Question Use adjusted age or actual age for preemies. . .

Synchro246

New member
I did a search, but didn't find what I wanted. Obviously, ideally RFing to the limits of the seat makes ages arbitrary, but for the sake of argument and legality:
Are there any guidelines for turning preemies FF in regards to their adjusted age vs their actual age?

It seems like it should be a no-brainer; a preemie needs to RF *at least* they reach the adjusted age of one year. I'm sure a lot of parents of preemies think of this (because they are constantly thinking in terms of adjusted and actual ages), but I'm guessing that a lot of pedis and even CPSTs forget about this kind of thing. What do you think? Does the CPST course talk about preemies?
 
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Patriot201

Car-Seat.org Ambassador
While it would make the most sense to RF a child (preemie or not) to the limits of the seat, you are right that many parents do not. While it would make the most sense to consider a child's ADJUSTED age, I think there are many parents who do not.

I used to babysit for a little girl who was born at 27.5 weeks. When her ACTUAL age was 12 months (adjusted age of 9 months), her parents turned her forward-facing. I *think* she weighed around 14 pounds at that point. :mad: She was WELL below the old 12 months/20 pounds guideline, but her parents turned her FF. She is now six (almost seven) years old, so I guess she did just fine, but it still angers me to even think of it.
 

crunchierthanthou

New member
good question. We only covered premies in terms of car beds and infant seats with weight limits below 5 lbs.

Ideally, age wouldn't really matter and only height and weight would come into play. I can dream, right? ;)
 

jdubsm

New member
My ped recommended the adjusted age for my twins and not their actual age. I didn't know about ERF at the time so I turned one at 14 months/21lbs(she was always car sick) and the other didn't turn until almost 2. They were turned way too soon and I wish I'd known then what I know now. Luckily we were never in a crash.
 

Wineaux

New member
Yep, we just covered the basic special needs seat stuff, and were told there was a special needs course we could take later if we were interested that went into much more depth. That course really gets you ready to deal with all of the various special needs seats. The whole adjusted age thing... I didn't know it existed till you mentioned it, and my DW is a NICU nurse! We're going to have a talk about this very subject, as I know I'll be pushing for adjusted age at all times. I really think that is something we should suggest be added to the curriculum.
 

henrietta

Well-known member
DS was born at 29 wks, and we always used his adjusted age--the NICU, peds, nurses, etc. were constantly reminding us that we had to take that into consideration when looking at his development. So, we didn't change that thinking regarding carseat safety.

Regarding the bare minimum for forward facing, most preemies born that early, when you would be taking adjusted age into account, are likely to have been born under 5 lbs, and aren't as likely to be 20 lbs before they are one year. In our state, the law is that a child must be both 1 yr and 20 lbs to turn forward facing, so most "preemies" wouldn't be likely to be turned super early (unless their parents are totally ignorant or just don't give a **hit). DS didn't hit 20 lbs till he was about 18 mos, I think.

As far as ERF to the max of the seat and preemies...I think the same holds true for preemie parents as others parents--they'll either read the info and make an educated decision or they won't. (And some honestly will be given incorrect info and will base their decision on this--such as our local techs here giving out bad advice).

I wish they'd make a bigger deal out of ERF at the hospital while the parents are a captive audience, esp regarding preemies, however, 12-16 weeks early is generally the earliest babies survive, so you are looking at a difference at most of 3-4 mos. I'm sure that makes a huge difference when looking at a 12 mos full term baby vs. a 12 mos 28 weeker (who is really only 9 mos). But at 2 yrs old, the difference b/t these 2 kid's spines probably isn't that different, and both are obviously better off RF. I don't know how many preemies are born at 32 wks vs. 28 wks. etc, but that tightens the gap a bit, too. It makes sense to me that we probably have more preemies born at 32 weeks than at 28 weeks, but that may not really be the case.

Just my thoughts as a preemie parent.

henrietta
 

ShumNum

Senior Community Member
I am a CPST, have taken the special needs class, and work in a NICU and we stress the ADJUSTED AGE not the chronological age for the child in terms of when the parent may even consider turning FFing. I do believe this is what the AAP recommends as well.
 

Shaunam

New member
I would hope people would use *adjusted* age, but that's probably not happening in most cases. When I took DD into the neonatal clinic one time, the doctor said one of their biggest issues with preemie parents is they want to force their child to "catch up". And one of the most dangerous things they do is start food when they child is only 1-2 months adjusted. :eek: She tries to tell them why it's a problem but she said most of the time they ignore her. It makes sense that you'd want your child to catch up, but not where safety is concerned. And pushing them to catch up isn't going to help.

I think I will bring this up the next time I take her in. And bring reading materials for the doctor. And pamphlets for her to hand out. :D
 

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