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From Diapers to Dating - Will My Preemie Ever Grow Tall?

Parents' concerns for the growth of their children born prematurely.

By Allison Martin

When you first look into the isolette at your tiny child or wrap your baby with miniature preemie diapers, it is hard to believe that they will ever be bigger.

Joyce, a mother of premature twins describes,

"I was afraid they'd be abnormally small and remain the funny -looking little trolls they were when they were born at 25 weeks. I really didn't believe they'll ever be "normal" looking."

Our preemies start very small and stay tiny for quite a long time. But will they really "catch up" in size like everyone seeks to reassure us?

It isnít possible to answer this question for each individual child, because there is so much variability among children and among factors effecting preemies growth and development. But there are some general rules which will provide some clues for your unique child.

First of all, eventual size is determined to a large extent by genetics. If you and your partner are tall, your baby is most likely to be predisposed to be tall also. And vice versa for those (like myself) who are shorter in stature.

In addition, food intake as babies and children grow is also a factor. This issue begins in the NICU. As many parents who have preemie babies, toddlers and preschoolers know - feeding can also be quite an issue for growing preemies. But there is some good news.

Many preemie babies and toddlers actually grow faster than average and seem to "catch up" with children who were born at normal development. "85% of premature infants have catch-up growth and land on the regular growth chart by two years of age," according to Dr. Raye-Ann deRegnier of Children's Hospital of St. Paul and the University of Minnesota.

Some children may not catch up during this period because of developmental issues, residual illnesses or susceptibility to infections or other ailments. However, there is apparently a second "catch up" phase around adolescence. A new article in the Journal of Pediatrics (June, 1998) describing adolescent growth of 32 extremely premature children states that "45% of all the children grew faster than normal between 8 years and 12-18 years".

What concerns do parents have about these their childrenís smaller size?

A mother of 15 month old twins shares her thoughts,

"I worry that my children will always be smaller than other children their age and I also worry what others say to them. It hurts me to have to explain to everyone who asks, "How old are they?'' "Why they are soooo small?" I hate the questions or the look as if I am not feeding my children enough."

If your child has developmental issues or other impacts related to prematurity, your anxiety can be heightened even more.

Laura, the mother of a two year old with mild physical disabilities and feeding disorder, shares her experience,

"Overall, my concerns are not about how big he is or how big he'll be, but more about how healthy he is and will be. I am very concerned about his nutrition and related development. I hold my breath every time he gets on the doctor's scale. It seems to be the ultimate test of my worthiness as a parent."

Sometimes your older child will be teased for their size. But we also find out that our children can compensate in amazing ways, given a base of confidence and support.

Janet, the mother of a preemie son who is now 9 years old, describes the concerns she used to have over her sonís size,

"Being the smallest in class (I was the smallest, too -- so I know how it affected me) usually brings some kidding such as "How's the weather down there?" or nicknames such as Peanut and Half-Pint. I think small size is even worse for boys, because the bully types (who are usually much bigger) tend to pick on the smaller ones. Also, sports is very important for most boys, and the smaller boys usually aren't as physically developed as the larger ones -- resulting in fewer opportunities to play or excel in a lot of sports, even on Little League teams."

But as her son as grown, Janet finds that he has been able to compensate and adapt to his situation,

"He really does "stand up" for himself quite well and did finally earn some respect in Physical Education last year in third grade when he consistently won jump rope contests and a long-distance run. While bigger boys have more size and muscle for the "hero" sports such as baseball and football, his compact size and aerobic ability gave him the advantage."

In closing, Laura's words apply to many of us,

"As for Ďmy soní and his future, he's come a long way, so I don't think he'd let a "little" thing like size ever hold him back from doing what he plans on doing."

© 1998 Copyright Allison Martin

Allison Martin, MPA, is the listowner of Preemie-Child and the owner of the Comeunity website. This article originally appeared in Early Editions, an online newsletter for parents of preemies.

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