• Nicole

Today My Preemie Is Two, But His Birthday Was In October: Understanding Actual vs Corrected Age

December 14, 2017 was the due date of my son, Garrett. He was born on October 15. Two months early.

This was not in “the plan” so we were completely unprepared when it came to understanding the major differences between having a full-term baby versus a premature baby.

One detail we quickly learned is that premature babies have two ages: actual and corrected.

Actual age is easy to understand; it’s their chronological age from the day they were born. Essentially, it’s just their age, but it has to be called something in order to differentiate it from their corrected age.

This is where it gets a little trickier.

Corrected age is their actual age minus the number of weeks or months the baby was born early. This really can’t be calculated until they reach their due date.

Before that, you count their age in gestational weeks. If a baby is born earlier than 36-37 weeks, they are not considered a newborn. They are premature.

Just because they are outside of the womb does not mean they skip the last phases of development. Instead, they have to continue to meet their gestational milestones in the NICU.

These are very important stages including lung, eye, and heart development. Even coordinating how to breathe, suck, and swallow doesn’t usually occur till 34-35 weeks. This is why many babies born premature are on ventilators, oxygen, and feeding tubes.

Garrett was born in October when I was 31 weeks pregnant. We continued to count his age in gestational weeks until December 14; the 40 week point when we could finally consider him to be a newborn.

This is when we started counting his corrected age.

His actual age was two months old, but his corrected age was essentially zero. Then, when his actual age was 3 months old, his corrected age was 1 month old. And so on and so forth.

The corrected age does not mean a baby is behind or delayed in development; it’s a guideline for expectations based on their early birth, and most resources suggest using the corrected age until two years.

Some preemies close the developmental gap prior to the two year mark, but this is the time when many premature babies can expect to even out developmentally with their peers. By this point, the development curve slows so the differences month to month are not so drastic.

For instance, there’s not a huge difference between a 24 month and a 26 month old. But there is a drastic difference between a 4 month old and a 6 month old.

Those early months were hard. The newborn stage was extended because of his corrected age so even at 3 months old, Garrett still looked and acted like a very new baby. This meant sleepless nights lasted longer, sporadic schedules lasted longer; and the colicky screams lasted longer.

On our few outings out of the house (another preemie characteristic includes a compromised immune system), people were always surprised to learn his age. And it was confusing to explain his corrected age; they would kind of wave it off and say something like “All babies develop in their own time.” Which is true, even for preemies, but they also require a unique kind of understanding and patience.

They are not the same as a full-term baby. They are not just small newborns. They are different. And they are very special. They overcome adversity from day one. Every milestone is truly a miracle.

So today marks an important step in our preemie’s journey: he is officially two years old.

And although I haven’t given much consideration to his corrected age since he was about 18 months, this was all I ever hoped for during those long days in the NICU; a healthy, happy, and well-developed little boy.

The days are long, but the years are short. - Gretchen Rubin


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