Hand to Hold's Official Blog: Written by Parents for Parents

On Catching Up. Or Not.

Two Years Old. Not caught up.

Two Years Old. Not caught up.

As the parent of a preemie, at some point during your NICU stay, or soon after, you will hear the famous, or infamous, “catch up by two” expression. This means that by two years old, your child is expected to have caught up developmentally with his or her peers.

While for later-term preemies this may be true, in the world of micro-preemies it is far less common. The earlier your preemie was born, the less likely he or she is to be all caught up by two years old. For many of our children, catching up is a myth.

What happens when you realize that your baby is far from caught up at two years old, or three years old, or even later? What happens when you realize that you are far from the NICU but prematurity will always be a part of your child’s life?

You may be angry. You may be sad. You may compare your child to your friends’ children, and get depressed. You may get unreasonably upset when strangers remark that “she looks so tiny. You need to fatten her up!” And you may feel guilt, overwhelming guilt, for not achieving some artificial and unreasonable benchmark.

At two years old, our daughter had been walking for only a couple of months, and she was so small she did not look like she should be walking. She had a severe feeding delay, getting most of her calories from bottles of fortified formula. She had constant reflux and routinely vomited several times a day. Catching up by two was, for us, in the same league as unicorns.

I felt like a failure. I failed at keeping her safe in my uterus for 40 weeks. I failed at keeping her identical twin sister alive. I failed to protect her from countless painful procedures and interventions. I failed to catch her up by the deadline. Does this seem familiar to you?

While I considered myself a failure, I looked at my tiny 2-year-old and saw a miracle of strength and resilience, a child who fully embraces life, its challenges and joys. She was, and continues to be, an inspiration. I am pretty sure you feel the same way about your child.

Two years later, after a long road that led to a successful kidney transplant this past March, we have a sturdy four-year-old. She still has some minor motor delays, but holds her own in a typical Pre-K classroom. Is she caught up? I don’t know, and I don’t care. She is hilarious and defiant, cuddly and a troublemaker. She likes to tap dance. She is a great little sister.

Prematurity will always be a part of her life, but it no longer defines her.

Melissa Haber About Melissa Haber

Melissa Haber (NY) is mother to Daphne, a surviving identical twin who was born at 27 weeks 4 days, moments after sister Leah passed away. Daphne was in the NICU for five long months, and had open-heart surgery to repair a congenital heart defect when she was six months old. At three years old, she continues to battle kidney disease and other delays related to her prematurity. Daphne is proud to have the greatest big sister in the world, six-year-old Lucy. The family lives outside of New York City. Melissa blogs regularly about life with a former micropreemie, parenting challenges, and loss and grieving. You can also follow her on Twitter.


  1. Gostoso de ler os seus escritos. Sempre fã. Daphne uma super personalidade. : ) engraçada.

  2. Love this! My micro is 5.5 now, and still not quite “caught” up with her Kindergarten peers. (And yet advanced in some areas–children are a mystery!) I often remind myself that our girl started walking AT two (the day before her birthday) and was non-verbal at 18 months…and yet started reading at 3.5. You said it best, “prematurity will always be a part of her life.”
    Hugs to you!

  3. Thank you for the post Melissa! My little one is almost two and mighty pint-size 18 pounder. I shared your post with the IUGR Support Group on Facebook, which helps support and spread awareness for Intrauterine Growth Restriction, a group full of inspirations, big or small! 🙂

    • Thank you so much for sharing, Dawn. The pressure we feel to make our kids grow is hard to describe to someone who is not a parent of a preemie. Of course, the pressure and stress don’t help with anything, it’s just another layer of misery. And great things come in small packages, as they say 😉

  4. Your feeling of guilt struck a cord…I could have written those same words of guilt about only carrying to 26 weeks, losing her twin brother. Thankfully we never heard caught up by 2, we were told Kindergarten and by Kindergarten she didn’t glaringly stand out. We are just short of 13 now. Caught up? I don’t know if that is ever the right word. We did years of OT. She will never have the fine motor skills to be a brain surgeon, but who cares? My daughter is a beautiful smart loving child. Forever she will do & process some things differently than the “norm” and it doesn’t matter. Size wise I am thrilled to say she is 5’3″ no longer marked as “tiny”. The experts say micro-preemies “catch up”, I think they take a whole different wonderful path.

    • Hi Kristen, can I please make your words mine? So glad your daughter is doing so well. By the way, 5’3″ is a great height, which I happen to share with her 🙂

      • In a few years I hope your preemie is eye level with you as well. PS I will brag for a moment to give a little encouragement of what happens to “delayed kids”. We have a good laugh at least once a year over the doctor who said the child would never walk, talk or even sit up. Reality is she is a straight “A” student in gifted classes, twirls baton competitively, and for years has been the Top Youth Walker for our local March of Dimes. I forgot to tell her while she was little what the experts said she would never accomplish. 🙂

  5. Thank you for this, I wish I could have found this years ago. This sums up what I felt in the first 4 years of my 32 weekers’ lives. I, too, felt guilty for all that you wrote. I can’t tell you the amount of comments people made about them being small for their ages. They’re 5-1/2 now, and still tiny, but overall they’re doing well.

    • Hi Mary, the thing about guilt is that it doesn’t help with anything right? It just makes everything more miserable… I am glad they are doing well. I reached a point in which I just accepted that tiny but growing would be our goal.

