Your Preemie's Growth and Development: 2 and Up

Medically Reviewed by Renee A. Alli, MD on June 16, 2021

By the time they're 2, your preemie has come a long way. It may be hard to believe that your child -- maybe a noisy, strong-willed toddler already -- is the same person as that tiny, fragile baby you anxiously watched over in the hospital.

What comes next? As they grow, most preemies become healthy children. But some continue to have health issues. And even kids that do well generally may have lasting health effects years and even decades later.

There's no way to know exactly how your child will grow and develop. In general, the earlier your child was born, the more likely they are to have lasting health issues. Watch out for signs of problems so you can get your child the care and treatment they need.

Your Preemie's Long-Term Health

If your child was born prematurely, they have a higher chance of some of these health concerns:

Growth problems. Kids who were born at less than 32 weeks of pregnancy -- what doctors call "very premature" -- are likely to be shorter and weigh less than other kids.

Learning disabilities. Some preemies have lasting problems with how they think and learn. About 1 in 3 kids born prematurely need special school services at some point.

Behavior problems. As they grow up, preemies may be more likely to have attention deficit hyperactivity disorder (ADHD) than full-term babies. They're also more likely to be shy or anxious.

Breathing problems and asthma. Lots of preemies need help breathing when they're born, since their lungs aren't ready yet. While these issues often go away, some babies born prematurely have lasting asthma or similar problems.

Other health conditions. Some preemies have more serious long-term complications. One example is cerebral palsy, which causes problems with movement and balance. There's no cure, but it can be managed with treatment. Other kids may have lasting problems with their vision, hearing, and digestive system.

Remember, your child may not develop any of these problems or may outgrow them. But being aware that they have a higher chance of having them is important. If you notice signs, you can get help from your child's doctor. The faster your child gets treatment for any problems, the better.

Your Preemie in Early Childhood

While your child might have been treated for lots of health problems in the hospital when they were born -- like apnea, reflux, and jaundice -- most if not all of those should be gone by now. Experts say that in terms of growth, most preemies are more or less caught up to full-term babies by age 3. When your child is still young you can:

Keep track of your baby's developmental milestones. Milestones are skills your child will learn, like riding a tricycle or walking up the stairs on their own. They're often linked with the average age kids are able to do them. When preemies are young, doctors use their "corrected age" -- based on their original due date -- instead of their birthdate when checking milestones. But by age 2, most preemies have caught up enough that you can start using their actual age.

Remember that milestones are just rough averages. All kids develop differently, whether they're full-term or premature. It's not a big deal if your child doesn't meet a milestone exactly on schedule.

Get help if you need it. If you do notice your child seems to be lagging behind, talk to their doctor. Make sure to ask about a state program called Early Intervention. It offers special services to help babies up to age 3 who have higher odds of developmental delays or disabilities. Some of these services are free. Other options include referral to private therapies such as physical therapy, occupational therapy, feeding therapy, and speech therapy.

Getting Your Child Ready for School

Watching your child go off to school is exciting -- and stressful, too. To help make the transition smoother and give your child support, you can:

Get in touch with the school early. Before your child starts school, talk to the staff -- like their teacher or the principal -- about their health issues and concerns you have. Ask questions about the school's special education programs. If your child's teachers understand their needs, they'll be better able to help them succeed.

Be alert for any new problems. Sometimes, learning disabilities or behavior problems only show up once a child starts school. If your child seems to be struggling, work with their teacher -- and make sure your youngster gets special services if they need them.

Gradually give your child more independence. After you spend so much time caring for your child, it can be hard to let them go off on their own. But you have to find a balance between protecting them when they need it and giving them the freedom they need to grow.

As Your Preemie Grows Up

Will the effects of being born premature last into your child's adulthood? It's possible. Some studies have linked being a preemie with a higher chance of getting conditions like diabetes, high blood pressure, and lung and vision problems in adults.

But again, remember that your child only has a higher risk of these problems. They may not develop any of them. You can look at being born premature as another thing that may raise your chances of health issues, like a person's genes, habits, home life, and lots of other things. After all, plenty of adults who weren't born prematurely develop the same health conditions.

The most important thing for a child who was born prematurely is to get good, consistent care -- both as a child and an adult. Being a preemie can create barriers to your child's development. But with the help of the right experts -- doctors, specialists, therapists, and others -- you can often find ways to work around them.

WebMD Medical Reference



Zaichkin, J. Understanding the NICU: What Parents of Preemies and Other Hospitalized Newborns Need to Know, American Academy of Pediatrics, 2017.

California Childcare Health Program: "What to Expect from a Preemie in the First Year."

March of Dimes: "Long-term health effects of premature birth," "The impact of premature birth on society."

UpToDate: "When a Baby Is Born Premature: The Basics," "Growth Management in Preterm Infants," "Long-term Complications of the Preterm Infant."

UK Healthcare: "Short and Long-Term Effects of Preterm Birth Fact Sheet." "Health Issues of Premature Babies," "Watching for Complications," "Preemie Milestones."

Mayo Clinic: "Premature Birth."

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