How much do premature babies gain per day? Weight gain in premature babies

The rate of weight gain in premature babies is an important indicator by which the baby's development is monitored. Depending on how quickly and in what quantity the child gains, we can judge possible problems, about what additional care he may need.

Premature babies need Special attention: It is important to monitor the nutrition of babies and how they gain weight. Due to immaturity gastrointestinal tract, low enzyme activity, lack of sucking or swallowing reflex, stomach rejection of food, such babies may have numerous difficulties with feeding. An indicator such as weight gain in premature newborns helps to understand how well the baby’s nutrition is organized, and whether adjustments are required in the frequency and quality of feeding.

What are the degrees of prematurity?

Premature babies are those born before the 37th week of pregnancy, weighing less than 2.5 kg. Depending on what week of pregnancy the baby was born and its weight, there are 4 degrees of prematurity:

I degree of prematurity - babies born at 35 - 37 weeks weighing 2-2.5 kg;
II degree of prematurity - babies born at 32 - 34 weeks weighing 1.5-2 kg;
III degree of prematurity - babies born at 29-31 weeks weighing 1 - 1.5 kg, the third degree of prematurity is considered deep;
IV degree of prematurity - babies born before 29 weeks weighing less than a kilogram, this degree of prematurity is considered extreme.

Features of development

The development of premature babies has its own characteristics. This is manifested both in appearance and in the immaturity of the development of organs and systems. How does the development of a premature baby differ?

The nervous system has a special type of functioning; it functions differently than in normal newborns. The child’s nervous system has not had time to go through all stages of development, which affects thermoregulation and decreased tone. Such babies need even more attention, especially from their mother. The baby is surrounded with care, affection, and comfort.
Children master behavioral skills later than their peers.
If the baby weighs less than one and a half kilograms, for normal development he needs to be in an incubator. This is a kind of incubator where an artificial microclimate (temperature, humidity, oxygen content) that is optimal for the baby is created and maintained. If the baby's mass is large enough, he no longer needs an incubator, but the room in which the baby is located must be warm and sufficiently humid.

Development of premature babies by month

In the first months after birth, doctors distinguish three main stages, which differ in the child’s weight gain and nutritional needs.

The first stage is when the child loses weight. This happens in both full-term and premature babies. But premature babies lose more weight (normally babies lose 5-6% of weight, and premature babies lose from 10 to 15%). The amount of nutrition during this period is minimal, but must be of high quality in order to provide the body with all the necessary nutrients.

The second stage is stabilization of the condition, the baby can independently suck the breast or bottle. Babies weighing 2.5 kg are already being transferred from the department with premature babies. The estimated weight gain for premature babies is about 125-200 grams per week.

The third stage lasts up to a year (but for very premature babies even longer). At this stage, much attention is paid to the baby’s nutrition; proper feeding helps reduce the developmental gap from peers.

How does a premature baby gain weight by month at different degrees of prematurity?

Depending on the time when the baby was born and body weight at birth, the intensity of weight gain will vary.

First degree of prematurity:

Month	Weight gain, grams
1	300
2	800
3	700-800
4	700-800
5	700
6	700
7	700
8	700
9	700
10	400
11	400
12	350

Second degree of prematurity - table of weight gain in premature infants by month:

Month	Weight gain, grams
1	190
2	700-800
3	700-800
4	600-900
5	800
6	700
7	600
8	700
9	450
10	400
11	500
12	400

Third degree of prematurity:

Month	Weight gain, grams
1	190
2	650
3	600-700
4	600-700
5	750
6	800
7	950
8	600
9	650
10	500
11	300
12	350

The fourth degree of prematurity is the rate of weight gain:

Month	Weight gain, grams
1	180
2	400
3	600-700
4	600
5	650
6	750
7	500
8	500
9	500
10	450
11	500
12	450

Growth gains

Depending on the degree of prematurity, the increase in the baby's growth will also vary.

Table of height gain in premature babies

Month	I degree, cm	II degree, cm	III degree, cm	IV degree, cm
1	3,7	3,8	3,7	3,9
2	3,6	3,9	4	3,5
3	3,6	3,6	4,2	2,5
4	3,3	3,8	3,7	3,5
5	2,3	3,3	3,6	3,7
6	2,0	2,3	2,8	3,7
7	1,6	2,3	3	2,5
8	1,5	1,8	1,6	2,5
9	1,5	1,1	2,1	4,5
10	1,5	0,8	1,7	2,5
11	1,0	0,9	0,6	2,2
12	1,2	1,5	1,2	1,7

Premature babies are those born up to 37 weeks of pregnancy, starting from the date of the last menstrual period, and having a body weight below 2500 grams. There are 4 degrees of prematurity depending on the gestational age and weight of the child at birth:

I degree– premature babies born at 35-37 weeks with a birth weight of 2000-2500 grams;

II degree– premature babies born at 32-34 weeks weighing 1500-2000 grams;

III degree– very premature babies born at 29-31 weeks weighing 1000-1500 grams;

IV degree– extremely premature babies born before 29 weeks weighing less than 1000 grams.

Of course, for such children, weight gain is one of the determining factors in the child’s physical development and health. Good weight gain can be ensured only with well-established, nutritious nutrition for the child, which satisfies his energy expenditure, when the baby receives all the nutrients, microelements, and protective complexes he needs. Difficulties with feeding can arise due to the immaturity of the child’s gastrointestinal tract, low enzymatic activity, frequent regurgitation, the stomach’s refusal to accept food, and the absence of a swallowing and sucking reflex. Depending on the problem, doctors feed the child through a tube or use parenteral nutrition, when nutritional solutions are administered intravenously to the child.

The best food for premature baby- this is mother's breast milk. Scientists have proven that milk adapts to the needs of the child, therefore the milk of a woman who gives birth ahead of schedule, has its own unique composition, adapted for a premature baby. While the baby cannot suckle, he is fed expressed milk, after the baby learns to suck and swallow (usually, when he gains 1.6 kg, these reflexes appear), he is gradually transferred first to partial, and then to full breast-feeding. If it is impossible to breastfeed, the baby is transferred to donor milk or a special adapted formula for premature babies. Indicators of weight gain determine the quality and adequacy of nutrition, the need to introduce or eliminate supplementary feeding.

