Long-Term Preemie Issues

What long-term complications could result from prematurity?

Learning Problems

Premature babies are more prone than most to face complications -- both short- and long-term. Learn about which long-term complications might arise, according to the University of Wisconsin Center for Perinatal Care, and what you can do about them.

Former preemies are more likely than full-term babies to suffer from learning deficits or learning disabilities at school. Up to 45 percent of infants weighing less than 3 1/4 pounds at birth have one or more abnormalities on testing at school age. It's usually not possible to predict at the time of discharge or during early development who might develop these difficulties. Common problems include:

  • Coordination problems: Difficulty writing, drawing, or doing jigsaw puzzles.
  • Language problems: Difficulty following directions, learning to read, or remembering words.
  • Thinking problems: Difficulty with memory, spatial relationships, or abstract concepts.

Behavioral Problems

According to the Journal of Developmental and Behavioral Pediatrics, behavioral problems are in many ways intertwined with learning problems. Both are more likely to occur in former preemies. Sometimes parents of preemies have a tendency to be overprotective of their child and avoid discipline. This can lead to or worsen any behavioral problems that may arise. These issues usually start before school age and often include:

  • Overly aggressive play
  • Temper tantrums
  • Refusal to comply
  • Excessive loudness
  • Inability to stay still for any period of time
  • Difficulty paying attention
  • Extreme shyness

Some parents of preemies are reluctant to set limits or enforce rules because of the difficulties that the child had to go through in the early months of life. However, providing structure and defined limits can often lessen or eliminate some of these behavioral problems.

If behavior problems persist or get worse, discuss them with your child's doctor or teacher.

Vision Problems

Former preemies can have any of a number of vision problems. These include:

  • Amblyopia (lazy eye due to unequal vision)
  • Decreased color vision
  • Nystagmus (frequent jerking movements of the eye)
  • Poor vision
  • Smaller field of vision
  • Strabismus (inward or outward turning of one or both eyes)

Symptoms can include:

  • Constant movement of eyes
  • Frequent crossing of eyes, beyond 3 months of age
  • Appearance of a cloudy or white texture on the surface of the pupil
  • Abnormal head tilt
  • Inability to fix his eyes on an object or a face
  • Drooping eyelid
  • Oversensitivity to light

Contact your doctor if you suspect that your baby suffers from any of these vision difficulties. Most of these problems can usually be corrected with glasses, contact lenses, or eye patches.

Hearing Problems

Preemies are considered at high risk for hearing problems. Watch out for these symptoms as your baby gets older:

  • 3 months: Baby doesn't recognize mother's voice or turn his head toward the direction of a sound.
  • 6 months: Baby doesn't enjoy vocal play or make noise in numerous tones.
  • 9 months: Baby doesn't turn his head when you call.
  • 12 months: Baby doesn't babble or isn't able to say "mama."
  • 18 months: Baby doesn't respond to requests or move to the rhythm of music.
  • 24 months: Baby's speech is difficult to understand, and he can't follow simple directions.

Speech and hearing therapists can help improve communication with a child who has hearing problems. Most hearing difficulties can be treated by hearing aids. If the loss is severe, children can be taught other forms of communication such as sign language or lip reading.

Dental Problems

Preemies have a greater tendency than other babies to suffer from dental problems. This may be a result of delayed tooth formation or gums that are altered by breathing tubes.

The dental problems a preemie is susceptible to include:

  • Abnormal enamel formation
  • Slow or delayed teething
  • High arch or groove to the palate
  • Abnormal bite

Often small abnormalities in enamel formation aren't visible. More severe abnormalities are noticeable, such as a gray or brownish color or an uneven surface and abnormal shape. The baby teeth are most often affected with enamel problems. Sometimes the first permanent teeth are affected, but usually to a lesser degree.

A high arched palate, often the result of breathing tubes, can affect a child's speech and bite. Most children seem to adapt to the shape of their palate. However, a preemie may be more likely to need braces when she's older.

Often dental problems look worse than they actually are. Teeth with enamel problems tend to be prone to cavities, but dental care and regular brushing can prevent this problem. Here are several ways to prevent tooth decay:

  • Bring your baby for a dentist's appointment around her first birthday, recommends The American Academy of Pediatric Dentistry.
  • Develop good toothbrushing habits as soon as the teeth break through the gums. The teeth should be cleaned two times a day -- first thing in the morning and before bedtime.
  • Avoid the habit of letting your child sleep at night or nap with a bottle. It can cause decay so severe that it destroys the teeth.

Reviewed 2/02 by Jane Forester, MD

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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