Learning to walk is an important milestone for any baby. For parents of preemies who may have had long NICU stays and multiple health problems, learning to walk is an eagerly anticipated step toward normalcy. For many parents, this developmental milestone marks the end of baby days and the beginning of the toddler years.
When Do Preemies Learn to Walk?
Among both preemies and full term babies there is a wide range of ages at which children reach milestones like learning to walk. Charts of developmental milestones are general guidelines to help parents estimate approximately when their children will learn new skills. A healthy preemie with an uneventful NICU stay and no major long-term health problems of prematurity will learn to walk according to standard developmental milestones for his corrected age:
- By 6 to 9 Months: By the time a preemie has reached 9 months corrected age, he or she should be able to stand up when supported by a parent or when holding on to a piece of furniture.
- By 10 to 12 Months: By the time a preemie is 12 months corrected (one year after his or her original due date), he should be able to pull up on a piece of furniture or crib rail, into a standing position. He should also be able to walk when supported by a parent or when holding on to something.
- By 13 to 18 Months: Preemies should be able to walk alone, with no support and with their heels flat on the floor, by the time they reach 18 months corrected age.
When comparing premature babies to a chart of developmental milestones, remember to use their corrected age. Corrected age is the age the child would be if he had been born at term. A baby who is 9 months old, but was born 2 months early, would be 7 months corrected age.
Why do Some Preemies Learn to Walk Later?
Even after adjusting for gestational age, premature babies are known to reach milestones, on average, later than full term babies. The more premature your baby or the more severe her medical complications at birth, the greater the delay. These delays may include learning to walk later than term infants. For instance, the average age for learning to walk is about 14.5 months for babies born before 32 weeks, and 13.5 months for term babies.
If your preemie has or had any of the following complications, he or she may learn to walk later than expected:
- Born before 27 weeks gestation
- Birth weight less than 750 grams (1 lb 11 oz)
- Bronchopulmonary dysplasia (BPD) or chronic lung disease
- Weak muscle tone (hypotonia)
- Cerebral palsy
- Frequent hospitalizations
- Significant medical support at home (respiratory support, feeding tubes, etc)
When to Be Concerned
If your baby hasn’t learned to walk by the time his or her friends have, try to be patient. The majority of preemies will learn to walk when they’re ready, within the expected time frame. Keep your pediatrician informed of your baby’s milestones so that your doctor can help you to make sure that your preemie is developing normally.
Your preemie may need extra help learning to walk if he:
- Cannot bear his own weight on his feet by 9 months corrected age.
- Stands on his toes at 9 months corrected and seems unable to bring his heels down.
- Cannot creep or crawl around the room by 12 months corrected age.
- Cannot walk by 18 months corrected age or walks on his toes.
How Can Parents Help Preemies Learn to Walk?
The biggest way parents can help their preemies learn to walk is by encouraging play and independence. Babies learn through play, so make learning to walk fun. Avoid infant walkers, especially with preemies. Walkers encourage poor muscle development and toe walking, which can make learning to walk properly difficult.
It's also important for parents to develop a close relationship with their baby's pediatrician. Premature babies require close observation over time to determine whether any delays they may have are a normal result of prematurity, or a cause for concern. Working with your baby's doctor can help you decide as a team if your child needs special therapies such as occupational or physical therapy.
If your child qualifies for early intervention programs, make sure to utilize them. Early intervention includes physical and occupational therapy for infants who need it, which can help preemies learn to walk on time.
Emory University School of Medicine. "Developmental Milestones" accessed 9-10-10 from http://www.pediatrics.emory.edu/divisions/neonatology/dpc/mileston.html
Bucher, H., Killer, C., Ochsner, S., Fauchere, J. "Growth, Developmental Milestones and Health Problems in the First 2 Years in Very Preterm Infants Compared with Term Infants: A Population Based Study." European Journal of Pediatrics 2002: 161, 151-156
MA Marin Gabriel, et al. "Age of Sitting Unsupported and Independent Walking in Very Low Birth Weight Preterm Infants with Normal Motor Development at 2 Years." Acta Paediatrica 2009: 98, 1815-1821.