5 Sep 2012

Preemie # 1 Goes to Kindergarten!

The time has come for our oldest preemie to start school.  A usual milestone for many, but not always an "easy" one for children who were born premature.  Thankfully, we have watched our firstborn preemie achieve and master each milestone right on time and sometimes ahead of the game.  It is a relief to feel that all things are "okay." 

There will be things to watch out for and pay attention to as he starts formal schooling and hopefully all will go well.  One of the many, many standard questions asked in the paperwork we had to fill in for our son's school was in the health section..."Birth complications?"  Why, yes. Yes, there were.  "Birth complications" lands on the #1 slot in the long "yes or no" list. And there is a reason...

I don't plan to dwell on the "what if's," but I do plan on being well-informed and helping others keep informed.  Children who are born premature often go through traumatic experiences right out the gate.  Their brains are still forming when they arrive early, which leaves the baby without defence mechanisms or an understanding of what they are experiencing and feeling.  Many premature babies can go through 60 procedures or more in the very early days following their arrival.  That is a lot for an adult to take, let alone an undeveloped little baby.  The following excerpt from an article entitled, Recognizing the Potential Effect of Stress and Trauma on Premature Infants in the NICU: How Outcomes are Affected?, discusses the potential long term impact on premature infants. This article was published in the Journal of Perinatology, Dec, 2003, 23:679-683. (The full article can be found here.)
            "When discussing an infant’s or child’s response to trauma, Perry et al(10) explains, “in the developing brain, these states [temporary responses] organize neural systems, resulting in traits.  Because the brain changes in a use-dependent fashion and organized during development in response to experience, the specific pattern of neuronal activation associated with the acute responses to trauma are those which are likely to be internalized.  The human brain exists in its mature form only as a byproduct of genetic potential and environmental history”.  Streech-Fischer and van der Kolk(13) believe that “chronic childhood trauma interferes with the capacity to integrate sensory, emotional and cognitive information into a cohesive whole and sets the stage for unfocused and irrelevant responses to subsequent stress.”
            Theoretically, as a premature infant grows, he/she may not be able to distinguish, on a subconscious or conscious level, between the here and now of a stressful event and the past events of the NICU due to the atypical development of his/her brain.  In addition, if a premature infant’s brain is programmed to respond to constant stress, subsequently as he grows older, he may have a difficult time sorting out how to respond normally to everyday circumstances.  It is important for us to abandon the myth that infants and children can “get over it because they didn’t even know what was happening.”  Dr. Perry, et al (10) believes that “children are not resilient, children are malleable.”  We must recognize the potential effect from the difficult events in the lives of premature infants and children."

This information may be a lot to absorb, especially when we constantly hear "kids are resilient."  Sure, they can be, but we have to let them be real too.  Just because we want them to be resilient, doesn't mean they can or should be.  They don't even know the meaning of the word!

I think the bottom line is for teachers, parents, family and friends to be aware of some of the potential realities premature children may face, not to immediately label kids and to seek proper support and guidance from infant and child developmental programs and specialists if and when needed.  Thankfully we live in a country with these options and supports in place. I am always grateful for this!

To our amazing little future graduate of the Class of 2027, we're ready to help you and watch you learn and grow during this great adventure!