By Angelia Fenton

Dear Family,
I am so excited to be going home. I am also a little scared. It is okay if you are feeling a little scared too. Even if I have had a big brother or sister, I may be different because I was born so early and so small. I decided to write this list of activities that can help preemies like me learn how to use our bodies and minds as we grow. These activities can be done anywhere and anytime, as we go about our normal routine. Not only are they good for my development, but also they are great ways for us to get to know each other. I cannot wait to get home and spend lots and lots of time with you.
Love always,
Your Baby

Preemie Development

The word development refers to the stages I go through as I learn new skills and mature. Typically, children reach developmental milestones (such as walking and talking) in a similar order and at certain ages.

However, there is often variation in the rate and age that children develop skills. Preemies, like me, often develop differently from babies who were born full-term. I may look and act different from other babies my age, so it's important not to compare me to them.

Corrected Age versus Chronological Age

Since I was born early, I will have two different ages while I'm little:

1. Chronological age is based on the day I was born
2. Corrected age is based on the day you expected me to be born

For example -- Today's date is June 2, 2000. My birth date was February 2, 2000, and I was 3 months early.

• My chronological age would be 4 months
• My corrected age would be 1 month

When looking at my growth and development, use my corrected age. So, I should only be expected to do what a 1-month-old can do.

Differences in Preemie Development

Below are some of the things that I may do because I was born before my body was ready:

• Straighten my arms and legs, arch my back, and stretch my head back
• Push my shoulders back and/or up towards my ears
• Cry one minute and then fall asleep the next, or look awake and alert and then suddenly start to cry
• Move my arms and legs in a jittery way
• Sleep most of the time
• Get startled by noises, lights, and touching

Understanding My Signals

There are many ways that I can tell you if I'm happy or not. You probably know many of them already. By spending lots of time watching me and holding me, we can get to know each other even better.

The following list some of the signals I may use and what they may mean.

I am happy and ready to interact:

• My eyes are open and I have a bright look on my face
• I look relaxed
• I coo and/or move my mouth like I want to smile
• I look at your face or an object without turning away

I need a break from interacting or I am upset:

• I look away
• I am frowning, grunting, or my forehead is wrinkled
• I am yawning, sneezing, spitting up, or get the hiccoughs
• I am saluting (straightening my arms and spreading my fingers out)
• I arch my back, push my head back, and try to kick away with my feet
• I am waving my arms and legs around in a disorganized way
• I close my eyes and fall into a light sleep
• I start to breathe faster or slower
• My skin color changes

Developmental Activities

As I mentioned earlier, the activities that follow can be done anywhere and at anytime of day. You don't need any special equipment or training to do them with me. We can just have fun.

Tummy Time
I need to spend time on my stomach everyday. You can lie down in front of me and talk to me, or put a mirror or brightly colored toy near me, so I have something to look at. It is a good idea to start tummy time as soon as I leave the hospital. If I don't learn to do it early, I may not like it later on.

Remember:
I should be awake and supervised during tummy time.

Keep Me Flexed
I need to be held and positioned so that my arms and legs are tucked in close to my body.

Midline Activities
It is important for me to learn how to use my hands in the middle of my body. Give me lots of opportunities to do the following:

• Bring my hands and fingers together
• Bring my hands up to my mouth
• Bring my feet together

In the beginning, I may need help doing these things. You can help me by letting me grasp your finger, or putting a small, light toy in my hands.

Head Positioning and Shape
I may have the tendency to turn my head to one particular side. It is important that I learn to look both right and left so I can equally use both sides of my body. In addition, turning my head in different directions will help it to have a nice round shape.

For all activities, make sure I get time looking right and looking left.

For example:

• Periodically change the position of my crib so that I can see the action in the room from different directions.
• Alternate the arm you hold me in when I am eating
• When holding me on your shoulder, make sure I alternate the direction my head is turned

Experiences with Textures
Let me touch and play with a variety of textures and weights.

For example:

• Soft things (stuffed animals, cloth diapers, etc.)
• Hard toys (rattles, teething rings, etc.)
• Uneven or rough surfaces (a washcloth, etc.)
• Hanging Out with My Toys

Hang objects above me in the crib or when I'm playing on the floor. Mobiles and crib/floor gyms work well for this activity.