Physiotherapy for Preterm Babies

A preterm baby is a born at less than 37 weeks gestation (more than 3 weeks before due date). Due to the decreased time in utero the baby has not fully developed the motor, sensory, respiratory or behavioural systems. These immature systems may struggle to adapt to the new environment and the baby may present with developmental delay or fussy behaviour, such as crying at minimal disturbance. Children may have discrete problems that emerge later at school such as attention or coordination problems.

In particular it is important to assess babies while they are still growing and developing their motor, sensory, and behavioural systems, and while their brains are developing and maturing. Timely and appropriate therapy can assist your child to develop optimally and decrease the risk of neurodevelopmental delay or disability. Any concerns can be identified early and treated accordingly. Research has shown that early intervention can have long term benefits and developmental stimulation within the first year of life can have positive cognitive effects.

Babies at particular risk are:

  • Born at less than 28 weeks gestation. Babies born at less than 32 weeks are at moderate risk for developmental delay
  • Weigh less than 1500g at birth
  • Intra uterine growth retardation (small for dates) babies
  • Bleed in the brain (interventricular haemorrhage Grade 3 or 4)
  • Cystic periventricular leucomalacia
  • Hypoxic Ischaemic encephalopathy due to decreased oxygen to the brain at birth
  • Seizures
  • Twins are also a risk factor due to the skeletal changes that can happen in utero as there is less space to grow

If possible your baby should be assessed whilst in Neonatal ICU by a physio, as this gives a good baseline as your child grows and develops. The assessment can determine what level your child is developing at, and if there are any concerns with respect to movement patterns, postures and behaviours. It is also important to have regular follow ups after discharge to ensure that your child is developing well and reaching their milestones quickly. For babies with a mild to moderate risk this can be done every 3-4 months until the child is a year old (corrected age from original due date, not date of birth). For babies that have concerns it is very beneficial to have regular physio appointments in order to help your baby to grow in the typical way, reach milestones timeously and assist with their learning and development.

At Rehabilita, Mayo Clinic and Flora Clinic on the West Rand, Roodepoort, Johannesburg, we have dedicated therapists who can assist you and your baby from birth and monitor and advise you during the developing years of your child.

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