Doctors divide the newborn period for premature babies into 3 main stages, which differ in the child’s nutritional needs and weight gain.

At the 1st stage, the newborn does not gain, but loses weight. This is a physiological feature of all children, but if a full-term baby usually loses 5-6% of weight, then a premature baby weighing more than 1.5 kg loses 10%, and a very premature baby weighing up to 1.5 kg loses 15%. This period usually lasts the first 7 days from birth. Despite the fact that during this period the amount of food is minimal, it should provide the baby’s body with all the necessary nutrients.

At the 2nd stage, constant weight gain is achieved, at least at the level of the prenatal period. When the child’s condition has stabilized, he can independently suckle a breast or bottle, and has reached a weight of 2.5 kg, the mother and child are discharged from the department for premature babies. The weight gain per week should be 125-200 grams, depending on the baby’s weight at birth. The increase is calculated as follows: + 15 g/kg daily.

At the 3rd stage, the child’s weight normalizes, lasting up to a year(longer for very premature babies). The task of parents during this period is to provide the child with adequate nutrition with a sufficient amount of calories and all the nutrients that are needed for the child’s growth, because a premature baby needs to develop more intensively in order to catch up with his peers. Usually, if a baby is born 1 month ahead of schedule, then he catches up with his peers in development by 1 year, 2 months ahead of schedule - by 2 years, and 3 months ahead of schedule - by 3 years, respectively.

Below is a table of weight gain for premature babies depending on age and degree of prematurity.

The table gives an approximate result for children who are fully breastfed; the numbers may differ, both up and down. Every month the child should be examined by a pediatrician who will assess the child’s physical development and health. Nutrition adjustments, calculation of supplementary feeding rates, recommendations for the introduction of complementary foods, vitamin supplements should be carried out only by a doctor.

Calculate the approximate weight gain of a premature baby up to one year online

Please indicate the baby's weight at birth (g)

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Babies born before 37 weeks are classified as premature if their weight does not reach 2500 grams. Moreover, depending on the gestational age at birth, 4 degrees of prematurity are distinguished. So, how many days does it take for a premature baby to gain weight, and how should he be cared for?

How many days does it take for a premature baby to gain weight?

So, experts distinguish 4 degrees of prematurity:

Babies born at 35-37 weeks weighing more than 2000 grams;

Babies born at 32-34 weeks weighing more than 1500 grams;

Very premature babies born at 29-31 weeks weighing more than 1000 grams;

Extremely premature babies born after the 29th week weighing less than 1000 grams.

So, how many days does it take for a premature baby to gain weight? Parents are certainly concerned about this issue, because it is the weight gain at this stage that largely determines his health and physical development. But only with adequate nutrition, when it satisfies the energy requirements of the child’s body, can good weight gain be ensured. But due to the immaturity of the gastrointestinal tract of a premature baby, some difficulties may arise with feeding the baby. Frequent regurgitation, low enzymatic activity, and lack of sucking and swallowing reflexes may occur here. In some particularly severe cases, feeding the child through a tube, parenal nutrition, or intravenous administration of food to the child may be required.

One way or another, you need to understand that for any premature baby better nutrition there will be breast milk. If the baby is not able to latch on to the breast, he is fed with expressed milk. Sometimes it may be necessary to introduce a special adapted mixture into baby food. At the same time, it is the completeness and quality of nutrition that determine the indicators of weight gain, along with the need to introduce or cancel supplementary feeding.

So, how and how many days does a premature baby gain weight? The preterm period is divided into three stages. Each of them has its own nutritional needs, as well as weight gain criteria.

So, at the first stage, it is not a gain, but, on the contrary, a loss of weight by the newborn baby. Normally, it ranges between 5-6%, but for very premature babies it can reach 15%. This period may include the first 7 days from birth. At this time, the baby requires minimal nutrition, which will only provide the child’s body with basic nutrients.

At the second stage, there is a constant increase in weight, at least to the level of the prenatal period. As soon as the baby’s condition stabilizes, he will be able to fully suck a bottle or breast, and his weight will be 2.5 kg, he will be discharged from the premature ward. At this time, babies should already gain 125-200 grams per week.

The third period of prematurity will last up to a year. At this time, the child's weight returns to normal. Nevertheless, parents must certainly provide him with nutritious and high-calorie nutrition. It is necessary for the normal growth and development of the child, intensive weight gain. Thus, children born a month prematurely catch up with their peers by the age of one year, and those born 2 months earlier - by the age of 2 years, respectively.

If necessary, the pediatrician who is observing the child will adjust his diet, calculate supplementary feeding rates, and also recommend vitamin supplements or appropriate complementary foods.

Unfortunately, premature birth is now far from uncommon. But modern medicine is capable of delivering a child even if its body weight does not exceed 900 grams, and if a child weighs from 1 to 2 kilograms, he has every chance of growing up completely healthy.

Such babies need special care and control. And it is important to know how premature babies should develop, how they gain and add kilograms.

Let's look at how such a baby should gain weight and height, based on tables of weight gain norms by month.

Which newborn is considered such?

Babies born before 37 weeks of pregnancy are considered premature., and having very low body weight, that is, their birth weight is less than 2500 grams and their height is up to 45 centimeters.

Reference! There is a chance to save a premature baby only if its weight at birth is more than 500 grams.

Indicators in grams by month

How does a premature newborn baby gain weight? From the table below you can understand what the rate of weight gain is by month for premature babies and how much a child should weigh before one year, for example at 4 or 9 months.

Age, months	Birth weight, grams
	Up to 1000	from 1001 to 1500	From 1501 to 2000	From 2001 to 2500
	Average weight gain, grams
1	180	190	190	300
2	400	650	700-800	800
3	600-700	600-700	700-800	700-800
4	600	600-700	800-900	700-800
5	550	750	800	700
6	750	800	700	700
7	500	950	600	700
8	500	600	700	700
9	500	550	450	700
10	450	500	400	400
11	500	300	500	400
12	450	350	400	350

How much should babies gain per day?

It is impossible to say exactly how much weight a baby should gain per day, since All children gain different amounts of grams per day. It all depends on the degree of prematurity of the child and on his general condition. On average, this value should be about 50 grams per day. But at the same time, the general condition of the child should be taken into account, as well as the number of feedings, urinations, and so on.

