Developmental Milestones

Milestones of 22-27 Weeks Gestation

Movement

• I am easily startled. Touch, light and noise might upset me.
• I need help to keep my arms and legs bent and close to my body.
• My movements are mostly jerks and twitches.

Sleep

• I sleep for 20 to 22 hours a day to grow and heal.

• I like it best when it is quiet and the lights are low.

Touch

• I like to hold your finger to comfort me.

• When you touch me, keep your hands steady and firm.

• My favorite touch is kangaroo care, also called skin-to-skin holding.

Senses

• One of my biggest jobs is keeping my heart rate and breathing pattern steady.

• I’m not ready to open my eyes. Protect me from bright light.

• I need to hear your voice. I will respond better if you talk to me quietly.

• Bring in a blanket that you’ve held on your skin, so I can learn your scent.

Feeding

• I may not be ready for a pacifier yet.

Social/Emotional

• I know when you are close to me.

Milestones of 28-32 Weeks Gestation

• I am trying to bend my arms and legs now, but I still need your help to curl up.
• I still need help to keep me tucked and supported, just like when I was in my mommy’s tummy.
• My signs of stress are: a grimace, stiff arms and legs, wide-open hands, toes spread apart, and the hiccups.

Sleep

• I am trying to be awake and calm for short amounts of time.

• I like it best when it is quiet and the lights are low.

• I grow and heal when I am in a deep sleep.

Touch

• I like steady, firm touch. Light touch may upset me.

• My favorite touch is skin-to-skin holding.

• Use my blankets or your hands to help me tuck into a fetal position. This is called hand containment.

Senses

• One of my biggest jobs is keeping my heart rate and breathing pattern steady.

• I open my eyes when the lights are low.

• I stay more relaxed with quiet noise. Speak softly to me. I can tell your voice from other people’s voices.

• Bring in a blanket that you’ve held on your skin, so I can learn your scent.

Feeding

• I am not quite ready, but I may start to show signs that I am ready to eat.

• Please give me my pacifier during tube feeds. (Ask my nurse or therapist which size pacifier is best for me.)

Social/Emotional

• I may become alert to your voice.

• I am learning to calm myself by bringing my hand to my mouth and face.

Milestones of 33-36 Weeks Gestation

Movement

• I may start to kick now when I am awake.
• I can turn my head from the middle to the side.
• My stress signs are: stiff arms and legs, arching, wide open hands, toes spread apart, yawning, sneezing, hiccups and turning head away.
• My self-calming behaviors are: hands to the mouth and face, grabbing your finger, holding my feet together, and sucking my fingers or pacifier.

Sleep

• I am waking up many times during the day and staying awake longer.

• I like dim lighting in the daytime and lights out at night.

• I still need deep sleep to grow and develop.

Touch

• I like skin-to-skin contact and steady, firm touch. Light touch may upset me.

• Ask my nurse or therapist if I’m ready for Baby’s First Massage.

• I still like to be swaddled in bed and when I am being held. It comforts me.

Senses

• Shield me from bright lights.  

• Loud noises still may upset me.

• I can see 6 to 8 inches away, but I am not ready for mobiles or pictures.

• I can tell your voice from other people’s voices.

Feeding

• A green pacifier helps to teach me how to suck for feeding.

• Please give me my pacifier dipped in milk, during tube feeds. This helps me practice sucking.

• Ask my nurse or therapist if I’m ready to feed by mouth.

• I am just learning how to suck, swallow, and breathe.

• Feeding is my hardest job. It may take time for me to learn.

Social/Emotional

• I am ready for you to hold and talk to me when I am awake.

• Teach me to comfort myself by helping me with my self-calming behaviors (listed above).

Milestones of 37-40 Weeks Gestation

Movement

• My arms and legs are bent almost all the time now.
• My movements are smoother because I am stronger now.
• I can turn my head from the middle to the side.
• My behavioral stress signs are: stiff arms and legs, arching, wide open hands, toes spread apart, yawning, sneezing, hiccups, and turning my head away.
• My self-calming behaviors are: hands to mouth and face, grabbing your finger, holding my feet together, and sucking my fingers or pacifier.

Sleep

• I am waking up several times during the day and staying awake longer.

• I like dim lighting in the daytime and lights out at night.

•  As a newborn, I sleep 17 to 20 hours a day.

Touch

• Ask my nurse or therapist if I’m ready for Baby’s First Massage.

• I don’t need as much help to keep my arms and legs close to my body, but I still like to be swaddled.

Senses

• Shield me from bright lights.

• Loud noises still may upset me.

• I can see 8 to 10 inches away and am starting to follow objects.

• Ask my therapist or nurse if I am ready for a mobile.

• I can tell your voice from other people’s voices.

Feeding

• A green pacifier helps to teach me how to suck for feeding.

• Please dip my pacifier in milk so I can practice sucking during tube feeds.

• I am getting better at sucking, swallowing, and breathing at the same time.

• Feeding is my hardest job. It may take time for me to learn.

• Patience and support will help me learn how to eat.

Social/Emotional

• I like to look at your face.

• I like to hear your voice.

• I love it when you are here to take care of me.

NICU Parents Discuss Having a Child in the NICU