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On Call: Preemie Milestones

Q. My daughter, who's almost 2, was born five and a half weeks early. She's still behind on big milestones, like talking. Is this normal?

A. Pediatricians give preemies two different ages: a chronological age, which is how old the child actually is, and a gestational age, or the age she would be if she'd been born on her due date. During the first two years, as long as a baby's development is on track with her gestational age, we don't worry. So if your child's a month or two behind, that's normal.

If she's been more behind than that, or if things aren't improving, there could be a problem. Generally, babies born early get closer to their non-preemie peers in size and ability as they approach 2. No two kids hit their milestones at the same time, but they should, for example, be able to say 18 to 25 words by a gestational age of 18 months.

If your child isn't already enrolled in early intervention (EI), talk to your pediatrician about this free, federally mandated program. You can get a full developmental evaluation for your daughter, as well as in-home speech therapy, physical therapy, and other services. I've referred a number of my patients to EI  -- it can make a big difference in a preemie's life.