If your child gains a little less, don’t immediately panic. The main thing is that there is no large weight loss.

Calculator

Also, To control the weight gain of a premature baby, you can use a special calculator or a formula for calculation. And you can use the calculator for weight gain of a premature baby on the website: Or on any other website that you can easily find on the Internet.

Growth chart by month

How do children grow in the first year of life? From the table below you will learn about the norms of growth in children by month:

Age, months	Height at birth, centimeters
	From 41 to 46	From 36 to 40	From 32 to 35	From 30 to 32
	Average height increase, centimeters
1	3.7	3.8	3.7	3.9
2	3.6	3.9	4	3.5
3	3.6	3.6	4.2	2.5
4	3.3	3.8	3.7	3.5
5	2.3	3.3	3.6	3.7
6	2	2.3	2.8	3.7
7	1.6	2.3	3	2.5
8	1.5	1.8	1.6	2.5
9	1.5	1.8	1.6	1.5
10	1.5	0.8	1.7	2.5
11	1	0.9	0.6	2.2
12	1.2	1.5	1.2	1.7

What determines the increase in centimeters?

Height gain in premature babies depends on the following factors:

Degree of prematurity.
Body weight at birth.
Conditions of intrauterine development.

Average, During the first six months, the baby grows by 2.5-5.5 centimeters. And in the first year of life 27-38 centimeters. Growth indicators by the age of one year are 70-77 centimeters. All values are given in an average statistical sense and should not be taken literally, but you can use them as a guide.

Why is my child not gaining height and weight? And of course, any parents are worried about this situation. Let's figure out what doctors say about this. Reasons why your baby is not gaining weight well:

Artificial feeding.
Most premature babies are on IV and there are many reasons for this. Milk may disappear due to the fact that the child does not eat enough or the woman could not breastfeed, and pumping did not produce results, and so on. But no formula, even the best, can compare with mother's milk. Therefore, it is necessary not to transfer the child completely to IV until the last moment.

Reference! If mother's milk is not enough, then feed the baby with formula. But this should be done only when the child is sleeping, so that there is no addiction to the bottle.
Not the right mixture.
If a child eats formula, then you need to select it correctly. The fact is that the body of a premature baby is very different from full-term babies. To feed them, you need to choose high-quality, especially light mixtures.
Malnutrition.
These babies are very weak and sleep almost constantly, not demanding to eat. And in such a situation, the mother needs to take strict control over the amount of food she eats. Doctors advise keeping a feeding chart and making a chart of how children gain weight and height. And the remaining milk should be expressed, this will increase the period of breastfeeding.

If a child refuses to eat, there is no need to force feed him. In case of frequent refusal, consult your doctor.

The baby may also suck poorly and get tired very quickly. Therefore, if the child stops eating, and you understand that little food was consumed, then take a 15-minute break and try to supplement the feeding.
Mother's condition.
The child and mother have an inextricably close connection even after birth. Therefore, any condition you have affects your baby. They also have a strong bad influence bad habits women.
Baby's health problems.
A weakened body is poorly resistant to infections. If you see the slightest signs of illness, go to the hospital immediately.
Maternal nutrition.
If the child is breastfed, then the woman should pay great attention to her own diet, because how much weight the baby gains depends on this.
Weight control.
Doctors advise detailed monitoring of the child’s regimen. Keep a notebook in which you record the number of feedings, urinations, and so on. The fact is that for a premature baby, the lack of at least one meal a day can significantly affect weight gain.
Kangaroo.
Doctors also offer a very effective kangaroo technique. It consists in the fact that the premature baby is not separated from his mother throughout the day. They even created special T-shirts for this. The child feels the warmth and protection of the mother, which is very important since, having been born prematurely, he was not yet ready to exist outside the womb. The child also has constant access to mother's milk.

Conclusion

Now you know the norms for weight gain in children and why sometimes a low birth weight child has trouble gaining vital kilograms. It is important to understand that a premature baby is the same child, just born at the wrong time. If you follow all the care rules and provide sufficient, proper nutrition, then there won’t be any special problems. And by the age of two, such a child will no longer differ from his peers. Modern medicine makes it possible to care for such children almost without problems, so don’t worry, because your condition affects the child.

Since premature babies are low birth weight, the main indicator of their development and health status is weight gain. As a rule, premature babies increase their weight faster than full-term babies.

This factor is also influenced by the degree of prematurity:

1 – children are born at 35-37 weeks weighing from 2000 to 2500g;
2 – children are born at 32-35 weeks, weighing from 1500 to 2000g;
3 – children are born at 29-31 weeks, weighing from 1000 to 1500g;
4 – children are born before 29 weeks weighing less than 1000g.

For example, a full-term baby doubles its body weight by 4-5 months, and a premature baby, weighing from 2000 to 2500 g at birth, by 3-3.5 months.

In the first month of life, babies with 1st degree of prematurity gain 300g in weight, with 2nd and 3rd degrees - 190g, and babies with 4th degree of prematurity - 180g. In the second month, babies from group 1 add 800g, children from group 2 - 700g, from group 3 - 650g, from group 4 - 400g. Starting from the third month of life, premature babies begin to gain weight from 650 to 800 g.

But these are just approximate figures; weight gain is also affected by:

quality and nutritional value;
frequency and duration of feedings;
family situation;
hereditary factor;
mother's nutrition.

Only a specialist can determine whether a premature baby is gaining weight well or poorly. But if the mother thinks that the baby is not eating well, she observes frequent whims of the baby, then she urgently needs to consult a pediatrician.

The mother’s task is to provide the premature baby with adequate nutrition, including a sufficient amount of calories and essential nutrients. After all, it is important for such a baby to develop intensively in order to catch up with his peers. To do this you need:

Feed your baby whenever possible breast milk, which contains a lot of amino acids, protein, oligosaccharides, antibodies. Unlike breast milk from a woman who has given birth at term, milk for a premature baby contains less lactose.
When feeding a baby through a tube in case of a poorly formed sucking reflex, it is important for a woman to provide the baby with breast milk, constantly expressing it. To do this, you need to purchase a breast pump, since it is very difficult to manually express milk in the amount required for the baby.
Attach to the breast at the baby's request. It is important to apply it correctly.
Be sure to feed your baby at night.
Ensure constant physical contact between the baby and mother.

