Milestones in the NICU

Tonight, I made the mistake of googling milestones babies are expected to reach by the time they are one month old. Nick will be officially three months old this Monday, but, since he was born over two months prematurely, everything but his vaccination schedule will be based on his adjusted age (meaning he is expected to act like a baby who is just about one month old.) Stupid, I know. I should have learned during my time on bed rest and in the NICU not to google worst case scenarios or listen to advice that doesn't come from a medical professional, and I know "normal" babies reach different milestones at different times and it doesn't necessarily mean anything, but still, I was curious.

According to parents.com, these are all milestones babies are supposed to reach by the time they are three months old:

1. Watches face intently: Nick does not even make eye contact with me. His pediatrician did say he has a lazy eye at his last appointment, so maybe that is why, but even when I am feeding him and his face is inches from mine, he doesn't seem to realize I am there and seems to just look through me.

2. Smiles at the sound of your voice: No. Maybe it is because Nick's constipation is making him so miserable, and maybe this will change once he has his appointment with the pediatric GI doctor and they get to the bottom of what is going on, but I have never seen Nick smile. 

3. Begins to develop a social smile: Again, big no on that one.

4. Supports upper body with arms when lying on stomach: Nick is doing a good job with tummy time and holding his head up, but he isn't at the point yet where he can support himself with his arms. 

5. Follows moving objects: Another no for this one. He did love the mobile his nurses placed on his isolette while he was in the NICU, but again, he just seems to look through things instead of focusing on them.

6. Begins to babble: No. Nick grunts, moans, and strains all day because he is trying so hard to poop, but definitely no babbling or coos. 

7. Becomes more communicative and expressive with face or body: Unless you count grunting, no. 

8. Starts using hand and eye coordination: This seems a little advanced for babies that little, but I haven't seen Nick bring his hands to his face at all, or even realize his arms are connected to his body at all. 

9. Imitates some movements and facial expressions: No, and I can't imagine Nick doing that any time soon.

Also, according to this website, formula fed babies are supposed to poop around two times a day. WHAT. Nick poops maybe twice a week, and that is after using suppositories and prune juice. So I am not totally crazy to be worried about this. 

I know, with his adjusted age,  that Nick has two more months until he is expected to be doing all of these. I know that even if he can't do all of these by July, it's not necessarily indicative of a problem. I know I know I know. But still. My biggest concern is that Nick does not seem to interact with me, or even realize I am there. The only time he ever really cries is if he's waking up in the middle of the night and is hungry and hasn't ate for a few hours, or when he's straining and trying to poop. The best way to describe Nick is that he is very expressionless. He's definitely not a happy, social baby, but he isn't a colic or fussy baby. Maybe fixing his constipation will make all of these things fall into place, and, once again, I know in the world of preemies, I am very lucky that this is all I am worried about. 

It also makes me really sad to think that, based off his actual age, Nick should be able to do all of these things already. I know this isn't fair to him, but if I were to compare Nick to the other babies born on Valentine's Day like him, they have likely reached, or are close to reaching, all of these milestones right now. When I read this list to my husband, he said "well, they (meaning the physical and occupational therapists from the NICU) said he might be behind." Of course, I know he is right. I know that while Nick was on oxygen and eating from a feeding tube, these babies went home with their parents within 48 hours of being born (!!!), and never had to worry about destats or bradycardias or adjusted ages. Anger was never a big emotion for me during the NICU, even though I can DEFINITELY see why it would be. I think this is because I got to experience two "normal" pregnancy and deliveries, so I didn't really get the feeling that I was missing out on anything (plus, Nick never had any huge health concerns.) But, as a primary grade teacher, I have taught students who had rocky starts to their lives for different reasons, and I know how important these first few months are and how greatly they can impact your for, literally, the rest of your life. I wrote about this in my piece that will be published on The Mighty sometime soon, but the guilt of knowing Nick could be impacted by his prematurity for the rest of his life, and knowing he was born prematurely because my body dropped the ball so massively, makes it really hard to read milestone checklists like this.