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Thanks for joining us for our #PreTermChats about Milestones, on Facebook.

We're very lucky to be joined by Dr. Jennifer Young who is here to answer your questions. She is a Neonatologist at Mount Sinai Hospital and Assistant Professor of Pediatrics at the University of Toronto. She also works in the Neonatal Development Clinic at Mount Sinai Hospital.


Michelle asks: How can I work on improving "low muscle tone" for my 3 month old (adjusted)?
DY: Tummy time is best to help core trunk tone and improve overall development.

Tim asks: Should motor development correlate exactly to the corrected age or is it sometimes delayed longer?
DY: Motor development is correlated to the corrected age but there e is always a range for development to emerge.


Desiree asks: What is the average age for speech to start becoming more evident in my toddler? How can I help her have a better understanding of words? I often worry that our two-language household (spanish and english) can confuse her and slow down her development.
DY: language is not just expressive but do remember the receptive component. Language development starts very early on even at the very early stage baby will hear sounds and acknowledge your sounds, with the toddler we hope that by a year that they are having good sounds and starting with a few words . By 18 months up to 20 words is normal.
D:Thanks for this. She is very alert and responsive when it comes to listening in either language and following the action being requested, so I guess it's just gonna be a matter of words starting to come into play sooner than later!


Julie asks: When should I be concerned for walking? My twins are 16 months corrected and can pull themselves up with the aid of furniture and cruise along holding on but cannot stand independently nor walk (albeit they've attempted steps with walkers).
DY: If they are pulling to stand, then walking is likely to emerge soon.
J: Thank you Dr. Young for your insight! Just wanted to thank you and your team as one of our twin girls, Emily, was in your care from birth in the NICU at Mount Sinai before being transferred to Sick Kids where she stayed for 101 days - Emily was born with multiple birth defects including Pierre Robin Sequence.
DY: You are welcome. I wish you all the very best.

Fabiana asks: What are some red flags in terms of motor development we should watch for the first few months after discharge?
DY: Red flags of gross motor development may include your baby has not developed good trunk control. This is enhanced by tummy time
F: In that case, should we start Physio. And how early is too early to start?
DY: there is no exact time when physio is started. the baby should be assessed and the need determined. However if it’s overall motor development, floor time is best for baby to help with motor development.


Christina asks:  What is the best way to do tummy time? And what types of toys or techniques should I be using to encourage them?
DY: Tummy time is done in small short segments about a total of 20 to 30 mins per day.   You get down to interact with baby, at face level. A rattle or simple toys will do.  You can even coordinate [tummy time] with diaper changes.

Dana asks: At what point should my child be sitting up? Everything I read says Preemies bones are under developed and may develop slower. And a what age should I be concerned if it hasn't happened yet?
DY: Sitting usually occurs around 6 to 8 months corrected age. If no attempts to sit are made by 8 months,  I would be concerned. 

Robin asks: My son is starting JK in September. As far as I know, he's caught up as Follow Up isn't concerned. Should I still disclose his prematurity to the teachers?
DY: Thanks for the question Robin. I would suggest that you disclose this info as it may be helpful in the future should he require any help in the school system. This may be beneficial for the teachers who can pick up subtle learning issues that can be as a result of prematurity.

Thank you so much Dr Jennifer Young and all the wonderful Preemie Parents for joining us today. If you have any more questions, please contact your NICU Follow Up Clinic.

See you next month for another #PreTermChats

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