As a preemie mama, one of the things that has plagued me over the last year was my inability to carry my daughter to term.  I developed severe preeclampsia and IUGR, and had to deliver at 29 weeks 2 days.  4 months later, we received another blow when Judith was officially diagnosed with a life-shortening, chronic, and potentially life-threatening lung disease: cystic fibrosis.  My husband and I knew from the start of Judith’s life that we wanted to do what was best for her, much like any parent would.  Part of this plan included a crucial element: vaccines.
Since preemies can be prone to complications from many different diseases, vaccines are an important part of their care.  It’s not just the standard vaccines that all children should get (think Hepatitis, polio, MMR, etc.) - it also includes critical vaccines against the flu, and against RSV.  Just like with adult vaccines against the flu, children can still get the flu (and yes, even RSV) even though they received the shot; the crucial element is the vaccine will prevent the virus from growing, and will help lessen the severity of the virus.  In some cases, it could make a difference in treatment, and could help keep the little one from landing back in the hospital (granted, there are exceptions to everything).  It’s one more step preemie parents can take to protect their child/children.

Many pediatricians will vaccinate a preemie based off of their actual age.  I remember having this discussion with our pediatrician and our neonatologists; they explained to me that they vaccinate preemies this way to help give their immune systems the protection it needs from these harmful diseases.  After receiving that information, I had a decision to make with my husband about how to approach vaccinating Judith: did we want to follow the standard vaccine schedule, or did we want to follow a delayed schedule?  I know a lot of preemie parents who choose/chose to follow a delayed schedule, and work with their pediatrician to set something up.  I also know a lot of preemie parents who follow the standard schedule, and I know many preemie parents who mostly follow the standard schedule but will delay a couple vaccines.  Personally, we follow the standard schedule with modifications: our pediatrician will not overload Judith with too many vaccines at once, but she will receive the vaccines within the recommended time frame.  That’s just our decision though - every preemie parent is different, and they need to follow a schedule they are comfortable with.

I know this isn’t a lot of information; the best source of information is your pediatrician, and they very well may recommend something different than the information I received.  Work with your preemie’s doctor, and figure out what will work best for your situation, and what you would be comfortable with.  Together, you and your doctor can help give your little miracle the extra protection they need!

(This was written several months ago as part of our personal NICU blog for friends and family but I think its appropriate to share again here.)

This is one of the first questions we get when people see Cora. Of course we don't get out much so this comes mostly from people at the doctors' office or people we meet on our nightly walks in the neighborhood.

The answer to "how old" is a tricky one. For at least the first year of her life, Cora has two ages. Her actual age-the amount of time that has passed since her birthday. And her adjusted age-the amount of time that has passed since her due date. For most things she is caught in between the two ages.

In some ways, Cora is a 3 month old baby. She's been eating, breathing, experiencing the world for that long. As parents, we've had all that time to get to know her and learn to interpret her cues. But in most ways, Cora's development is tied to her adjusted age. She will hit most major milestones based on her gestational age not her real age. This means she will be about 3 months behind her peers on a lot of developmental issues. Her pediatrician watches her growth on a special preemie chart (Cora is almost in the 50th percentile!) rather than one based on her age since she wouldn't even be on the chart at all.


To help Cora catch up, she is enrolled in a program called Early Childhood Development. ECI is a team of specialists who work with low birth weight babies for the first three years of their lives to help them catch up to their peers. Right now Cora has an Occupational Therapist and a Nutritionist who visit our house regularly. Her OT comes every other week and works on developing muscle tone and cognitive behaviors such as making eye contact. The nutritionist comes every other month to help make sure Cora is gaining weight and growing appropriately. Both give us homework after every visit so that we can work with her daily.

So we have a 3-month-old-newborn who will do things at her own pace. Right now she is working on head and neck control, grasping things with her hands, and focusing on toys with her eyes. We've seen her make big leaps in each of these areas in the last week and celebrate every tiny milestone, just as we have since her birthday (real or adjusted!).