Premature babies make fewer friends in the first few years of life, a new study has found.
The study, published in The Journal of Pediatrics, found premature babies spend less time socialising in early childhood.
According to the study, children born very prematurely reported four friends at age six, compared with children born at full-term, who had five friends at the same age.
Premature Babies Make Fewer Friends, Study Finds
The study also found prematurely born children saw their friends less frequently, giving them fewer opportunities to develop their social skills.
The research, led by Professor Dieter Wolke from the University of Warwick, found premature babies were less accepted by their peers.
The good news however, is the effects are temporary, and the children catch up socially when they start school.
Preterm Children Have Fewer Early Childhood Friends And Feel Less Accepted
The researchers analysed over 1,000 children born in Germany in 1985-6.
Of these children, 179 were born before 32 weeks, 737 were born between 32 and 36 weeks, and the remaining 231 were born at full-term.
The children included in the study didn’t suffer from major neurodevelopmental impairments that could have inhibited their social skills.
The parents of participants were asked about the number of friends their children had, and how regularly they saw them.
The children and parents also completed a picture quiz to assess how they felt they were perceived by their peers.
The parents of babies born before 32 weeks reported their children to be less accepted by their peers.
Why Do Premature Babies Have Fewer Friends?
There are probably numerous reasons why premature babies have fewer opportunities to socialise, compared with their full-term peers.
Firstly, premature babies often start life with a lengthy hospital stay. While other new mothers are out making friends and attending baby groups, the parents of preterm babies spend most of their time in the Neonatal Intensive Care Unit (NICU).
One of the reasons preterm babies have fewer friends might simply be new mums miss a key window of opportunity for making friends at baby group.
Premature babies are also more likely to suffer from health complications. Common colds and viruses can be extremely harmful to preterm babies, which means parents are less likely to take them out to busy playgroups and other social settings where germs are easily spread.
BellyBelly contributor Maria Pyanov, mother of a baby born at 31 weeks, said:
“Typically, when you’re discharged from the NICU, you’re advised to avoid crowded places, childcare centers, and anyone with a recent illness. How long you’re advised is dependent on your child’s health condition. It could be anywhere from just a few weeks to even a year or two for micropreemies.
“My daughter was discharged in late November, at the beginning of cold, flu and RSV season in the US. We were initially advised to limit her exposure to germs through the end of peak illness season, which was April. That’s five months of essentially hibernating. In addition, she required a surgery in June. Any illness postpones surgical procedures so we continued limited exposure through June.
“Fortunately, my daughter is the youngest child and she had the opportunity to socialise with her siblings. Had she been our first child, she could have gone seven months outside the NICU, and nine months in total, including her NICU stay, and seeing other children just a handful of times”.
For parents of babies who need to avoid to germs, it might be difficult to socialise with other young families simply due to young children often being ill.
Families in the NICU might develop strong bonds with families of other patients but often NICUs cover a wide geographical area and these families might not live close enough for regular socialising after discharge.
Maria said, “We became close with several NICU families. Adding in geography and common illness, however, we rarely get together. It’s currently cold, flu and RSV season, and although my daughter is cleared from extra precautions, a few of our NICU friends are still required to take extra precaution. If she has just a runny nose, we need to reschedule our play dates with many of our NICU friends”.
Parental anxiety can also play a part. Having a premature baby, especially one who is born unwell, is incredibly stressful. Seeing your baby attached to wires and machines, and housed in a little plastic incubator, is nothing short of terrifying.
Most NICU parents will do anything and everything to limit germ exposure and avoid readmission to the hospital – even if it means avoiding desired social interaction. Parents might also want time to settle into a new routine and spend lots of extra time bonding in a environment that’s finally calm.
The anxiety of a potential future hospital admission can play a role in the reduced number of social interactions even after their baby is cleared from extra precautions.
What Does This Mean For Parents Of Preterm Babies?
The study found once the preterm children began school, they seemed to catch up socially. However, researchers still believe it’s important to close the social gap as early as possible, to avoid any long term problems.
Professor Wolke explained: “Having friends, playing with them and being accepted is important for social support and personal wellbeing. Having fewer friends, feeling less accepted can lead to feelings of loneliness and increases the risk of being excluded or bullied.
“Although most preterm children catch up with their full term peers during early elementary school, future interventions to improve friendships and social interaction skills should start before school entry to prevent later psychopathology and behaviour problems.
“Improving early parenting and motor, cognitive, and behavioural development may also facilitate friendships and peer acceptance for children across the whole gestation spectrum. Multimodal training methods may be particularly effective when involving parents, teachers, and classroom settings”.
In the researchers’ conclusions, they recommended support be offered to parents of premature babies. The aim was to advise parents and encourage them to help their children to develop socially.
Maria said, “Our first few weeks at home were filled with doctors’ appointments and eventually therapy, surgery, etc. My daughter was very fortunate to have siblings, so this was a bit of a non-issue for us.
“However, if you’re a concerned preemie parent, I’d say note this information but please do not stress! The reality is, life with a preemie is a bit atypical. Instead of weekly play group, you may have weekly weight checks. Instead of sleepless nights with a congested baby, congestion may mean a hospital stay.
“However, once your baby is cleared for typical interaction, make it a point to expose her to a variety of social settings. It’s possible you’ll need to be extra cautious about germs for years, but find as many opportunities for her to interact with others as you can safely do.
“Also, unlike the ‘fourth trimester’ with my term children, I didn’t have as much opportunity to be sure she felt a secure attachment in the early weeks. Researchers didn’t look at the role of oxytocin and parent child attachment, but it stands to reason these preemies could be a bit more insecure during early childhood.
“Be sure to focus on helping your child feel as secure as possible. Lots of skin-to-skin, babywearing, and answering cues and cries ASAP helped my daughter quite a bit. Her social anxiety periods happened around the same time as term babies but seemed to be a bit more intense and longer lasting than her peers. Lots of reassurance, rather than pushing her to independence, helped immensely”.