A ‘preterm baby’ is a term used for any baby born before the end of 37 weeks of pregnancy. Extremely preterm babies may be born as early as 23 weeks of pregnancy. The term, “chronological age” refers to the actual age of your baby; the time since its birth. “Corrected age” is a term often used in hospital and is the age your baby would be if they were born on their due date. Usually corrected age is used to compare developmental milestones and growth until two years of age while chronological age is used for immunisations.
It is a good idea to have your baby weighed weekly for the first four to six weeks once you go home from hospital. After that, if your baby is growing well, you can weigh less often. Weights can be done at your local child health centre, pharmacy, general practitioner or dietitian. Ideally, it is best to go on the same day each week and to use the same scales each time. Naked weights are optimal but if you can’t then a clean dry nappy and the same clothes each time e.g. a singlet is alright. Length and head circumference measures are also useful every two to four weeks to check that growth is proportional. The dietitian, doctor or child health nurse will usually plot your baby's growth on a ‘Growth Chart’. The red baby book (the one you get given in hospital) has the most common (Centre for Disease Control or CDC 2000) growth chart at the back. The World Health Organisation (WHO) growth chart can be downloaded from the WHO website and is recommended by many centres. Remember - plot for corrected age until two years NOT actual age.
It is not unusual for babies to be discharged within days of stopping fortified breast milk or preterm formula. Most babies will adapt to this reduction in calories by increasing the volume they demand during breast or bottle feeding – this adjustment can take several days to a week. It is also important to remember that in the hospital nursery, your baby was given a very specific amount of feed at every feed, so it takes some time to get used to being able to demand as much as they want.
Your baby’s growth may falter for a week or so while they get used to receiving breast milk and demanding bigger volumes, however if their weight gain remains slow and is under the minimum recommended for a period any longer than two weeks in a row seek advice from a dietitian. A good rule of thumb is:
For nutrition advice make an appointment with an expert paediatric dietitian at Mater Health and Wellness on telephone 07 3163 6000. They will be happy to discuss growth and answer any of your questions or concerns about feeding, starting solids and signs of readiness.