4 month old not hitting milestones

[Clearslug]

Hi everyone,

Just wondered if anyone was in, or has been in, a similar situation to me to help ease my mind a little.

Basically, I gave birth to my son (my first born) 6 weeks prematurely (33+5) in July due to my waters going early. He had the cord wrapped round his neck at birth, and spent 3 weeks on SCBU due to his prematurity (he didn't have the sucking reflex as this doesn't develop til 35 weeks so needed to stay in to be tube fed and gain weight up until he was 38 weeks). He was jaundice for a few months and weighed 4lbs at birth but otherwise did well from the start and was (and is) a small but otherwise very healthy boy.

He's now 5.5 months (but really 4 months if he were born on time, and this is the age we're using to track his milestones) and weighs around 11/12lbs. Lately I've noticed he's not meeting his motor skill development milestones. Cognitively, he seems spot on - he's very smiley, tracks well, babbles and coos and has a strong attachment to myself and his dad.

However, his upper body strength is very weak - he can hold his head up (albeit wobbly) when held upright, and at 45 degrees (again a bit wobbly) when propped up on his tummy time toy, but when pulled up by his arms his head lags backwards like a newborn and when placed down flat on the floor he can only move his side to side, not up. He also seems to have very little arm strength and when on his back can't reach far or lift his arms above his head to bat items, even though he's interested in them.

The HV visitor has just said 'wait and see' and at his 3 month check said she didn't think anything sinister was going on, but that he generally was just delayed due to his prematurity. However, it's now a month after she last visited and despite lots of tummy time he's not really improved. The more I read, the more I'm convincing myself he has cerebral palsy (mixed muscle tone - he has strong legs but weak upper body and is quite hard to handle as he likes to bend his body back like he's skydiving when you hold him upright against you).

He's got a developmental review with his paediatrician in March but I'm driving myself crazy because my gut says something isn't right and it's a very long time to wait - especially as I know that if it is CP, early intervention is key.

My sister is a nurse and has suggested that he may just take a little longer than usual (even based on his adjusted age) to hit these milestones but at 4 months adjusted, I'd expect him to be able to hold his head up by now?

Has anyone else had a baby (prem or term) that was delayed or had similar symptoms? What was the outcome?

All my friends babies seem to have had great motor skills at around just 2 months but none of them were prem so I suppose I'm just looking for something to fairly compare him to, to see if this is normal or if I need to get a 2nd opinion (I've taken him to the GP and discussed with the HV so far - both of which have just said 'wait and see, he's premature after all').

Thanks in advance, from a worried mummy x

My ds was 6 weeks prem and spent a couple of weeks in Scbu. He was late reaching all of his physical milestones, didn't crawl until he was 1, didn't walk until 18 months. He caught up and by the time he was 2 you wouldn't have known he'd ever been delayed.

On the other hand his twin hit all of the milestones early so I think it's just one of those things.

My LG was 6 weeks premature too and I was very anxious that she had CP when she was a baby. Mainly as she’s stiffen up at times. It was however just anxiety due to the stress around her birth and scbu stay. She was slow to do everything and very sleepy for her first 4-6 months. She’s 5 now and perfectly healthy. I would persist with your health visitor and explain your concerns so they can reassure you. X

The stiffening up was just startle reflex and normal baby jerky movements . As a first time mum I had no idea that this was all normal

Push to get an earlier review.
You can diagnose low tone (head lag)right now.
You can ask hv to refer to community paed physio right now. As you say it is better to get early intervention. The birth etc makes it a higher risk for cp so you are right to push for early review.

You could also pay a private paed physio. See if there are any local cp groups/physio/bobath centre to get an assessment.

Thanks all for the advice, it's very much appreciated. Butlerboo - was your son having problems with head lag etc also? If so, did this start to improve around 6 months?
Missmiller - he's only stiff in his legs, his upper half is very wobbly. Did you speak to anyone about your concerns because your daughter was prem? Did they say it was typical?
Cestlavie, I think you're right. If anything, seeing a private paed will either confirm my concerns or put my mind at rest. I've found a local private paed who specialises in CP. he's not cheap at £275 for the initial assessment (45 mins - I'm in the wrong line of work!!) but knowing what's going on with my little boy (even if it's nothing), is priceless.

I would pay private physio sessions rather than paed.
Physio can give input and ideas to promote good posture etc.

Hi @Clearslug, could you please update on your baby? I have similar concerns regarding mine. Most grateful.

Hi @Jpan - sorry you’re going through the same worries. The good news is, despite it taking a very long time for my son (who will be 5 next month!) to reach his physical milestones, he did do it. I’d say he probably wasn’t at the same level physically as his peers until at least 2. He took a long time to walk, he was about 22 months but was totally on target with all the non-physical ones from about 3 months.
I did take him to a paed physio who confirmed it was just due to prematurity and that he definitely did not have CP. She knew as soon as she saw him - she said he’d have to have pretty much no tone for her to be concerned and that his reflexes were strong.
Was your baby premature? If you’re really worried take them to the GP and ask for their opinion, but from my experience you just have to be really, really patient and don’t base their development on the usual timescales or on other kids their age. My little boy does swimming, tennis and football training now and despite being one of the smallest and youngest in them, he’s amongst the top in each group so has definitely made up for his first 2 years - perhaps he feels he has something to prove?!
Ive just had my second son who is now 9 weeks old and was 5 days overdue. I’m amazed by the difference between him and DS1 at this age - he’s like DS1 was at 6 months already - the difference in prem and term babies for the first year is insane, but I don’t think anyone really warns you how long it takes them to catch up. Just be very patient, try not to panic but I would definitely recommend a physio to confirm or rule out your concerns as I know it just eats you up otherwise!
Good luck ☺️ X

@Clearslug - I’m so grateful to you for replying to this… 5 years after the initial post! Must have felt like a real blast from the past. Congrats on your new bub!

My boyo is 4 months old as of today. He is not a premie (born 38+1). He has a huge 99% percentile head. He can defo hold it up more than he could two months ago but it’s always wobbling around a lot. He seems to have a really weak back too… basically, I really relate to what you said here: “he has strong legs but weak upper body and is quite hard to handle as he likes to bend his body back like he's skydiving when you hold him upright against you)”.

if you don’t mind me asking - when did he start reaching out and batting for toys?

many, many thanks again.

@Jpan my dd has always been weaker upper body. We moved dangling toys within her reach almost like she was batting them by accident to then notice them and then properly bat them xx She's fine now, just always been weaker in that area but no problem now at 14 months

Hi @Lhiurvhcf - thanks so much. I think I’ll try that!