The first year with your preemie often involves juggling many check-ups and appointments. Because our babies’ brains and bodies are so plastic, early intervention is a critical tool for supporting preemies. Premature babies are always evaluated based on their ‘adjusted’ age rather than their actual age. This means that if your baby was born at 32 weeks, when they are two months old (8 weeks) they are evaluated as a newborn.

Dr. Yasmin Lyons is a pediatrician who has worked extensively with preemies. She emphasizes that: “Often the baby is doing what is completely normal for their corrected age, and it’s important for parents not to compare the progress with that made by other babies.” You’ll quickly decide who to talk to about your baby being a preemie. Margie, a mother of a preemie born at twenty weeks, told me: “I just always gave the adjusted age of my preemie because I just didn’t want to have to have the whole conversation with strangers."

As parents of preemies, we start feeling more confident when we see our baby eating and reaching textbook milestones. This can vary dramatically depending on how premature our baby is. In other words, a “30-weeker” will have a very different roadmap in the first year then a “34-weeker.” Hospital preemie clinics can be a good resource for reassurance. Premature baby clinics in addition to a pediatric neurologist often include an occupational therapist and a physical therapist, allowing a more thorough evaluation of the premature infant. Susan, a mother of a 33 week preemie, told me: “I was worried because Isabel wasn’t holding her bottle. The neurologist at the preemie clinic told me, ‘Oh she can totally do it, she is just choosing not to!’ I was so relieved that she was on track and making her own decisions!”

The most important thing to understand is that your preemie will always be evaluated at their ‘adjusted’ age, allowing an equal playing field in the evaluation. Based on adjusted age, your doctor will be looking for the following things:

At three months: Gross motor skills: open hands, some holding/grasping, some neck control, visual tracking (i.e., following an object or person with their eyes), cooing vowel sounds, smiling.

At six months: Gross motor: rolling over, head control, pushing with their legs while you are holding them, spinning on their stomach, holding toys and shaking, bringing toys to their mouth, lots of prolonged eye contact, engaged with those around them.

9-12 months: Gross motor skills: “the army crawl” (pulling themselves forward on their tummy), sitting up on their own, holding and shaking toys, pulling upright. Language progresses to consonants and vowel sounds strung together, with a few words identified. Smiling and laughter is a regular part of your life.

As a general rule, pediatricians give premature babies a wide margin to be reaching targets based on how premature they were. Variations within a twelve week range can be normal, yet with good intervention concerning physical, occupational, and speech therapy, almost all premature babies are deemed “done” with being “premature” by 24 months!

With a preemie, it is important to understand that the first 100 days at home need to be treated like a “fourth trimester.” This means low stimulus, few visitors, and staying cozy.

As most babies will be discharged when they are exhibiting stable newborn ability and behaviors, your first three months caring for a preemie need to be treated as the “newborn phase,” regardless of the child’s age. Parents need to take time to get used to the physical around-the-clock effort of being a parent. It is realistic to expect your preemie will sleep more than the average newborn, yet will probably wake at more frequent intervals for feeds.

A lot of what your baby is doing may look random to you, but he or she is actually making small developmental steps every day, such as holding eye contact for longer and longer periods, slowly waking up for calmer and more alert periods, and moving (kicking legs and waving arms) in rhythm to your voice.

Feeding and weight gain is still a critical issue and your pediatrician will be watching weight carefully in your baby’s first two weeks after discharge. If you are bottle-feeding, it is easy to see if the baby is getting enough milk, but if you have transitioned to breastfeeding, frequent weight checks can help ensure that your baby is getting proper milk transfers. There can be challenges when premature babies first start nursing. Ayelet Kaznelson, an IBCLC lactation consultant, comments, “After a baby has been discharged, we can sometimes see a weight drop after two weeks. We really want to ensure good milk transfer, but not all preemies may be strong enough.”

Skin-to-skin contact in the early weeks at home is one of the best things you can do with your preemie. Undress your baby (except for their Pampers diaper), then lay them on your chest with their head on your left side (to hear your heartbeat!), and cover them with a blanket if needed. This “kangaroo care” fosters anti-stress hormones in your premature baby, as well as aiding in neurological development -- and that’s without the tired parent having to do very much! It’s nice to know that this helps them grow and cope, just while gently holding them!

We often worry whether we will be able to care for our little ones, especially when they’re preemies. One of my students, a mother of twins born at 32 weeks, describes the moment at which she knew everything would be okay: “We had brought Annabel home three weeks before little Natalie. When Natalie came home, I remember sitting with both of them on my lap, each only four pounds, wondering how I would ever be able to care for both girls. At that moment, Natalie, reunited for the first time with her sister, rolled into little Annabel’s arms, and I knew we would be okay. We were all together -- we were finally a family.”

My wife and I didn't realize how opposite we were until after we were married. The only thing we found that we agreed upon was our taste in furniture.

This was fun for a while. When confronted on the topic, we had our standard lines like "We complement each other" or "Opposites attract you know!"  We realized that we got each other to try new things. She got me to travel; I got her to break her cleanliness obsession. A fair trade, I thought.

While this may have been fun when it was just the two of us, once our family expanded, it became a bit more serious. We quickly discovered that our parenting styles were also quite opposite., and our conflicting ideas now affected others. So we decided to try to take the best parts of both of our personalities and make it work for everyone.

