World Prematurity DayEvery year, about 12,000 babies in the Netherlands are born prematurely. Many of these children are doing well, emphasizes Anneloes van Baar, professor of Pedagogical Diagnostics and Treatment at Utrecht University. ,,But they often have trouble concentrating well and have lower average results for math and language. Ultimately, of course, we want them to be indistinguishable from full-term children when they enter secondary school.”

    Usually a pregnancy lasts 37 to 42 weeks. But sometimes things turn out differently. In the Netherlands, the treatment limit for extremely preterm infants is 24 weeks. The chance of survival increases significantly with every week that the pregnancy has lasted. After 28 weeks, the survival rate is about 95 percent.

    “For a long time, the focus was on keeping premature children alive,” says behavioral scientist Fabienne Naber, affiliated with Het Kleine Heldenhuis, a training and knowledge center in the field of prematurity. “If a baby was up to weight and did well, it could go home. Hardly any consideration was given to the possible effects of the special start on further development.”

    Development insights

    Nowadays, the development of children born at a gestational age of less than 30 weeks is monitored at fixed age points in a Neonatal Intensive Care Unit (NICU). In addition, parents of babies born before 32 weeks have recently also been offered the ToP program (Transmural Development Support for Preterm Children), in which a specialized child physiotherapist makes twelve home visits during the first year of life and gives parents insight into the behavior and their child’s development.

    Nevertheless, there is still room for improvement in supporting parents of premature children, according to Naber. “Parents often struggle with guilt and stress, which makes them less able to respond to what their child needs. By supporting parents well in the hospital and providing insights, you can positively influence parent-child interaction and prevent socio-emotional problems as much as possible.”

    For example, pouching, in which the child is placed on the bare chest of the father or mother, can help to reduce stress. “Children born prematurely experience a lot of stress,” says Naber. “That has an inhibiting effect on the development of the brain. Pouching is therefore not only good for a child’s attachment to the parents, but also for reducing stress and thus stimulating brain development.”


    It is said: from the age of 2 we no longer correct for age and you are no longer premature. But you are premature for the rest of your life

    Fabienne Naber

    Effects on school results

    In a recent study, preterm birth was associated with lower school achievements among 12-year-olds. For the study, the Cito scores of 4677 premature children (before 30 weeks) were compared with the results of their term peers who had spent 40 weeks in the womb. About 10 percent of these premature children turned out to need special education. The prematurely born children also scored less well on language and arithmetic and had a lower school recommendation than their peers.

    “Many premature children are doing quite well,” emphasizes Van Baar. ,, That is how 90 percent manages in regular education. But we also see that a part needs special attention. For moderately premature children, after 32 weeks, nothing extra actually happens. Yet we see that they also function less well. That may not be very dramatic because they don’t drop out extremely often, but they often have trouble concentrating, for example.”

    Special attention

    Prematurity deserves more attention, according to both experts. “The worries should not dominate,” says Van Baar, “but it is good to keep your eyes open and to remain alert to possible effects. That also means that we must support parents of premature children as best as possible: what extra does your child need to flourish?”

    That special attention remains necessary, agrees Naber. ,, It is said: from the age of 2 we no longer correct for age and you are no longer premature. But that is not possible at all. You are premature for the rest of your life. The number of weeks you have spent in your mother’s womb does not change.”

    This can play a role, for example, when a child starts primary school, says Van Baar. “A difference of three months at that age can determine whether a child is ready to go to school. It is good to reflect on that.”

    What can you expect from the ToP program as parents of a premature baby? This includes help with ‘reading’ your baby: the behavior of premature babies is often less predictable or less clear. If your baby was born prematurely, you therefore need extra patience and time to make contact with your baby, explains Parents of Nu expert and ToP pediatric physiotherapist Hanneke van der Westen.