Developmental Differences in Premature Twins: A Pediatric Perspective

Q: Developmental Differences in Premature Twins: A Pediatric Perspective

Response： Please see the attachment. <br>Wishing you health and happiness! Sincerely, Pei Ren-Sheng.

Regarding developmental status?

Hello doctor, my twin baby boy was born at 35 weeks with a weight of 2100 grams.
Next month, on July 9th, he will be 6 months old, but developmentally he is at 5 months.
However, his growth and development are different from his sister's.
She can sit up straight when held, but he is still quite floppy.
His shoulders are not as firm as hers; they feel relatively soft, and he cannot sit up straight.
Additionally, he is easily startled and wakes up with any noise or movement, often showing signs of fright and crying.
His emotions seem unstable, and he cries frequently.
He loves to roll over, but when he does, he tends to spit up milk.
He enjoys rolling around in bed.

Doctor, is it normal for his bones to seem so soft? Could he have rickets or osteochondrodysplasia? Is his frequent crying indicative of a muscle development issue or pain? How can I prevent him from spitting up milk? He currently has a disinterest in feeding, and I hope that the milk he manages to drink can be absorbed properly.
I apologize for asking so many questions, and I appreciate your help!

Di er bao shuang bao tai de ma, 30~39 year old female. Ask Date: 2009/06/30

Dr. Pei Rensheng reply Pediatrics

Response: Please see the attachment.
Wishing you health and happiness! Sincerely, Pei Ren-Sheng.

Reply Date: 2009/06/30

More Info

Understanding the developmental differences in premature twins, particularly in your case with a 35-week-old twin boy, is crucial for ensuring that he receives appropriate care and support. Premature infants, especially those born before 37 weeks of gestation, often face a range of developmental challenges due to their early arrival. The differences you are observing between your son and his twin sister are not uncommon, and several factors can contribute to these variations.

Firstly, it is important to recognize that developmental milestones can vary significantly among infants, particularly those born prematurely. The adjusted age, which you mentioned as being 5 months, is a critical factor in assessing development. At this age, many infants are still developing their muscle tone and coordination. It is not unusual for a premature infant to exhibit some degree of hypotonia (decreased muscle tone), which may explain why your son appears "soft" and struggles to sit up or maintain a straight posture. This condition can improve over time with appropriate interventions, such as physical therapy.

Your concerns about your son being easily startled and having emotional instability are also valid. Premature infants often have immature nervous systems, which can lead to heightened sensitivity to stimuli. This sensitivity may manifest as startling easily or crying more frequently. It is essential to create a calm environment for him, minimizing loud noises and sudden movements, which can help reduce his anxiety and improve his overall comfort.

Regarding your worries about potential skeletal issues, such as rickets or osteogenesis imperfecta (brittle bone disease), it is essential to consult with a pediatrician or a pediatric specialist. While hypotonia can be a sign of underlying conditions, it is also common in premature infants and may not necessarily indicate a skeletal disorder. A thorough examination and possibly some diagnostic tests can help rule out any significant concerns.

As for the issue of spitting up or vomiting after feeding, this is also common in infants, especially those who are premature. Gastroesophageal reflux (GER) can occur when the lower esophageal sphincter is not fully developed, leading to milk coming back up after feeding. To help minimize this, consider the following strategies:
1. Feed in an upright position: Hold your baby in a more upright position during feedings to help keep the milk down.

2. Smaller, more frequent feedings: Instead of larger feedings, try offering smaller amounts more frequently to reduce the likelihood of spitting up.

3. Burp frequently: Burp your baby during and after feedings to help release any trapped air that could contribute to reflux.

4. Keep him upright after feeding: Hold your baby upright for at least 30 minutes after feeding to help prevent reflux.

If your son continues to show signs of feeding aversion or if his spitting up worsens, it is essential to consult with a pediatrician. They may recommend further evaluation or interventions to ensure he is receiving adequate nutrition.

In summary, while your concerns about your son's development are understandable, many of the issues you are observing can be attributed to his premature birth. Regular follow-ups with your pediatrician, early intervention services, and a supportive home environment can significantly aid in his development. If you have any further concerns or if his symptoms persist, do not hesitate to seek professional advice. Your proactive approach to his care is commendable and will be beneficial for his growth and development.

Similar Q&A

Developmental Concerns for Preterm Twins: When to Seek Specialist Help

The twins were born preterm at 30 weeks and 4 days and were hospitalized during which they underwent cranial ultrasound. The older brother had mild intraventricular hemorrhage (Grade I), while the younger brother showed periventricular echogenicity. After discharge, a follow-up c...

Dr. He Shenglong reply Pediatrics
Hello: Low birth weight preterm infants who experience pulmonary immaturity leading to respiratory distress, or complications such as intraventricular hemorrhage, may have a higher incidence of developmental delays compared to full-term infants, depending on the severity of their...

Understanding Genetic Disorders in Infants: Growth Assessment and Delayed Development

For newborns and young children, it is important to be aware of genetic disorders such as cystic fibrosis, sickle cell disease, and phenylketonuria (PKU). Growth assessment should be conducted through regular monitoring of weight, height, and head circumference, comparing these m...

Dr. Xiao Kaiwen reply Pediatrics
Developmental milestones refer to the expected developmental achievements of children at various stages. They can generally be categorized into: (1) social behavior skills, (2) cognitive and visual abilities, (3) language and auditory skills, (4) fine motor skills and self-care a...

Assessing Developmental Delays in Infants: Understanding Milestones and Testing

Hello, Dr. Hsiao! My brother is now nine months and five days old. Today, we took him to see a neurologist who assessed his development and said, "His development is only at the level of a seven-month-old." I looked at the developmental milestones for 9-10 months in the...

Dr. Xiao Kaiwen reply Pediatrics
The development of parental records in the child health handbook does not necessarily require full compliance to be considered normal. There is considerable variability in the neurological development of infants and young children of the same age, and such variability can still b...

Understanding Incomplete Development in a Twin Pregnancy at 9 Weeks

Hello Doctor: Previously, an ultrasound showed that I was having twins, and there were heartbeats. However, at a larger hospital during the 9-week mark, it was found that one baby was developing healthily, with a clear view of the head, brain, and limbs, while the other was getti...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, if there is another underdeveloped condition, we can only observe it. If it resolves on its own, it generally will not affect the normal fetus. However, we can only monitor and track it, as there is no specific treatment available. Wishing you good health.