Low Birth Weight Baby

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The key takeaways are that low birth weight is defined as less than 2.5kg, regardless of gestational age. LBW babies are classified based on severity into categories such as low, very low, and extremely low birth weight. Common problems preterm babies face include difficulties maintaining temperature and blood sugar levels, breathing issues, and feeding difficulties.

Low birth weight babies are classified into preterm (short gestation), small for age/date term infants, and further classified based on severity into categories such as low (<2.5kg), very low (<1.5kg), very very low (1000-1500g) and extremely low (<1000g) birth weight.

Some common problems preterm babies face include difficulties maintaining temperature and blood sugar levels, respiratory distress syndrome, apnea, feeding difficulties, gastrointestinal issues like NEC and GERD, hematological problems, electrolyte imbalances, and potential long term complications like cerebral palsy and developmental delays.

LOW BIRTH WEIGHT BABY

INTRODUCTION

• Birth weight is the body weight of a baby at


its birth.

• Low birth weight (LBW) is defined by the World


Health Organization as a birth weight of a infant
of 2.5 kg or less, regardless of gestational age
Low Birth weight

• Low birth weight (LBW) is a term used to describe


babies who are born weighing less than 2.5kg
grams. “Or” Babies with a birth weight of less than
2500gm irrespective of the period of their
gestation are classified as low birth weight babies.

• Average newborn weighs about 2.5 - < 4kg.


INCIDENCE
• 50% of pre term are Low birth weight baby.
• 80% of neonatal death and 50% of infant mortality are
due to LBW.
• Higher incidence of LBW babies in Bangladesh is due
to higher no. of babies with IUGR rather than
preterm.
• About 10% of all LBW babies require admission to the
NICU
CLASSIFICATION
OF LBW BABY

Low Birth Weight (LBW)babies are grouped as

• Preterm (short gestation) .

• Small for Age/Date (SFA/D) term infants.


• According to severity :
• Low birth wt baby - < 2.5 kg Low Birth Weight
(LBW) :
Any neonate weighing less than 2500 gm at birth
irrespective of gestational age.
• Very low birth wt baby - <1.5 kg
Any neonate weighing less than 1500 gm at birth
irrespective of gestational age.
• Very very low birth weight baby

• Any neonate weighing less 1000-1500 gm at birth


irrespective of gestational age.

• Extreme low birth wt baby - <1.0 kg

Any neonate weighing less than 1000 gm at


birth irrespective of gestational age.
CAUSES OF LBW

Foetal Causes :
• Foetal distress
• Multiple gestation
• Erythroblastosis foetalis
• Placenta praevia
• Abruptio placenta
• Foetal abnormalities
Maternal Causes :
• Maternal Malnutrition
• Poverty
• Multiple pregnancy
• Elderly gravida
• Illiteracy
• Chronic medical illness – CHD, CKD
• Infection during pregnancy – UTI,
Chorioamnionitis
PROBLEMS OF
PREMATURITY
Early
• Hypothermia (Temp < 95oF)
• Hypoglycaemia (RBS < 2.2 mmol/L)
• Respiratory Distress Syndrome / HIE
• Apnoeic spells
• Infection
• Feeding difficulties – Inability to suck & tolerate
feed
• Problems of gut – NEC, GERD
• Haematological problems – Anaemia, DIC, Vit. K
deficiency, Hyperbilirubinaemia
• Electrolyte imbalance
Late
• Cerebral Palsy
• Mental Retardation & poor school performance
• Seizures
• Microcephaly
• Retinopathy of Prematurity (ROP)
• Bronchopulmonary Dysplasia (BPD)
• Hearing & Visual impairment
• Growth failure
• Child Abuse
MANAGEMENT
Management depends on the birth weight of the
baby
1. >1.8 kg otherwise normal - requires special care
at home
2. > 1 .5 kg but < 1.8 kg - requires Hospital care
3. < 1.5 kg - Management in NICU
HOME MANAGEMENT
 Feeding : EBF
 Thermal Regulation :
 Proper wrapping of the baby
 Maintenance of the room temperature
 Kangaroo Mother Care (KMC)
 Prevention of infection
 Immunisation
 Follow up after 2 wks or if any problem arises
• Danger signals for early detection and referral to
hospital
• Lethargy, refuse to feed
• Hypothermia
• Tachypnea, grunting apnoea
• Seizures
• Abdominal distension
• Bleeding, icteric over palms/soles
Indication for hospitalization

• Birth weight : <1800 gm

• Gestation : <34 weeks

• Unable to feed

• Sick neonate
HOSPITAL
MANAGEMENT
Principle of management of LBW in hospital

• Correction of hypothermia

• Correction of hypoglycaemia

• Detection of other complications

• Treatment of other complications

• follow up with all vital signs being monitored


continuously
HOSPITAL
MANAGEMENT

• Maintenance of Airway, Breathing & Circulation

• Feeding : Appropriate feeding method to maintain


nutrition of LBW babies is determined by
gestational age, birth wt & oral feeding skills.

• Daily fluid requirement for Preterm baby starts


with 60ml/kg.
• Daily requirement in preterm is increased by
20ml/kg/day and can be raised up to 150
ml/kg/day.
• Baby receiving phototherapy need 10- 15 ml/kg
extra fluid daily.
• <1.5 kg Ryle’s tube feeding
• > 1.5 kg EBF or by feeder
Thermal Regulation :
• Prevention of infection: indication for antibiotics
• Start antibiotic therapy without any symptoms too
• Inj. Vit K
Other supportive management
• Follow up <1.5 kg by overhead radiant warmer > 1.5
kg Like Home management
Parameters to be monitored in hospital
• Temperature
• Respiration
• Feeding
• Weight of baby
• Bladder & bowel condition
• Abdominal distention
• Appearance & extent of jaundice
• Along with the clinical assessment, investigation
may be needed
 Discharge Criteria
 Able to maintain temperature
 Weight > 1.8 kg and shows steady weight gain for 3
consecutive days
 Able to take & tolerate full feeding
 Parents confident enough to take care of baby at
home.
 After attainment of 34wks of gestation and weight
>1400 gm
ANY
QUESTIONS

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