It is important to record the number of times your baby urinates to determine how much supplemental feeding he needs. It is better to use expressed mother's milk as supplementary feeding. But if it is not enough, then supplementary feeding is done with a special mixture for children with low weight. A child in the first month of life should have at least 16 urinations per day.

Weight gain is the main indicator of the health and development of a premature baby. It is important for him to ensure proper breastfeeding.

Premature babies have their own physiological and anatomical characteristics. This article will tell you about the conditions of the newborn, its development and care features.

Premature babies are special creatures. Already outside the mother’s belly, but still immature and unadapted for the normal life of a newborn. Such children urgently need special care and increased attention.

It does not always happen that prematurity for a particular baby is a very serious problem, because even prematurely, sometimes children are born with a normal weight, breastfeed well and develop adequately.

Problematic premature babies are those born with a deficiency of body weight.
Caring for such a baby is aimed at preventing hypoglycemia, maintaining optimal warmth and feeding itself.

How to quickly gain weight for a premature baby?

Most the best option Feeding a premature baby is mother's milk. It is worth noting that the milk of a woman who gave birth on time differs in composition from the milk of a mother who gave birth to a baby untimely. For premature babies, nature has provided milk with less fat and more protein.

If possible, it is necessary to feed the baby with breast or expressed mother's milk. If this is not possible, they are fed with special mixtures. Before reaching a weight of 1800 g, a starting, saturated formula is used; upon reaching the weight limit of 1800 g, a “transitional” formula is used for feeding
Today, they use a calorie rather than volumetric calculation of nutrition for premature babies, which is more correct. They begin to feed the baby literally drop by drop, with 5-15 ml of milk or formula, gradually increasing the volume
For babies with very low weight, the daily volume of milk is 60 ml, then the volume is increased by 20 ml per kg of weight daily until the baby begins to receive 200 ml per 1 kg of weight per day
Babies born weighing more than 2500 kg receive feedings at the rate of 150 ml per kg of weight per day, the total volume is divided by 8 and given every 3 hours. To monitor weight gain, the baby is regularly weighed and control feedings are carried out (weight before and after feeding)
If breastfeeding for some reason is impossible, pediatricians recommend special formulas Nenatal, Enfalak, Pre-Nan, Pre-Tuttelli, Similak Special Care for premature babies

It is especially important for premature infants to introduce complementary foods on time.

Juices (vegetable or fruit) are introduced from 1-3 months, with 3-5 drops, gradually increasing to the required volume (month of life multiplied by 10)
From 2 months they give fruit puree, starting from 0.5 tsp
Hard-boiled egg yolk is introduced from 3 months
From this age, cottage cheese is also introduced (10 g for a month, then add another 10 g, give 20 g for another month, over the next months +5 g, until the volume is 50 g)
From 4 months, the first complementary food is introduced in the form of porridge cooked in water or vegetable broth; after a month, the second complementary food is added - vegetable puree. Meat puree(10 g) can be introduced from 5 months
An 8-month-old baby can already be offered bread or unsweetened baby cookies, and vegetable soups and meat broths are added to the diet. At 8-9 months, 3 complementary foods in the form of fermented milk product or cow's milk already replaces one meal of the baby's main food product

Anemia in premature babies, hemoglobin level

Premature babies due to their physiological characteristics susceptible to anemia. This condition develops towards the end of the 1st and beginning of the 2nd month of life. There are 3 degrees of anemia of prematurity with hemoglobin:

100-85 g/l
84-70 g/l
indicators below 70 g/l.

Symptomatically, the phenomenon of anemia is expressed in severe pallor of the skin, when listening - an increase in heart rate (heart rate), systolic murmur is possible, a decrease in tone and activity, the child stops gaining weight.

The first and second degrees of anemia do not require special treatment; the baby should be fully fed and saturate the body with B vitamins, vitamin E, ascorbic acid, and folic acid.

In severe cases, blood transfusions are indicated - transfusion of small volumes of red blood cells until hemoglobin rises to 90 g/l.

Jaundice in premature babies, bilirubin in the blood

Such a concept as physiological jaundice of newborns for premature babies exists very conditionally. Jaundice manifests itself as more or less pronounced yellowness of the skin and occurs on the 2nd or 3rd day after birth
This condition is caused by insufficient functional development the baby’s liver, as a result of which indirect bilirubin (formed during erythrocyte breakdown) accumulates in the blood
Indirect bilirubin, which should normally be converted by the liver enzyme glucurone transferase into direct bilirubin, which is harmless to the body, has toxic properties
Large concentrations of its content in the blood are dangerous for very severe brain damage - the so-called kernicterus.

Jaundice in babies born at term is temporary and harmless; this condition lasts for about a week. In babies born prematurely, this condition lasts from 1 month and can last longer than two. The more complex the baby’s general condition, the longer the jaundice lasts.

Methods for preventing kernicterus:

irradiation with fluorescent lamps to enhance the breakdown of bilirubin
administration of hemodez and albumin solution intravenously
Luminal therapy to bind bilirubin for 5 -10 days

Colic in premature babies

Every mother has encountered this unpleasant phenomenon - intestinal colic. Premature babies are especially susceptible to colic.

They may experience attacks of abdominal pain more often and more intensely than in ordinary children. The leading role in such intense suffering of the baby is played by the insufficient development of the intestinal enzymatic system and nervous system, due to which gases are formed in too large quantities. The pressure of gases on the intestinal walls causes severe muscle spasms and pain.

The cause of colic may be improper feeding or intestinal allergies.

How you can help your baby:

dry warm diaper on the tummy
installing a gas outlet tube
belly massage
colon cleansing enema
special carminative teas for newborns (cumin, dill, chamomile, mint)
Espumisan drops, Sub-simplex

If these methods are not effective, the baby must be examined to exclude surgical pathology.

Height and weight of premature babies by month

A baby born prematurely gains more weight and height in the first year of life compared to normal peers. The only exception is the first month, during which the weight increases slightly.

By the third month the weight doubles, and by the sixth month it triples. Up to 6 months, height increases by 2.5 - 5.5 cm, 7-8 months - height increases by 2 cm, from 9 to 12 months - 1.5 cm every month.