  6. Thanks for this article Melissa. My son was born at 24 weeks and 5 days and is now almost 18 months. I have been concerned about his walking and speech lately although I try and remind myself that he WILL NOT be on the same developmental plane as others (even other preemies). I find it hard to believe that by the time my son is 2 that he will be on the same developmental level as others who are chronologically 2. My son is just now doing what 8-10 month olds are doing. He is on the verge of walking and I am estatic! Like I have read others say… We celebrate everything, the BIGS and the smalls! Because to us micros, they are GIGANTIC!! Thanks again!!

    • Angie,

      We also had a 24 weeker who is now 3 and 1/2. It took her a long time to do a lot of things like laugh, crawl, walk, talk, etc. but she does all those things now! And in retrospect, I wouldn’t trade any of the pain and worry and stress AT ALL!

      When she did hit all of those milestones, in her own sweet time, it was such an awesome (in the true meaning of the word) experience for my husband and I! I still feel overwhelmed every time I think about the amazing moment when my daughter crawled for the first time – and we caught it on film – after thinking for months that she never would. And the joy on her face and sound of her proud laughter when she finally walked alone (also on film) is my Peter Pan happy thought! 🙂 We still have our struggles – currently eating – but I know all the super big downs are going to be matched by super big highs that parents of full-term kids just never understand or get to experience.

      Hang in there! Your little one is a fighter and is going to keep on amazing you when you least expect it!

      • Hi Loren,
        Thanks for sharing. My son does have eating issues too, but I take it all in stride. He is a fighter and a miracle and I am in complete AWE at him just being… HIM. I count every accomplishment he makes a blessing. Thanks for your words of encouragement!

    • Hi Angie, I think on the verge of walking at 18 months for such an early preemie is totally amazing. I bet you were given much grimmer odds when he was first born, right? His development is his development. No use comparing to anyone else’s.

      • Melissa,
        I was told all the horrible things that could happen when my son was born. Those same people who gave me the grim news also had loving and caring hands that cared for my son to help him overcome the odds and by God they sure helped! He struggles with some things, but with continued guidance he will continue to overcome the odds. THANKS for your encouraging words.

  7. Very true, Melissa! Our 26-weeker is now 3 1/2, and I believe he is just now catching up to his peers. I feel like it’s a victory that I’m no longer consumed with all the delays. When he was a toddler and he didn’t roll, crawl, or walk, it was overwhelming, but now I just see him as the delightful miracle that he is. And when he runs and talks, I am so, so grateful!

    • Hi Summer, we too celebrate and don’t take for granted milestones such as “first time she ate lunch at school.” These milestone were never a given for us, and yet… Our children are remarkable.

  8. Kristen Padavic says:

    Catching up is the least intelligent phrase ever used in child development. It is a physical impossibility catch-up – development begins when the sperm and egg meet. If your child is born 10 weeks early, they will always “be” their adjusted age, developmentally. This doesn’t mean that they may “appear” to be more like their actual age peers at some point – maybe at 6 months, maybe at 9 years old. Regardless, the phrase is idiotic.

    • I agree and wish that terminology did not put so much pressure on parents to accomplish the impossible. It’s not like you can “get over” missing out on 3 or more months of development in utero, or several months in the hospital. The differences can become less apparent (though sometimes not) but a preemie will always be a preemie.

  9. Great post! I actually felt better once I heard preemie moms tell me they had heard it will take one year for every one month they are early. So, with that formula, mine won’t be ‘caught up’ until 3. They just turned 2 on 12/9, and let me tell you, it’s the hardest thing to feel like I have to explain why my daughter isn’t walking yet (I have 2 surviving triplets). My son only started walking around his birthday. There are other issues too, and it’s hard not to compare. In the end though, I look at them, and I am amazed at how far they’ve come. There is no greater joy than that, caught up or not. 🙂

    • Hi Angela, thanks for your words. I am glad your surviving triplets are doing well. I am not sure why we all feel such a need to justify and explain our children. It is something I strive to get past. She will be 5 in March and it is much better than it used to be 🙂

  10. Thank you for this. We have a 24 weeker (almost 4 months adjusted). Every time I read about moms who have gone before me.. And their stories, I just cry. It’s so good to hear other people who understand. It’s so good to hear others flinch when they hear, “tiny” in the grocery store, or get tense every time pt comes because you don’t know if they’ll see “a problem”. Just knowing others have gone through it, felt all the hardships, and overcome them all… So uplifting. Thank you.

  11. My children were all born early, but not micro preemies. My oldest was born at 36 weeks. He is now 6, doing 3rd-4th grade reading and3rd grade math. He is still small for his age and a bit clumsy, but he is thriving!
    My second was born at 35 weeks after 9 weeks of restriction due to preterm labor. He will be 5 tomorrow and he is at or above average for everything. Size, academics, scocial skills, etc.
    My youngest was born at 34 weeks. She will be 4 in just over a month. She is VERY social and on or above for her milestones. She is still very small. She is wearing mostly size 2T clothes now and she is 28-29lbs! She has come a long way. We have been through a lot between our three, but not nearly as much as all of you micro-preemie parents. I hope that all of you and you children have amazing success in their lives at their own time and on their own time frame. My kids all did different things at different ages. My oldest was walking before 9 months, my youngest had no interest in trying to walk until she was about 16-17months.


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