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Care of Low Birth Weight Babies (LBW)

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  1. Care of Low Birth Weight Babies(LBW) Ms.Umarani

  2. CLASSIFICATION OF Low birth weight (LBW ) BABIES • As per Gestational age • Pre-term • Term • Post term • As per birth weight • Small for gestational age/date(SGA/SFD): birth weight <10 thpercentile • Large for gestational age/date(LGA/LFD): birth weight >40 thpercentile • Appropriate for gestational age/date(AGA) • birth weight between 10 th and 40th percentile

  3. Low birth weight baby < 2500gm • Very low birth weight baby <1500gm • Very very low birth weight baby <1000gm

  4. Risk factors for LBW • Malnutrition • Severe anaemia • Infection • Unregulated fertility • Age(<16 yr) • Hard physical work during pregnancy • Smoking

  5. Prevention and control of LBW • Dietary improvements • IFA tablets • Controlling infections • Early detection and treatment of disorders • Family planning

  6. Problems of LBW neonates • Respiratory distress • Hypoglycemia • Hypothermia • Intracranial hemorrhage • Sepsis • Anemia and polycythemia • Feeding and other GI problems • PDA • Retrolental fibroplasia

  7. Management of LBW babies • WEIGHT <1.5 KG • Intensive care • Feeding • Antibiotics • Incubatory care(Temp.,Humidity,Oxygen) • Kangaroo Mother Care WEIGHT >1.5 KG • Incubatory care(Temp.,Humidity,Oxygen) • Radiant warmer • Kangaroo Mother Care • Infant Feeding -Bottle feeding / Breast feeding

  8. Global Recommendations for feeding • Colostrum • Exclusive breastfeeding for 6 months • Continue breastfeeding for up to 2 years or more • Introduce nutritionally adequate and safe • complementary foods after the age of 6 months

  9. Importance OF COLOSTRUM • Antibody -protects from infection and allergy • White cells - protects from infection • Purgative - clears meconium; helps prevent jaundice • Growth factors - helps intestine mature; • prevents allergy • Vitamin A -reduces severity of infections; • prevents eye diseases

  10. Cont… • Breastfeed on demand • Show mothers how to breastfeed • Tell her how to maintain lactation • if she is separated from the infant • 8-10 times or more in 24 hours • Breastfeed at night also • No restrictions on length/numbers of breastfeeds

  11. benefits of breast feeding • Available easily • Allergic condition reduced • Anti-microbial factors • Best food for infant • Bonding between mother and child • Body shape returns quickly back to pre-pregnancy level • Breast cancer risk reduced

  12. Cont… • Bleeding reduced • Biochemical advantages (Prevents hypocalcaemia & hypomagnesaemia) • Clean • Cheap • Development of IQ, jaw, mouth • Digested easily

  13. Signs of correct attachment • Signs of correct attachment • mouth wide open • lower lip is turned outside • chin touching the breast • areola of breast not visible below the lower lip • areola of breast and nipple are inside baby’s mouth • tongue under the teat

  14. Helping Mothers with Breast Problems • Fullness • Engorgement • Mastitis • Breast abscess • Cracked nipple • Sore nipple • Inverted nipple

  15. INDICATIONS FOR Artificial Feeding • Mother very ill/died/unavoidably absent • Failure of breast milk production • Mother rejects infant • Principles of artificial feeding • 1.Think of infants requirements: Energy:100kC/kg Protein: • 2 g/kg Carbohydrate:10 g/kg 2.After 4 months diluted milk can be used • 3.Feeding 6-8 times (during illness more feeds)

  16. What can be used for artificial feeding? • 1.Dried milk • Dried whole milk • Simple to reconstitute • Fortified with vitamins • Expensive • 2.Cow’s milk • Cheap • Easily available • Dilute with water for <4 months infant • (25-33% water) • Add sugar (5-10 gm)

  17. Risks of artificial feeding For child: • diarrhoea and respiratory infections • allergy and milk intolerance • infant mortality • malnutrition,Vitamin A deficiency • chronic diseases (DM,hypertension) • Lower IQ • For mother: • interferes with bonding • pregnancy sooner • overweight • anaemia • ovarian and breast cancer

  18. Baby Friendly Hospital Initiative (BFHI) • Launched in 1991 by WHO and UNICEF • 1.Have a written breastfeeding policy that is routinely communicated to all health care staff • 2.Train all health care staff in skills necessary to implement • this policy • 3. Inform all pregnant women about the benefits and management of breastfeeding • 4. Help mothers initiate breastfeeding within a half an hour of birth • 5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants

  19. Cont… • 6 . Give newborn infants no food or drink other than breast milk, unless medically indicated • 7.Practice rooming-in : allow mothers and infants to remain together 24 hours • 8.Encourage breastfeeding on demand • 9.Give no artificial teats or pacifiers (dummies or soothers) to breastfeeding infants • 10.Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital

  20. Thank you...

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