Normally, such babies increase their weight compared to birth weight by 4-6 times, children with a high degree of prematurity - by 6-8 times. Average height 12-month premature babies - 70-77 cm, that is, it increases by 27-38 cm from the moment of birth.

First month

Swallowing and sucking reflexes are poorly developed. In their absence, the child is fed through a tube. There is practically no weight gain, very low activity. The main task is to protect the baby from cold and infections.

Second month

It is still difficult to suck and the baby gets tired easily. Body weight is gradually increasing. The baby can be placed on his stomach.

Third month

The main thing is sleep and food. Body weight doubles. Learns to fix his gaze, develops facial reactions and a grasping reflex. Tries to raise his head.

Fourth month

The baby begins to hold his head confidently, begins to smile, fix his gaze, holds a toy, and makes sounds. Characterized by an increase in muscle tone.

Fifth month

The baby shows interest in the world around him, smiles, and his auditory and visual attention improves. The baby accurately determines which side the auditory stimulus is coming from and is able to hold the object in his hand.

Sixth month

The baby's weight triples. The active development of the baby finally expands the possibilities of communicating with him. He recognizes familiar faces well, hums and babbles. Actively swings its legs and arms and squats slightly, pushing off the surface if taken under the arms.

Seventh month

The baby already knows how to roll over onto his tummy, begins to crawl, and confidently holds toys. Activated psycho-emotional development. The first teeth may be emerging.

Eighth month

Motor activity is characteristic. The baby crawls well, tries to sit, and stands on all fours. Shows an active interest in communication. He understands if he is asked to find some object, listens carefully to his mother’s fairy tales, nursery rhymes, hums and babbles in response.

Ninth month

Sits confidently, sits down on his own, holding onto a support, crawls on all fours. “Communicates”, tries to pronounce the first syllables.

Tenth month

Stands well and can walk while holding support. Knows his name, reacts to all sounds, pronounces individual syllables well. Learns to play with familiar objects and watches their movements with interest.

Eleventh month

Can take his first steps without support. Emotional activity is at the level of an ordinary child. Plays with cubes and pyramids. He communicates well with family.

Twelfth month

He can already move independently. Actively communicates with others as much as possible, speaks the first words. Normally, by this time, in terms of physical development, a premature baby catches up with its full-term peers. Neuropsychic processes lag somewhat behind. In general, by this time the baby gains weight 5-7 times its birth weight.

Head circumference of a premature baby

Pediatricians monitor the increase in head circumference of a premature baby with special care. This attention is due to the risks of developing pathologies of the central nervous system. Normally, children gain 4-5 cm in head circumference in the first month, during the second - 2-3 cm, the next month - 2.5 cm, before six months - another 1.5 cm, and after the sixth month - 0.5- 1 cm every month.

Rickets in premature babies

All diseases in children born prematurely have a unique course and are difficult to diagnose. Therefore, prevention is more effective than treating pathology.
The special metabolism of premature infants can create conditions for the development of rickets even with proper feeding and good conditions external environment
If the correct diet is violated, the risk of developing rickets increases. Visible manifestations of rickets can be detected by 2 months, earlier signs diseases are visible only on x-rays

Signs of the disease:

deformation of some bones
the skull is slightly flattened at the sides
large fontanel
fragile rib bones
X-ray shows osteoporosis of skeletal bones

Pediatricians prescribe for the prevention of rickets in premature infants:

Ural Federal District from 5-6 weeks
taking vitamin D (300 thousand units in a course of 2 weeks), in case of illness the dosage is doubled
fish oil in the same amount, which is replaced with vitamin D for signs of rickets
Ca twice a day for 1 month

In addition to specific prevention, nonspecific measures are carried out:

walks on fresh air,
swimming with a gradual decrease in temperature from 39 to 37 degrees
vitamin C
rosehip extract or juices from the second month of life

Fontanas in premature babies

In a baby born prematurely, the sutures between the cranial bones and the posterior fontanel are open. Fontanelles - small and large in size larger than usual, although a large one may be small in size due to displaced bones.

Closing of the fontanelles occurs somewhat later than in full-term babies (the small fontanelle is closed in full-term newborns). If there are no complications and the child develops normally, then the large fontanelle should close by 16-24 months.

Hearing in premature babies

Premature babies are very vulnerable and hearing problems are much more common among them than in children born at term. The immaturity of the nervous system, complicated by additional factors, causes a high risk of hearing impairment.

Risk factors:

infections
high bilirubin
fetal hypoxia
birth injuries
cerebral hemorrhages
hypothermia
long-term mechanical ventilation

On the 3-5th day of life, the premature baby is necessarily examined by an otolaryngologist and hardware audio screening is performed to identify hearing impairments.

Congenital hearing problems account for a total of 3%.

5% of children are at risk of hearing problems at 5 years of age. At home, the child must be observed very carefully at corrected 3, 6, 9 months: what is the reaction to loud sounds, sound in general, does the baby distinguish voices, reacts to his name, call, does he listen to speech.

A child at risk should be observed until his/her own speech appears.

Skin of a premature baby

Premature babies have very thin and vulnerable skin. The epidermal layer is poorly developed, which makes the skin weakly protected from microorganisms. After removing the vernix skin The baby becomes brightly hyperemic; this redness can last up to 2 weeks. After the skin becomes its normal color, it begins to actively peel off.
Jaundice gives the skin a yellowish appearance, while pallor and a bluish tint indicate internal pathology. Babies with a high degree of prematurity may have bluish extremities and the nasolabial triangle area
The baby's body is covered with soft hairs - lanugo. Subcutaneous fatty tissue is not developed, the elasticity of the skin is significantly reduced, it is easy to gather into folds, this sign is especially pronounced in very premature babies

The excretory function of the skin is complicated due to the fact that the sweat glands begin to work only at the age of three months, this can contribute to the child overheating.

Nervous system

The baby’s brain structures are immature, reflexes are weak, and decreased muscle tone is observed. The sucking reflex at birth is weakened or not developed; its development is stimulated with a special acupressure
A disrupted thermoregulation mechanism requires constant maintenance of the optimal temperature for a premature baby. Sense organs are quite developed and function well immediately after birth
Such children often have convulsive syndrome. They have a high risk of developing cerebral palsy, the signs of which are visible from birth, and the final diagnosis is made after 12 months
Due to the high risks of developing pathologies of the central nervous system, premature babies are observed by pediatric neurologists, they are prescribed massage courses for the treatment and prevention of diseases

How long should you walk with a premature baby?