It really started before we had any children. She didn't think she wanted any. I was excited about fatherhood and wanted as many as possible. She finally agreed to one. When our son was born, I wanted her to breastfeed him. I felt it was very important. Suffice to say she was not into it, and refused. He got formula. Baby number one softened her stance on kids considerably, and we both decided we wanted a second baby. We had another boy, but by this time, she was all about breastfeeding.

At that point, I was happy but exhausted. I figured we were good with two kids, and that we were finished with baby making.But she insisted we needed a third! I could scarcely believe it, but her mind was made up. In fact, she wanted a third boy, saying she was used to them, and wouldn't "my three sons" be adorable. I was nervous about the responsibility of a third, but if I were to have one, I really wanted a little girl. I took a chance and agreed on the third. Our boys got a plump, pretty little baby sister named Amelia. She was always hungry, always crying, hardly slept. Precious, but more work than either one of us anticipated.

As our kids have grown, we still maintain differences. My wife is known to bribe the kids. I don’t give in to tempting them. When it comes to fatherhood, I let the kids do want they want (or not) when it comes to activities. Their mother is a bit more involved, wanting to choose for them. And like many parents with different styles, our kids have figured out that if mommy says no, ask daddy -- or vice versa.  

While, our differences haven’t always made things simple, I feel they have helped our kids --and our family in general -- become better-rounded.  My kids have gotten my wife's wanderlust and her fashion sense. From me, they've picked up a sense of humor and an interest in art and photography. Somehow, they've seemed to have absorbed the best of each of us. And that's something both their mom and dad are thankful for.

Photo by Limor Zellermayer on Unsplash

If you’re like me, you’re eager for your new baby to spend as much time as possible with her relatives. Seeing your baby bond with aunts, cousins, and grandparents is immensely special, and I couldn’t wait for my girls to meet their extended family. Unfortunately, there was one thing that made this a challenge: Many of them lived far away. We live in New York, but my girls have grandparents in Vermont and various aunts and uncles all over the United States—but I didn’t let that stop us! Here’s how I was able to keep my daughters close to our faraway family:

Picture this: Got extra pictures lying around? Make a photo album with some of the outtakes, and then read it to your baby a couple of times a week. I named the people in the photos and told stories about them. This helped my daughters remember the faces, so that cousins and uncles weren’t complete strangers when they met them in person.

Go digital: Put technology to good use and set up an account on a video chat site with faraway family. Your new baby will look forward to video chats, especially if you make them a regular event, and she’ll begin to recognize faces and voices during these sessions. To truly keep your relatives in the loop, share even more: post pictures through Pampers Baby Book app, put videos on YouTube, or by start a blog to document your new baby’s days.

Family trips: Every summer, my entire family spends a week or two on the same tiny island in Maine. We rent houses near each other and enjoy lounging on the beach, eating lobster, and playing games. My girls love this annual vacation, and it’s definitely brought them closer to their cousins who live in Colorado and Virginia.

Little Picasso: All grandparents will love to receive homemade art in the mail. As my daughters got older, we made sure to ask them to put aside a few of their finger paintings, hand prints, drawings, and scribbles to send to grandma and grandpa. (If you’re tech-savvy, you could also scan them to relatives.) Your child will have fun making a special piece of artwork for her family, and your relatives will love the gift!

It took some time before my girls bonded with all of their faraway family members, but now, they are as close to them as if they lived next door! Don’t worry if your new baby seems nervous around her relatives at first. She will get to know them better over time -- no matter the distance.

Photo by ???????? Janko Ferlič on Unsplash

My name is John. I am a human alarm clock, a firefighter, a peace officer, a cook, a teacher, a husband, a photographer, a chauffeur, and a laundry service. In short, I'm a stay-at-home dad of three.

I wanted one, maybe two kids. If anyone would have told me I'd be a dad of three, I wouldn't have believed them. Who can afford three kids these days? Who has time to take care of three kids? With three, you and your wife are outnumbered. It's mayhem. Not me. Not us -- and that's for sure.

My wife, Christina, wanted the third. She wailed for months about how her life wouldn't be complete without a third. She went so far as to say she had a dream one night that there was another baby sitting up on a cloud somewhere, trying to find her way down to us.

So here I am. At least when they were babies, I could take a nap when they did. I worked when they napped. They didn't complain when I served them strained peas. 

Having my children nearly five years apart means that they are all in different schools and need to be awakened and driven at different times. These days, my life is like the movie Groundhog Day, only four times in a single day.

My daughter, the cloud-sitter, is the most trying in the morning. She tries on three or four outfits before pronouncing them all "horrible." I attempt to watch YouTube videos demonstrating various types of braids, so I can get her hair just right. My efforts usually end in tears -- mine, not hers! I must promise to watch the video while she is in school, so as to get it right the next day. For the next five hours, I squeeze in cleaning up, a shower, working on my photography, grocery shopping, and laundry.

The arrivals home are staggered like the departures. The oldest arrives first, and the homework parade begins. While I am cooking dinner, I hear my daughter screaming that my middle son is in her room, so I need to go make peace. After he complains that he is "bored," he goes in his room to make some kind of electrical project which has on occasion caused him to run out yelling "FIRE!"  While I am putting out the fire, I will hear banging in the backyard, where his brother is building a fort -- with wood he got from my deck. "You said you were going to tear it down someday, right?" he asks, innocently.

When I was in the throes of colic and 2:00 a.m. feedings, I told myself it had to get easier. But now, I see the truth: It was easier when they were babies. It's twice as hard now. Twice -- times three. But you know what? It's also three times the joy, three times the pride, and three times as much love. And I wouldn't have it any other way.

Photo by Juliane Liebermann on Unsplash