Your Preemie’s Gross Motor Development

When you’re expecting a baby, you spend the months leading up to their birth envisioning what life will be like. You do your best to plan and prepare, but if there’s one thing babies are good at, it’s throwing curveballs. Parenthood is a lesson in learning to expect the unexpected, and it’s one that you learn early on if your baby is born prematurely.

Babies who are born before 37 weeks gestation are considered premature Because premature babies, also referred to as preemies, are not as developed as full-term babies at birth, their growth and development looks a little bit different. To get an idea of what to expect from your preemie’s development, you should first calculate their adjusted age.

What is adjusted age?

Adjusted age, or corrected age, is a more accurate way to assess whether your preemie is developmentally on track. It accounts for their prematurity and gives you a better idea when they should be reaching developmental goals. Rather than tracking your preemie’s milestones by their actual age, you use the age that they would be if they had been born on their due date.

How do you adjust for prematurity?

To calculate your preemie’s adjusted age, you need to consider two things: their due date and their birth date. Using weeks or months, take their chronological age (the age they are right now) and subtract the weeks or months preterm. For example, if your baby is 15 weeks old but was born 9 weeks early, their adjusted age is 6 weeks.

Tracking gross motor milestones

Use your preemie’s adjusted age to see if they’re developing on track. If your preemie’s actual age is 4 months but their adjusted age is 2 months, you can expect them to reach the gross motor milestones of a 2-month-old and not a 4-month-old.

Birth to 2 months

• Turns head left and right while on back

• Lifts head and is able to turn it left and right during tummy time

• Head lag with pull to sit

• Kicks both legs and moves both arms while on back

3-4 months

• Raises head in line with trunk when pulled to sit

• Pushes up on forearms while on belly

• Rolls from belly to back

• Tolerates tummy time well

• Brings hands to midline

• Bats at toys

5 months

• Rolls from back to belly

• Brings feet to mouth when on back

• Pushes up on hands with arms extended while on belly

• Pivots in a circle while on belly

• Sits briefly with support

6-8 months

• Catches self with loss of balance while sitting

• Crawls on belly

• Reaches for toys while sitting

• Sits independently

9-11 months

• Crawls on hands and knees

• Cruises around furniture

• Transitions between laying down and sitting upright

• Pulls to stand

• Sits independently with trunk rotation

12-15 months

• Assumes tall kneeling

• Walks on knees

• Walks independently

• Stands without support

• Crawls up on chairs or other furniture

16-18 months

• Walks up one step at a time with hand held

• Creeps down stairs

• Walks with a heel-toe pattern

• Walks sideways and backwards

• Runs

When will adjusted age no longer matter?

All babies grow and develop at their own pace. Even among full-term babies, there’s a wide age range for what is considered typical in gross motor development. Where one baby may be walking at 9 months old, it’s still completely normal for another baby to not take their first steps until 15 months old. The more premature your baby is, the longer they may need to catch up on gross motor development. However, most preemies catch up to their full-term peers by 2 years old!