What Is a Low Birth Weight Baby
A low birth weight baby is a newborn who weighs less than 5 pounds 8 ounces (2500 grams) at birth.
Low birth weight can result from preterm birth (birth before 37 weeks of pregnancy), poor fetal growth, or a combination of both. Low birth weight is associated with increased risk of health problems and complications, both in the short-term (such as respiratory distress and infections) and in the long-term (such as developmental delays, chronic health problems, and decreased life expectancy).
Classification of low birth weight babies
Preterm babies
They were formed before 37 had completed a lengthy period of development.
The range of their mean load for their gestational age is between the 10th and 90th percentiles.
Babies who are small for their gestational age (SFD)
Despite being conceived at term.
They are also known as IUGR children, or children with intrauterine growth retardation.
They are under the tenth percentile of the mean load for their gestational age in terms of weight.
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Features of LBW Baby
Low birth weight (LBW) is a significant concern for newborns and their families. Babies with LBW are at increased risk of health problems and complications, and it is essential to be aware of their clinical features.
Here are some of the most common clinical features of a LBW baby:
Small size and weight:
LBW babies are usually smaller in size and lighter in weight compared to full-term babies.
Respiratory difficulties:
LBW babies may have trouble breathing and may require extra oxygen or other respiratory support.
Increased risk of infections:
LBW babies are at increased risk of infections, including respiratory infections, sepsis, and meningitis.
Temperature regulation problems:
LBW babies may have difficulty regulating their body temperature and may be more susceptible to hypothermia or hyperthermia.
Feeding difficulties:
LBW babies may have trouble feeding and may require special formulas or feeding techniques.
Delayed development:
LBW babies may experience delays in reaching developmental milestones, such as sitting up, crawling, and walking.
Brain development issues:
LBW babies may have a higher risk of neurological problems, such as learning disabilities, attention deficit hyperactivity disorder (ADHD), and cerebral palsy.
Eye problems:
LBW babies may have a higher risk of retinopathy of prematurity (ROP), a condition that can cause blindness.
Causes of low birth weight(LBW) babies
The reasons for Low birth weight (LBW) include:
Preterm birth:
When a baby is born before 37 weeks of pregnancy, they may have a lower birth weight due to insufficient time to grow and develop in the womb.
Intrauterine growth restriction (IUGR): This occurs when the fetus does not receive enough oxygen and nutrients from the placenta to grow at a normal rate.
Multiple pregnancies:
Having more than one baby in the womb (e.g. twins, triplets) can lead to competition for resources and can result in lower birth weights for each baby.
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Maternal health issues:
Conditions such as malnutrition, high blood pressure, and smoking can all negatively impact fetal growth and result in LBW.
Genetic factors:
Some genetic conditions can also cause LBW.
Poor prenatal care:
Lack of access to prenatal care, or not receiving adequate care, can also contribute to LBW.
Socioeconomic factors:
Poverty, lack of access to adequate nutrition, and other factors associated with low socioeconomic status can also increase the risk of LBW.
Impact of low birth weight on mother and Baby
The impact of low birth weight on a mother and baby can be significant and includes:
For the mother:
Increased risk of preterm labor and delivery, which can result in additional health problems and a longer recovery period.
For the baby:
Increased risk of health problems at birth and in the long term, including breathing difficulties, infections, and developmental delays.
The baby may also have a higher risk of chronic health conditions later in life, such as heart disease, diabetes, and high blood pressure.
Low birth weight can also impact the family, as the parents may need to take time off work to care for the baby and may face additional financial strain.
It can also lead to emotional stress and strain on the family.
Complications of low birth weight
Low birth weight can lead to several complications including:
Respiratory distress syndrome.
Increased risk of infections.
Developmental delays and learning difficulties.
Increased risk of chronic health conditions such as diabetes and high blood pressure.
Increased risk of death in the neonatal period.
Nursing management of low birth weight babies
Maintaining Respiratory Health
Position the baby with a slightly elevated neck.
Carefully suction the airways.
Observe and record the baby's breathing rate, behavior, signs of discomfort, such as pullback, nasal flaring, apnea, and cyanosis.
Stimulate respiration by gently tapping the sole of the foot.
Provide oxygen therapy using a mask and a bag, starting with 100% concentration and then reducing to 40% to prevent retrolental fibroplasia.
Perform chest physiotherapy by using techniques such as percussive tapping, vibration, and changing the position of the patient to remove and eliminate respiratory secretions
Maintenance of normal temperature
To maintain a stable internal body temperature and prevent hypothermia, the following steps should be taken:
Maintain an environmental temperature of 30 + 2°C through heating devices such as climate control systems, heaters, and radiators.
Keep the baby's skin temperature between 36.5-37.5°C.
Place the baby in an incubator with a desired level of humidity (60-65%) and proper temperature.
Monitor the baby's internal body temperature continuously, using a low reading thermometer.
Take measures to prevent heat loss during care.
Maintenance of Nutrition and Fluid
Low birth weight infants require 120-150 kcal/kg body weight/day, 150-200 ml/kg/day of water, and 4-6 gm/kg/day of protein to meet their growth requirements.
Begin feeding the baby early to prevent hypoglycemia, hyperbilirubinemia, and kernicterus.
Feed the baby frequently.
If the baby has a poor sucking reflex, I/V fluid and naso gastric feeding may be necessary. Droppers, spoons, and pipettes can be used for feeding.
Record the baby's weight daily to monitor weight gain, using the same scale and wearing the same amount of clothing each time.
Prevention of Infections
Low birth weight infants are susceptible to infections due to weak immunity.
The following measures should be taken to prevent infections:
Thoroughly wash hands with soap before handling and caring for each baby.
Provide separate clothing, feeding equipment, thermometer, stethoscope, etc. for each baby.
All staff in the neonatal care unit must wear nursery shoes, sterile outfits, and masks.
People with infections should not enter the neonatal care unit.
Limit visitors in the unit.
Clean the nursery floor and surfaces with soap or carbolic solution regularly.
Clean hatcheries and baby beds with soap water and germicides.
Autoclave clothing and materials.
Keep infected babies in a separate unit.
Limit baby showers but maintain hygiene.
Address any issues promptly.
Provide Stimulation
- Nurses should provide sensory stimulation to the low birth weight infant through talking, singing, snuggling, and gentle touching during care.
Visual stimulation can be provided through colorful hanging objects.
Change the baby's position regularly. Place the baby on their right side after feeding to prevent spitting up and choking. Allow the mother to care for the baby with proper precautions or to visit the nursery to see and touch the baby.
Inform the Parent about Infant’s Progress
Keep the parents informed about the baby's condition and progress to ease their anxiety.
Discuss necessary treatment plans. Allow the parents to see the baby.
Discuss post-release care with the parents, including proper heat, nutrition, growth, and hygiene practices at home. The low birth weight baby is typically released from the neonatal care unit when they have gained enough weight (approx. 2000 g or more), have good energy, and are able to suck effectively.
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