Premature infants are, by definition, born prior to 37 weeks gestation. When a baby is born prematurely, the medical staff completes a series of assessments to evaluate their health and development. Premature infants are at a higher risk of complications due to underdeveloped organs and systems.
With technological and medical advances and the important role of early intervention services, the outlook for premature infants has improved, especially over the past 20 years. Survival rates for an infant born at 28 weeks were estimated to be 70-80% in 2005 and are now 94-95%.
From Specialized Medical Care to Going Home
For any parent, bringing a baby into the world can be both exciting and stressful. For parents and caregivers of premature infants, the concerns are heightened. Depending on how premature the infant is, families may spend weeks or months in the NICU and/or the special care nursery where their baby is on monitors 24×7 with the care and treatment of a highly specialized medical team. Finally, it’s time to go home. A major milestone that typically is a mixture of excitement and anxiety. Gone are the team of medical specialists and the 24×7 monitoring. Now what does the family do?
Generally, families of premature infants born in a hospital will receive a referral for early intervention services prior to the family leaving the hospital. Families are provided with various ongoing resources including possibly medical and developmental monitoring through NICU follow-up clinics post discharge and from the infant’s pediatrician. At Partners in Child Development, our Early Intervention Programs serve the Greater Lowell and Greater Lawrence communities with services to families and their premature infants as soon as they leave the hospital but also based on what the family would like for support.
Early Intervention Services for Premature Infants
At Partners in Child Development, our Early Intervention Services begin with a developmental evaluation and following that evaluation, services are provided at the infant’s home with the parents and/or caregivers of the baby. Typically, our services are provided once a week, but the frequency is determined by family needs and preferences.
For premature infants, the focus of our Early Intervention Services is on supporting and educating the parents and caregivers while also working with the premature infant to monitor and support their development. Support for the family is especially important as often, and understandably so, the family is worried and sometimes overwhelmed.
Our services include supporting and educating caregivers, including siblings, completing ongoing assessment of milestones, and/or connecting mothers to available resources. Risks of postpartum depression tend to be significantly higher for a mother having a premature infant and the emotional toll on the family can be significant.
While causes of premature births can vary, multiples are often born early. Many of our Early Intervention families (EI) with premature births have had twins. Whatever the reason why a baby arrives early, at Early Intervention Services we embrace a coaching model to provide ideas and suggestions to the family to help support the infant’s development. This includes recommendations and suggestions to incorporate into the regular routines of their day to try between our visits. During the following visit, we discuss what is going well and what is still a challenge and revise recommendations and suggestions to successfully support their development.
Common Focus Areas of Early Intervention Services for a Premature Infant
Our experience has shown that premature infants commonly have risks of developmental delays for feeding and motor skills. Our Early Intervention Services are designed to assess and assist with any identified developmental delays or risks.
Feeding
The growth of any baby is dependent on feeding and Early Intervention Services assist parents and caregivers with feeding once they are home. Alexis Latsey is a Registered Nurse at Early Intervention Services and offers support and advice for parents and caregivers including those with premature infants. Her role on the EI team with respect to feeding is focused on assessing an infant’s skills and preferences, assisting if the baby is having challenges coordinating their sucking-swallowing-breathing, following through on recommendations from their pediatrician, and helping families to read their baby’s cues as they grow so the baby is getting the nutrients needed to fuel their growth.
During home visits, Alexis is a resource for the parents and caregivers to answer any questions. She may observe breast feedings if the mother is comfortable with her doing so. Alexis may also consult with other EI specialists such as occupational therapists for additional feeding support. With ongoing visits, the family builds a relationship and comfort level with the support from EI as the family settles into their new routine.
As the baby grows and transitions to solid foods, Early Intervention Services provides support and guidance to help the family and the baby with that transition.
Motor Skills
Premature infants are at a higher risk of delays with respect to motor skill development. Early Intervention Services provides support and therapies to assist families with premature infants with assessing and developing motor skills.
The EI support team may include a nurse such as Alexis or a physical therapist such as Cindy Pelletier who has worked with the pediatric population for her entire career.
These skilled and highly trained specialists work with families and their preemie to assess, monitor, and support a baby’s development of motor skills. Important target areas that will be assessed and monitored with a premature infant include:
- Symmetry of movement (comparing the right and left sides of the body)
- Muscle tone
- Newborn Reflexes
- Head control
Nicole, a mother of twins born at 28 weeks describes the benefits to her premature twins and her family from the services provided by Early Intervention Services: “The therapists were warm, knowledgeable, and amazing. We trusted they had our daughter’s best interest in mind as they continued to listen, adjust, and address all our concerns through almost three years working together…we strongly believe that the care the girls received through EI has played an essential part in their overall growth and development.”
Conclusion
While the experience of bringing a premature infant or infants home may cause anxiety and concern, Early Intervention Services offer support, encouragement, and therapies to help the families while helping their premature infant grow and develop.
“Early Intervention Services was the greatest gift in the early part of our twins’ lives. For me, our physical therapist was truly wonderful. She focused on how the twins were doing and how I was doing; listening attentively and reassuring me every step of the way. We are eternally grateful for Early Intervention Services and their help in our girls’ development and in the support provided to our family.”
Anne, mother of premature twins, Andover, MA
Read the brief story of these premature twins.
While initial developmental progress is measured comparing the preemie’s adjusted age to chronological age, over time the gap is usually closed. Typically, by two years old, children born prematurely are meeting developmental milestones.
Getting Started is as easy as 1,2,3.