The premature baby should be protected from sudden temperature fluctuations. Babies whose body weight at birth was more than 1.5 kg can be taken out into the fresh air from the age of two weeks, but only in the summer
In the off-season, when the outside temperature is 10 degrees Celsius, you can go for a walk with your baby only from a month, preferably from a month and a half (if the weight is more than 2.5 kg). If the temperature is lower, then you can start walking from the age of two months, when the weight is 2.8 - 3 kg
The walk time is initially 10-15 minutes, adding 5-10 minutes daily, bringing the total time spent in the fresh air to 1.5 hours

Bathing a premature baby

If the child’s body weight at birth is less than 1.5 kg, then bathing is not carried out in the first 3 weeks of home stay. Children with more weight can start bathing within a week. For bathing, the water must be boiled until the baby reaches 3 months of age. The temperature of the water is 38 degrees, the air in the room is 25.

Caring for a premature baby at home

After returning home with the newborn, the mother must provide the child with the most comfortable temperature conditions (23-25 degrees). Housing is ventilated every 3-3.5 hours. To maintain the required level of humidity in the room, wet cleaning is carried out regularly (3-4 times a day)
If the baby needs additional heating, use heating pads with water at 60 degrees, which are wrapped in diapers and placed at the feet (under the blanket) and on the sides (on the blanket) at a distance of 10 cm. The heat source should be constant
The baby's face should be left open. After a month, the child’s own heat exchange is established and the need for artificial heating disappears. The baby's body temperature is regularly measured
A newborn weighing up to 2 kg needs a two-layer set of things and is additionally wrapped in a flannelette blanket, a woolen envelope, and covered with flannel on top. Do not swaddle the baby tightly so as not to restrict breathing. Clothes for him must be absolutely clean and ironed on both sides.

Massage for premature babies

Premature babies are advised to have a massage at home.

The type of massage depends on your birth weight. You can start your first massage sessions no earlier than one month. If the baby was born weighing up to 2 kg, then this can only be gentle stroking; if the birth weight was higher, then light patting, tapping, and kneading can be used. It's worth starting with 5 minutes.

Rules:

carried out no earlier than an hour after meals and no later than 30 minutes before meals
the child should not be sleepy
total duration - about 10 minutes
the room should be warm and well ventilated
if the child responds well, then sessions can be carried out 2-3 times a day
start with light stroking, then add light rubbing and kneading, vibration
First they massage the head, fingers, hands, feet, then the arms and legs and the body itself
movements should be rhythmic and slow
patting and kneading alternate with stroking

Special therapeutic massage is carried out as prescribed by a pediatrician or neurologist and is carried out by a specialist.

Why does a premature baby groan?

A premature baby is born weak and therefore often cannot even cry “fully” when something bothers him, so he may squeak or grunt. The baby can grunt in his sleep and while awake. A baby can make such unusual sounds if his tummy is bothering him (constipation), he is uncomfortable or cold, or he is hungry.
At an older age, he may be bothered by colic and the child grunts and strains at the same time. After all the measures aimed at alleviating the baby’s condition, the groaning stops
In a dream, the baby may groan for the same reasons (discomfort or pain) or due to neurological disorders, so you must tell your pediatrician and neurologist about this phenomenon

Why does a premature baby lose weight?

For babies born prematurely, pediatricians divide the newborn period into three stages, which differ in their course.

The first stage is characterized by weight loss. Regular babies also physiologically lose weight after birth, but premature babies lose much more weight as a percentage - from 10 to 15%, while full-term babies lose 5-6%.

This period lasts the first week after birth and does not depend on the quality of feeding. In the subsequent stages of newbornhood, a systematic increase in body weight occurs.

Temperature of a premature baby

The thermoregulatory system of a premature baby is extremely poorly developed, so its body temperature directly depends on the ambient temperature
Increased heat transfer and decreased heat production easily leads to rapid hypothermia, especially in very premature babies. Hypothermia can lead to rapid development of pneumonia
It is just as easy to overheat a baby as it is to overcool it. Skin vessels do not know how to respond correctly to thermal stimuli, sweat glands are underdeveloped, the thermoregulation center is imperfect - these factors lead to the fact that during the first 4-5 months of a premature baby it is easy to overheat to very high levels - 39.5-40 degrees
This condition is dangerous due to disorders of the central nervous system, convulsive or hemorrhagic syndromes
It is important to know that premature babies may not show an increase in temperature in response to infection; even the most severe pathologies - pneumonia, peritonitis, osteomyelitis - may show a slight low-grade increase of 37.1 - 37.3 degrees
Such features can lead to difficulties in making a diagnosis, so it is extremely important to create an individual optimal microclimate for the baby

How long should a premature baby sleep?

Babies born prematurely are weak and immature and can initially sleep up to 20-22 hours a day. In a dream, a child grows, immature nervous system making up for lost time.

The baby's periods of wakefulness are short, he gets tired and quickly falls asleep during feeding. As you gain weight and regain strength, your periods of wakefulness become longer.

Vaccinations for premature babies

Vaccinations for premature babies have some restrictions based on the degree of prematurity and the weight of the newborn. In general, premature babies are vaccinated according to the schedule approved by the Ministry of Health. If the baby has certain health problems and has medical tests according to indications, an immunologist will prepare an individual vaccination schedule for the baby.

Vaccination against tuberculosis (BCG) for premature infants weighing less than 2000 g is given just before discharge, and not immediately after birth.
All premature babies are vaccinated against hepatitis in the first 12 hours of life. Subsequently, the child is vaccinated against hepatitis three times, without taking into account the vaccination given in the maternity hospital
The first DPT vaccination (against diphtheria, whooping cough, tetanus) plus against Haemophilus influenzae and polio is given on time, at 3 months, then according to schedule

Video: How do premature babies develop?

How does the development of a premature baby up to one year proceed by month? For parents who have the responsibility of caring for such a baby, it is often a matter of life and death. The health and development of a child born prematurely depends largely on the degree of prematurity. The primary role is played by the level of assistance provided medical care. However, the love and resilience of parents is equally important.

