Upon learning that their baby will be born early, many parents wonder what he or she will look like. It is important to remember that a premature baby’s appearance is as unique as that of any child. Their appearance will be shaped by how many weeks they’ve spent in the womb. A baby born very early misses some, or even all, of the third trimester of pregnancy. This last trimester is a very important time in any baby’s development. So while a premature baby has all of their organs present, most still have a tremendous amount of maturation or development to do.

How might a premature baby look different from a term baby?

If your baby is born prematurely, your doctor looks at a number of physical characteristics to assess their stage of development. Babies born between 37 and 39 weeks will usually look a lot like babies born at term. Those born earlier may have noticeable differences. Let’s look at some of those now.

Skin: The earlier a baby is born, the thinner and more fragile their skin will be. As an underdeveloped barrier, it’s less able to protect your baby.

Veins: The thinner your baby’s skin, the more visible their veins will be.

Lanugo: This is your baby’s first hair, keeping them warm in the womb and helping the protective vernix stick to the skin. It’s usually gone by the time a baby is full-term. Extremely premature babies may not have had time to develop it, but premature babies are often very hairy.

Vernix: Preterm babies often have very little of this waxy, protective substance on the skin.

Eyes: A baby born at 25 weeks of gestation or fewer may have their eyelids fused. They can still recognise mum by her voice and smell. With care, their eyes will be wide open 3–4 weeks after birth.

Ears: Cartilage won’t develop until 35 weeks of gestation, so your baby’s ears may be softer than you’d expect.

Flexibility: The more premature a baby, the bendier they will be.

Genitals: If a baby is born before 30 weeks, their genitals may be underdeveloped.

Reflexes: Babies are born with very primitive reflexes, like the grasp and Moro reflexes, that indicate their nervous system is in good working order. All of them should be present in a baby born at 30 weeks of gestation. At 25 weeks, some premature babies do have them, though reflexes that would help them to feed will likely be absent.

Floppiness: If a 25-week-old baby is held face-down on your hand, his whole body will usually droop. Babies closer to term will make an effort to hold up their arms and legs.

The Dubowitz or Ballard Score: Some doctors use lists of physical and neurological criteria to assess a baby’s developmental stage. If you see them moving your baby’s foot to their ear or pulling them up by the arms to see how far back their head goes, this is probably what’s happening. Don’t worry, they aren’t hurting your baby.

What is my baby’s “corrected age”?

Understanding your baby’s corrected age will help with monitoring their development until they’re about two years old. Their chronological age won’t be accurate in tracking their development. For example, a month-old term baby may smile at you, but a baby born at 28 weeks might spend its first month in the NICU and still be learning to feed. Their corrected age is their chronological age minus the weeks they were born before their due date. So, a three-month-old baby born at 30 weeks of gestation will have a corrected age of two weeks.

What will my premature baby look like?

In this article from Unii's Premature Baby Journey, Unii and top paediatrician Dr. Su Laurent look at how a premature baby's appearance might be different of that of a premature baby.