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Management of LBW Babies
Management of LBW Babies
Etiology of prematurity
• Physical Characteristics
• –
• General movement poor and powerless cry.
Prematurity
Date of LMP
Physical features
Breast nodule
Genitalia
Sole creases
Ear cartilage /
recoil
• – Less subcutaneous fat and edema.
Breast nodule
Preter Term
m
Preterm Term
Identification: Preterm LBW
Male genitalia
Preterm
Preterm Term
Term
Identification: Preterm LBW
Female genitalia
Preterm Term
Identification: Preterm LBW
Sole creases
Preterm
Term
Identification: Preterm LBW
Ear Cartilage
Preterm Term
LBW: Identification of types
SFD / IUGR
Intrauterine growth chart
Physical characteristics
Emaciated look
Loose folds of skin
Lack of subcutaneous tissue
Head bigger than chest by >3cm
Intrauterine growth chart
4400
3200
APPROPRIATE FOR DATE
2800
2400
10th percentile
2000
1200
Birth asphyxia
Meconium aspiration syndrome
Hypothermia
Hypoglycemia
Infections
Polycythemia
Care of LBW babies
1. Prevention of infections
- Gentle and minimal handling
- Handling with clean hands
- Room must be warm, clean and dust-free
- Immunization at right time
2. Prevention of hypothermia
Convection
Evaporation
Radiation
Conduction
or electric heater
Warmly wrapped
Radiant warmer
Begin at 60 to 80ml/kg/day
Increase by 15ml/kg/day
Maximum of 180-200ml/kg/day
Gavage feeding
LBW: Feeding
Katori-spoon feeding
LBW: Supplements
THERMAL SYNCHRONY
If the temp of the baby decreases by 1°c , correspondingly the
temp of mother increases by 2 °c to warm up the
baby.
If the temp of the baby raises by 1°c , the temp of the
2.KANGAROO FEEDING
POLICY
kangaroo position is ideal for breast feeding.
Exclusive breast feeding is the policy.
Feeding is done once in 90-120 min.
If the baby can suckle , it is promoted.
If baby cannot suckle , expressed breast milk to be fed.
If the baby is unable to swallow , EBM is fed by
nasogastric tube.
3a.EARLY
DISCHARGE
Criteria for discharge:
Wt gain of at least 40g a day for 5 consecutive days.
Baby should feed well on breast milk.
Temp should be maintained.
There should not be any evidence of illness.
Successful ‘in-hospital adaptation’ of the mother and other
members of the family.
3b.FOLLOW-
UP
After discharge , KMC is continued
at home.
Follow-up is done daily by the
health worker for one week
and ensured that baby is feeding
well and gaining about 40g
weight daily.
Afterwards once a week till the
baby reaches 40
weeks of post conceptional age.
BENEFITS OF KANGAROO MOTHER
CARE
1. Benefits to baby
3. Benefits to family
KMC is economical compared to cost of intensive care.
There is better follow-up.
KMC promotes bonding among the family members.
4. Benefits to
Hospital
KMC saves materials like incubators, O2 cylinders.
Saves in man power in terms of nursing staff.
5. Benefits to Nation
Infant is small
Skin is thin , blood vessels can be easily seen beneath
the epidermis
Skin wrinkled and red with an excess of lanugo and little
or no vernix
No subcutaneous fat deposits
Head is large in proportion to the body
Eyes prominent but closed
Ears are soft and chin recedes
Thorax is less firm
Abdomen protruded
Genitalia male: few scrotal rugae, testes are not
descended female: labia and clitoris are prominent
Extremities: thin, muscle are small
Nail: soft and short
Palms and sole: minimal creases and appear smooth
Generally lies inactive with arms and legs extended
Reflex activity not fully developed
Low Birth Weight Baby
Nursing management of low birth
weight(LBW) babies
• –
• Provide chest physiotherapy by percusion, vibration,
postural waste to release and expel respiratory
emissions.
b) Maintenance of Thermoregulation
Environmental temperature to be kept up at 28 + 2OC via
climate control system, brilliant hotter, hot blowers, room
radiator.
• Skin temperature of the infant to be kept up at 36.5-37.5
C.
Adequate warmth
Life support
With mother
Referral note
PREVENTION OF LBW BABY
A . DIRECT INTERVENTION MEASURES