Exceptions to Developmental Milestones: Two to Five Months
If your infant came home from the NICU on supplemental oxygen, feeding tubes, and/or a large number of medications, she may not be able to put forth much effort to accomplish developmental milestones at this time (just like you would be unlikely to get up and learn a new dance step if you were home in bed with the flu or just recovering from surgery). If your child is still in the NICU at 2-5 months of age her developmental progress will definitely be affected by her health status.
When a child has had early medical complications, her use of muscles for movement is likely to be affected. A baby may not have the strength to kick her legs, or repeatedly reach for an object. One way to help improve these skills is to provide extra support to facilitate movement. Placing a rolled diaper or blanket behind the shoulders or under the upper thighs can place limbs in positions so they can be more easily used. Rolls placed behind the shoulders move your infant’s arms and hands towards the middle of the body, helping maintain a position to look at a hand or swipe at a toy. Rolls placed under your infant’s upper thighs cut down the strength needed to lift and kick her legs. For some children, holding an object placed in their hands is too tiring. If the object is fastened lightly in the hand with a Velcro strip, the baby can look at the toy, bring it to her mouth or shake it without having to use much energy.
Infants who have medical problems can easily get overwhelmed by social stimuli. The baby may fuss or turn away when being spoken to or when looking at an adult. The baby may be able to listen but not look, or look but not listen. Combining both looking and listening or looking, listening and eating can cause the infant to become distressed. You may need to start out doing only one thing at a time with your baby (see Increasing Social Tolerance). Watch for signs of what your baby seems to like and gradually add to and expand her skills.
If your child has a significant vision problem it is important to become involved with a program that will help you with reading your infant’s cues and in stimulating your baby. Vision is a great motivator for young infants. An infant’s facial expressions, especially the eyes, are an important avenue for parents to connect and communicate with their baby. Look to the baby’s hands to tell you what the baby is feeling. Are the hands suddenly still when you talk, indicating the baby is listening, or do they opening and closing in excitement? (Vision Impairment, Vision Resources).As your child’s health becomes more stable her development should progress. You should notice a steady increase in abilities even if it is at a slow rate. Once your child is eating, gaining weight, is off oxygen or off medications, she should gradually progress towards a level of performance you would expect for her corrected age.