Premature babies grow into healthy, strong, smart boys and girls. They do not lag behind in mastering skills, but only develop according to their own pattern. During the first year of life, body weight and length in premature infants increases at a rapid pace compared to full-term newborns. Nature has set them the task of “catching up”, and in some cases “overtaking”.

Groups of premature babies

Group	Gestation period, in weeks	Newborn weight, in grams	Increase in body weight per year, in times
1	36-37	2000-2500	4-5
2	32-35	1500-2000	5-7
3	28-31	1000-1500	6-7
4	Less than 28	Less than 1000	8-10

If a baby is born weighing less than 1000 g, he is called “extremely premature”. Babies of this weight make up less than 5% of all premature newborns. For the life of such a child one has to fight hard and for a long time. All vital functions of his body require artificial support. With modern advances in neonatology, even children weighing 500 g are cared for. But in these cases there is a high percentage of complications and disability. By the way, in Russia, since 2012, there has been a law on compulsory nursing and registration of children weighing 500 g. There is a lot of discussion around this topic, including a moral one.
Particular attention is paid to children born with a body weight from 1000 g to 1500 g. They are called “deeply premature”, but they have a great chance not only to survive, but also to be full-fledged, healthy people. Such children need artificial ventilation, oxygen supply, enteral (through a tube in the stomach) and parenteral (through a vein) nutrition. Hormones, amino acids, enzymes, and glucose are added to special nutritional mixtures, which contribute to rapid growth and infant development.
Special conditions. Children weighing up to 1500 g are not prepared for independent functioning. To nurse them, it is necessary to create conditions adequate to those in the womb. Babies are placed in incubators (incubators) - incubators for premature babies. Here the required temperature and humidity are maintained, the necessary research and support are carried out. Babies weighing up to 1700 g are kept in the incubator and then placed in a heated crib. With a weight of 2000 g, the baby, as a rule, no longer needs special thermal support.
Features of development of a premature baby at 34 weeks. The baby is able to suck on his own. This is an important indicator when caring for children born prematurely. Babies in this group are at risk of apnea - a sudden and involuntary stop in breathing, most often during sleep. Therefore, they need to undergo additional examinations. The causes of apnea are poorly understood. They are associated with muscular, respiratory, and neurological disorders. If there are no complications, the baby quickly gains normal weight and goes home with his happy parents.
Development of a premature baby born at 36 weeks. Such children, as a rule, do not experience any complications. They can breathe and suck on their own. They may not need intensive care. However, such babies must undergo additional examinations and, after discharge, are closely monitored by a pediatrician.
The degree of prematurity is associated not only with weight, but also with the overall maturity of the body. It happens that babies are born weighing 2500 g, but in terms of maturity of organs, systems and functions they are inferior to those who weigh 2000 g.

What does a baby born prematurely look like?

Babies born prematurely have a number of characteristics. External signs appear to varying degrees.

Small weight and height. The length and weight of a baby's body can impress with its tiny size.
Disproportion in the body. The baby has a big head. It is 1/3 of the body length (for comparison, in a full-term baby it is 1/4). The brain part of the skull is larger than the facial part. The belly, relative to its entire length, is also large and spread out. The navel is significantly lower than in full-term babies. The neck, legs and arms are short.
Softness and pliability of the skull bones. The fontanelle is open. Bones can move, cranial sutures can separate.
Softness of the ears. The ears are so soft that they can bend inward and stick together.
Fuzz on the body. The back, shoulders, hips, forehead, cheeks are covered with soft hair. In medicine, this phenomenon is called lanugo.
No subcutaneous fat. The skin of the baby seems to be transparent. You can see blood vessels underneath.
Weakness and lethargy. Physical activity reduced, weak cry, lack of hunger, hypotonia, undeveloped sucking reflex - all these signs in medicine are called adynamia. They only occur in very premature babies.
Weak and short nails . The symptom is less common than the others.
Bug-eyed. It does not appear immediately, but two weeks after birth. Characteristic for children with a high degree of prematurity.
Underdevelopment of the genital organs. Girls may have a gaping genital cleft with underdeveloped labia majora. In extremely premature boys, the testicles have not descended into the scrotum.
No swelling of the mammary glands. It happens in very premature babies.

The listed signs may appear in combination or partially. Some of them can occur even in full-term babies.

When the baby gets home

It depends on the degree of prematurity. He can spend from a week to six months in the hospital. The stages of caring for premature babies are as follows: providing first aid in the maternity hospital; transfer to the pediatric intensive care unit; then to the intensive care unit; From here, if the dynamics are good, the baby is discharged home. The mother can be next to the baby in the hospital, help the medical staff care for her, and bring her. And even take the baby in your arms. By the way, this is one of the most unique and effective ways nursing It's called the kangaroo method. Under what conditions is the baby discharged home?

No complications, stable progress in overall development.
Well-established thermoregulation.
The child does without support and control of breathing and the cardiovascular system.
Able to breastfeed or bottle independently; weight gain has increased to 2000 g.

And one more thing, no less important condition: parents know how to feed a premature baby, how to provide for the baby proper care and where to go if necessary.

Development by months

Table - Increase in weight and height of premature babies by month and year

Age (in months)	4 group (up to 1000 g)		3 group (up to 1500 g)		2nd group (up to 2000)		1 group (up to 2500 g)
Age (in months)	Weight, g	Length, cm	Weight, g	Length, cm	Weight, g	Length, cm	Weight, g	Length, cm
1	180	3,9	190	3,7	190	3,8	300	3,7
2	400	3,5	650	4	700-800	3,9	800	3,6
3	600-700	2,5	600-700	4,2	700-800	3,6	700–800	3,6
4	600	3,5	600-700	3,7	600-900	3,8	700-900	3,3
5	650	3,7	750	3,6	800	3,3	700	2,3
6	750	3,7	800	2,8	700	2,3	700	2
7	500	2,5	950	3	600	2,3	700	1,6
8	500	2,5	600	1,6	700	1,8	700	1,5
9	500	1,5	600	1,6	700	1,8	700	1,5
10	450	2,5	500	1,7	400	0,8	400	1,5
11	500	2,2	300	0,6	500	0,9	400	1,0
12	450	1,7	350	1,2	400	1,5	300	1,2
Weight and height gain per year	≈ 7080	≈ 33,7	≈ 8450	≈ 31,7	≈ 8650	≈ 27,5	≈ 9450	≈ 25,3

