Low Birth Weight Baby

INTRODUCTION
Low birth weight is a term used to describe babies who are born weighing less than
5 pounds, 8 ounces (2,500 g). An average newborn usually weighs about 8 pounds.
A low-birth-weight baby may be healthy even though they are small. But a low-
birth-weight baby can also have many serious health problems. A baby who is very
small at birth may have trouble eating, gaining weight and fighting off infections.
Some may have long-term health problems, too. About 1 in 12 babies (about 8
percent) in the United States is born with low birthweight.
Babies with low birthweight look much smaller than other babies of normal
birthweight. A low birthweight baby's head may appear to be bigger than the rest of
the body, and he or she often looks thin with little body fat.
 TYPES

• A low birth weight baby will fall into one of three categories:
• Low birth weight (LBW): A LBW baby weighs less than 2500 grams, or 5 lbs 5 oz.

• Very low birth weight (VLBW): A VLBW baby weighs less than 1500 grams, or
about 3 lb 9 oz.

• Extremely low birth weight (ELBW): An ELBW baby weighs less than 1000 grams,
or about 2 lb 3 oz.
 causes OF low birth weight in a baby

• Preterm birth. About two-thirds of all low birth weight babies are preterm, or born before the 37th week of pregnancy.
Nearly all very low birth weight babies are premature.
• Genetics. About one-third of a baby’s birth weight is determined by genes, so if you and/or your partner was a small baby,
there’s a greater chance your baby will be born small too. Chromosomal abnormalities, along with heart defects, can also
cause IUGR and low birth weight.
• Problems with the placenta. If the placenta doesn’t get enough oxygen or nutrients to a baby or the placenta’s blood supply
is impaired, she may grow at a slower rate during pregnancy.
• Carrying multiples. If you’re carrying more than one baby, the space inside your uterus can get cramped quickly, which is
why 60 percent of twins are born early and frequently at a low birth weight. On average, twins are delivered at around 35 or
36 weeks and weighing about 5.5 pounds.
• Not gaining enough weight during pregnancy. Gaining less than the recommended amount of weight during pregnancy
can result in a baby who’s born at a low birth weight. Talk to your health care provider if you have a history of an eating
disorder, are struggling to gain the recommended amount of weight in the second or third trimesters, are losing weight in the
first trimester, or have severe morning sickness and can’t keep down any food at any point during pregnancy.
• Substance abuse. Drinking alcohol, smoking cigarettes, using illicit drugs and abusing prescription medications during
pregnancy can inhibit a baby’s growth in the womb, leading to IUGR and a low birth weight baby.
• Chronic medical conditions and infections during pregnancy. Having high blood pressure or
heart disease during pregnancy — or infections like the flu, rubella, cytomegalovirus, syphilis or toxoplasmosis — may
cause IUGR, which can result in a low birth weight.
Which babies are at risk for low birth weight

• Chronic health issues during your pregnancy.

• