By- Beyona Rachel- Occupational Therapist, Prayatna-Kochi

A preterm or “preemie” baby is one born too early, typically around three weeks or more before the expected due date. While full-term pregnancy lasts about 40 weeks, preterm births occur before 37 weeks of pregnancy. Due to their early arrival, preemies are often smaller in size, have low birth weight, may struggle to maintain body temperature, and could face challenges with vision, hearing, feeding and overall development.

Types of Preterm Babies

Types of preterm- Preterm births fall into four categories according to their gestational age:

· Late preterm (34-36 weeks): Most preterm babies are in this category. They often look similar to full-term babies but will have difficulty with issues with feeding, maintaining body temperature, and have a slightly higher risk of respiratory problems. Though they are healthier than earlier preemies, they may still require close monitoring and specialized care.

· Moderately preterm (32-34 weeks): Babies born in this category are at higher risk for health complication. They will need assistance with breathing, temperature maintaining, and feeding. With the right care, many moderately preterm babies will lead a normal life, but they may still face developmental or health challenges in early life.

· Very preterm (born before 32 weeks): These babies are born much earlier than the planned date. They suffer from significant underdevelopment. Their lungs, brain and digestive system may face many health risks. Intensive care is often required in this stage.

· Extremely preterm (born before 25 weeks): Babies born at this stage suffer from serious complications. They are born well before many vital organs are fully formed. While survival rates have improved with advances in medicine, extremely pre-term babies may face long-term health and developmental issues.

Each stage of premature birth requires care specifically designed to address the unique challenges of that stage.

Key Risk Factors for Premature Birth

· Are expecting multiples (twins, triplets or more).

· Are under the age of 17 or over the age of 35.

· Having a family or personal history of pre term births.

· Smoking, drinking alcohol or using other substances while pregnant.

Developmental Patterns and Tracking

If you’re wondering, “When do preemies catch up?” It’s important to remember that every baby is unique and grows and develops at their own rate, whether full-term or premature. While each journey is unique, professionals use adjusted (corrected) gestational age to track developmental milestones for premature babies. By creating a nurturing and supportive environment, engaging in gentle developmental activities, and staying vigilant with regular healthcare appointments, parents can help their preterm baby thrive. Occupational therapy (OT) plays a crucial role in supporting preterm infants and their families, both in the Neonatal Intensive Care Unit (NICU) and during early development at home. Here’s how OT contributes:

· Positioning and Handling: OT assists in positioning the infant to support joint alignment, prevent deformities, and enhance breathing. Gentle handling techniques also help promote self-soothing behaviours and improve body awareness.

· Feeding Support: Many preterm infants struggle with feeding due to weak sucking, swallowing, and breathing coordination. OT helps assess and support oral motor skills and feeding positions for baby and mother.

· Sensory Regulation: Premature infants often have underdeveloped sensory systems. Occupational therapists help with sensory regulation by adapting the NICU environment to reduce stimuli like bright lights and loud noises, creating a more womb-like setting to promote calmness and comfort. They also educate parents on sensory-enriching activities, such as gentle touch, swaddling, or appropriate stimulation, to promote the baby’s comfort and sensory development both in the NICU and at home.

· Motor Development: Preterm infants are at higher risk for motor delays. OT assesses and works on fine and gross motor skills, using age-appropriate activities to encourage movement, reaching, and grasping etc.

· Parent Education and Empowerment: OT educate parents on handling techniques, safe positioning, and developmental activities to practice at home. They also provide guidance on developmental milestones, the importance of tracking development, and fostering parent-child bonding. The focus is on empowering parents and building their confidence to support their child’s growth effectively.