Table - Comparative characteristics of motor skills of full-term and premature children

Skills	Child weighing up to 1500 g	Child weighing up to 2000 g	A child weighing up to 2500 g	Full-term baby weighing up to 3500 g
Visual and auditory concentration	3 months	2-2.5 months	1-1.5 months	2-4 weeks
Holds head confidently while lying on stomach	5 months	4 months	3.5-4 months	2.5-3 months.
Rolls over from back to stomach	7-8 months	6-7 months	5.5-6 months.	5-6 months
Starts to crawl	11-12 months	10-11 months	9-10 months	8-9 months
Sits up independently	10-11 months	9-10 months	8-9 months	7-8 months
Stands alone	12-14 months	11-12 months	10-11 months	9-11 months
Walks independently	14-16 months	12-15 months	12-13 months	11-12 months

What to look for when looking at a table?

There is no group of “extremely premature” children. The birth rate of such children is low. The methods of nurturing them are comparable to space technologies, and the stages of development can be greatly delayed.
Average indicators by month are given. Should be considered individual development, genetic predisposition, general health.
After six months, the indicators of premature babies gradually level out to the level of full-term babies. Psychomotor skills develop at approximately the same time, if the baby does not have any complications.

The difference in skill acquisition compared to mature newborns is 1–3
month. This depends on the degree of prematurity of the baby.

1 month . Unlike full-term babies, the baby does not gain weight well during the first month. This is due to weak sucking activity and an undeveloped swallowing reflex. If the baby is at home, the parents’ task is to protect him from exposure to cold, pathogenic microbes, and viruses. Contact with the outside world should be limited.
2 months . Strength is increasing, but it is still difficult for the baby to suck. During this period, there is a noticeable weight gain, which is the main indicator of the healthy development of a premature baby. From the beginning of the second month the baby can.
3 months . Sleep and food are two basic things for a baby at this age. You just need to make sure that the baby does not turn his head to one side and change his position. Also at this age, facial reactions appear; the baby fixes his gaze on his mother’s face and tries to raise his head. He doesn’t smile yet, but he reacts to tactile contact. The grasping reflex, visual and auditory attention develops. Body weight doubles.
4 month. The baby raises and confidently holds his head and makes sounds. Grabs a toy with his hand. During this period, it is possible to increase muscle tone, which is well relieved by massage and gymnastics.
5 month. Holds a toy in his hand. He smiles and begins to show a keen interest in the world around him. Sound and visual reactions are greatly improved. The child turns his head towards the sound and accurately determines its source.
6 month. Body weight triples. The child makes attempts to roll over from his back to his stomach. When communicating, he noticeably perks up, recognizes his relatives, jerks his legs and arms, and roars. If you hold the baby under the armpits, he rests his feet on the surface and squats slightly. After six months, caring for a premature baby is no different from caring for babies born on time.
7 month. Shows activity, easily, on his belly, holds the toy well in his hand. At this age, if the baby was born at 35–37 weeks.
8 month. Makes his first attempts, stands on all fours, tries to swing. All motor skills are conscious and skillful. At this age, he shows interest not only in his own affairs, but also in communication. Understands when he is asked to show an object. The baby is interested in verbal contact - words, intonations, songs, nursery rhymes, fairy tales.
9 month. He sits more confidently and tries to crawl. The need for communication increases even more. The first teeth are cut if the baby is born at 32–34 weeks. Pronounces the first syllables.
10 month. Stands confidently, moves, holding onto support. But for now he gives preference to crawling. Likes to watch moving objects. Reacts quickly to sounds, listens to them, knows his name. At this age, the first teeth are cut if the baby was born before 31 weeks.
11 month. The period of active crawling continues. Although the baby is already able to stand up and sit down confidently. Can stand for a long time without support and even take several steps without support. During this period, he is attracted to cubes, pyramids, and all moving toys. He communicates well with loved ones.
12 month. The baby can walk on his own. This once again confirms that premature babies “catch up” with their peers in development by the age of one year. Sometimes this happens later - at one and a half years. Pediatricians note that in physical development Premature children succeed more than in neuropsychiatric. The age-related maturity of neuropsychic processes in such children can be formed by 2–3 years. These indicators are within normal limits.

What do you need to know about the features of medical monitoring of premature babies? Required: weekly observation by a pediatrician for 1 month, then twice a month for up to six months; monthly determination of hemoglobin level to prevent anemia; prevention starting from 2 weeks; quarterly consultation with an orthopedist and neurologist. Additionally, in the first year of life, consultations with a physiotherapist, ophthalmologist, otolaryngologist, cardiologist, and endocrinologist will be needed.

Features of care: 6 important points

A premature baby requires more attention and precautions when caring. Which ones?

Parents need to stock up not only with knowledge and skills, but also with patience, love and faith in their baby.

Separately about feeding

Feeding premature babies has a number of features that parents need to know about.

. After discharge, the baby should be able to latch and suckle on his own. In the first months, the baby still has little strength, and the energy expenditure during sucking is high. Therefore, it is recommended to supplement him with expressed milk from a spoon. The main task of the mother is to feed the child for as long as possible.
Artificial feeding. If breastfeeding is not possible, use adapted mixtures for premature babies with a high content of protein, vitamins, fatty acids. It is imperative to consult a pediatrician when choosing a formula for your child.
How many times should you feed your baby? Depending on the degree of prematurity: from 10 to 20 times a day, in fractional portions. When the baby begins to gain weight from the second month of life, 8 feedings per day will be enough.
Upon discharge, parents receive a number of recommendations from neonatologists and pediatricians. It is important to comply with care requirements and not engage in amateur activities. It is also important to know: the development of a premature baby by month depends on the degree of prematurity. The higher it is, the more time the baby will need to develop psychomotor skills.

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Babies with a height of less than 45 cm and a weight of less than 2500 g, born before 37 weeks of pregnancy, are considered premature. Their respiratory, cardiovascular and thermoregulatory systems are still immature, so these babies require medical supervision and special care. And first of all, mothers think about how to gain weight for a premature baby.

How do premature babies gain weight?