In the 24/25 weeks’ gestation baby, sucking is very primitive. By 28 weeks’ gestation, your baby will be able to suck and swallow, but not in a coordinated manner. It will be 32-34 weeks’ gestation before your baby will be able to co-ordinate both sucking and swallowing, although only for a short period.
This may be visually evident in a breastfed baby as they attempt to nuzzle to the breast to take 3-4 sucks. The ability to coordinate sucking and swallowing may slightly vary from baby to baby. As your baby progresses towards term gestation age, their sucking coordination and duration will also progress. As your baby gets stronger and sucking develops, tube-feeds will be phased out and replaced with feeds from the breast or bottle7.
Your baby’s body might look limp (hypotonic) because of muscle weakness. They may have a flat posture on the mattress. This is in contrast to a full-term baby who tends to adopt a more curled up (flexed) position. From 28 to 29 weeks’ gestation, your baby’s reflexes may start to develop in a primitive way and they may start to grasp. Your baby’s movements will be less coordinated and seem jerky. Again, as your baby grows in strength, they will adopt a more flexed position with more coordinated movements.
Sleep states cannot be clearly classified in a very premature 24 weeks’ gestation baby. At this age, there is little eye movement during sleep. This progresses toward obvious/classified states of deep sleep, active sleep, and wakefulness by 30-32 weeks’ gestation.
The weight of your baby will be recorded in Kilograms (Kg). There are conversion charts in the neonatal unit to convert Kilograms to pounds (lbs) and ounces (oz), if you so wish. A rough guide is that a 24 weeks’ gestation baby weighs between 0.55-0.85 Kg, i.e. 550-850 grams(g). Weight progresses by roughly 0.1 Kg (100 g) per week to approximately 1.3-2 Kg (1300-2000 g) by 32 weeks’ gestation.
These values are rough guidelines and there is a wide variation of normality. Factors that may influence a baby’s weight include: gender; maternal age; ethnicity; parity; smoking; alcohol or substance abuse; hereditary factors; and health and well-being of the mother.
Both male and female premature babies have immature genitals which may look different to a term baby’s. Your baby’s sex organs may look larger than average or expected. In the female premature baby, there may be a prominent clitoris at 24 weeks’ gestation. This will continue to be prominent until the labia develop about 34 weeks’ gestation.
For the male premature baby, testes appear in the scrotum by 28 weeks’ gestation. Nipples appear at 26/27 weeks’ gestation. As your baby grows towards term age, the breast tissue plumps out and becomes more visible3.
Please be aware that every baby has a different pace of progression. There is a wide range of normality. Try not to compare your baby to a sibling or another infant being cared for alongside your baby. Should you have any concerns, please speak to your doctor or nurse.
1The American Congress of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Prenatal-Development-How-Your-Baby-Grows-During-Pregnancy
2Cochrane, 2009. Sinclair L and Sinn JKH. Higher versus lower humidity in the prevention of mortality and morbidity of premature infants in incubators. Cochrane database of systematic reviews. www.cochranelibrary.com (http://www.cochrane.org/CD006472/NEONATAL_higher-versus-lower-humidity-for-the-prevention-of-morbidity-and-mortality-in-preterm-infants-in-incubators)
3Preemies – Second Edition: The Essential Guide for Parents of Premature Babies. Dana Wechsler Linden, Emma Trenti Paroli, and Mia Wechsler Doron. Gallery Books; New York, (2010).
4Cabal LA, Siassi B, Zanini B, Hodgman JE, Hon EE: Factors affecting heart rate variability in preterm infants. Pediatrics 1980, 65(1):50-56.
5Ikeda T, Ishikawa H, Shimizu K, Asakawa K, Goseki T: Pupillary Size and Light Reflex in Premature Infants. Neuroophthalmology 2015, 39(4):175-178.
6Tatzer E, Schubert MT, Timischl W, Simbruner G: Discrimination of taste and preference for sweet in premature babies. Early Hum Dev 1985, 12(1):23-30.