child is a little person, but don't expect Junior to pull up a beanbag and nosh on nachos with dad at all hours of the night. Not only will you need to put some thought into your child's feeding and sleeping routines, you've also got to make sure any siblings are ready to step up their game as well. And, oh yeah, did we mention the diapers? Well, hold on 

1:Travel 

Babies thrive on schedules. Even when traveling, do your best to stick to the regular routine and schedule to keep your little one in the best mood possible.

2:Sleep

Sleep begets sleep. First-time parents don't believe it, but a healthy nap-time routine makes for a better night's sleep. Overtired babies have a hard time falling asleep and wake more often in the nighttime. Begin establishing a healthy, sleeping pattern as early as two weeks. Your newborn might not be ready for a schedule, but keeping the routine demonstrates early on what you expect in terms of adequate baby rest.

3: Skin Care

Sunscreen isn't recommended for children under 6 months of age. Keep them in the shade until you can safely protect theirskin.

4: Siblings

Accentuate the positive. A new baby means a lot of changes for the family. Praise your older children for their help, patience and understanding, and they will adjust to the new family member with ease.

5: Play

There is nothing wrong with the basics: patty-cake and peekaboo are games that have been used for years to entertain babies, while helping their brains grow. Your child will respond to the stimulation and enjoy the interaction.

6: Pets

The family pet needs to adjust to the new family member. Bringing home a blanket or outfit the baby has worn is always helpful, but also keep Fido to his normal routines. Skipping the long morning walk is fine for a day or two, but lack of exercise and attention will only make the animal resentful. Find a routine that works and stick with it.

7: Feeding

Consider starting your child off with a vegetable rather than a sweet fruit. Introduce vegetables as soon as you start solid foods to get your child's nutrition off on the right foot.

8: Diapers

Most babies experience diaper rash in their lifetime. Whether it is caused by a new food, wet diaper or side effect from medicine, the red, chapped skin is painful to baby and worrisome for Mom and Dad. The best treatment? A dry bottom. Make sure your child is completely dry after a diaper change, even if it means going naked for a few extra minutes. Change diapers more frequently, and use one of the many over-the-counter products to soothe and calm the skin.

9: Crying

Babies cry. It's no secret. It's their only method of communication. After you check all the basics of hunger, diaper and noise, remind yourself that your child has been in a quiet safe womb for a long 40 weeks. Swaddle him or her in a blanket, hold them snugly and rock softly. Recreating that little nest will help calm a fussy newborn and hopefully, provide some much-needed sleep.

10: Bathing

You might need a daily shower to wake up, but baby needs a gentle bath every other day or so. Skip the soap, and use a gentle made-for-baby cleanser to protect baby's sensitive skin.

Substance Use During Pregnancy

Tobacco, alcohol and drugs can have harmful effects on anyone's health. When a pregnant or nursing woman uses these substances, her baby also is exposed to them, for all substances cross the placenta through the umbilical cord and enter into the baby's bloodstream.

While pregnant, it is best to eat well, stay healthy and avoid ingesting anything that might be harmful to the mother's or baby's health. A health care provider can give you more information about these issues.

"Street" Drugs

A pregnant woman who uses drugs like cocaine, crack, heroin and methadone may have a baby born addicted to the substances she took during her pregnancy. Cocaine is one of the most harmful drugs to unborn babies. Cocaine can cause a woman to miscarry and may cause preterm birth, bleeding, fetal death and fetal strokes, which can lead to brain damage and death. After birth, a baby who has been exposed to cocaine prenatally goes through withdrawal, signs of which include jitters and irritability. These babies are hard to comfort and are often unable to respond to their mothers. Cocaine use during pregnancy also may be linked to an increased risk of sudden infant death syndrome, or SIDS.

Amphetamines or "speed" also are harmful to unborn babies. One study showed that the fetuses of mothers who used speed during pregnancy had decreased weight, length and head size. Another study showed that these babies had more strokes, or bleeding into their brains.

Marijuana

Marijuana can affect fetal and infant development and may cause miscarriage. Although the effects of marijuana on an unborn baby are still unknown, studies have indicated that prenatal marijuana use is linked to premature births, small birth size, difficult or long labor and an increase in newborn jitteriness.

Marijuana smoked by a pregnant woman remains in the baby's fat cells for seven to 30 days. Smoking marijuana can affect the amount of oxygen and nutrients the baby receives, which may affect growth. Marijuana is never safe during pregnancy and it can harm the baby at any stage. In addition, marijuana can have long-term effects on infants and children, such as having trouble paying attention or learning to read.

Alcohol

Drinking alcohol can increase the risk of miscarriage, stillbirth, newborn death and fetal alcohol syndrome (FAS). Babies with FAS have low birth weight, heart defects, facial defects, learning problems and mental retardation. Since it is not known if there is a safe level of alcohol during pregnancy, the best advice is not to drink at all. Even one drink a day has been shown to have effects on the growing fetus. The best time to stop drinking alcohol is before you conceive. If your pregnancy is unplanned, you should stop drinking as soon as you suspect you are pregnant.

Tobacco

Women who smoke during pregnancy are more likely to have babies who are too small. Smoking also increases the risk of miscarriage, preterm labor, stillbirth and newborn death. Babies born weighing less than 5 pounds may have more health problems early in life and learning problems later in school. If you smoke, quit now. Ask your health care provider for information about classes or support groups for pregnant women who want to quit smoking.

Prescription Drugs

Some prescribed medications may be harmful to your unborn or nursing baby. If you are taking any prescribed drugs, tell your health care provider as soon as possible so that your medications can be changed or adjusted as needed.

Over-the-Counter Medicines and Vitamins

Avoid over-the-counter medicines such as antacids, laxatives, sleeping pills, cold medications and pain relievers. While some are safe for pregnant women, many are not. If you feel you need any of these medications, first check with your health care provider. This applies to large doses of over-the-counter vitamin preparations as well, for taking large doses of extra vitamins can be harmful to you and your baby.

Caffeine

Caffeine is present in coffee, tea, cola drinks and some medications. For at least 10 years, there has been controversy over whether caffeine is harmful during pregnancy. Some studies suggest caffeine is harmful, pointing to an increased risk of miscarriage, early delivery or lower birth weight. Other studies have shown that women who consume a moderate amount of caffeine do not experience these problems. Because results are conflicting, no one knows the true risk. We recommend drinking as little caffeine as possible.

Ask your health care provider for more information about substances and their effects on pregnancy. Remember -- your baby needs a healthy mom!

Reviewed by health care specialists at UCSF Medical Center.

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.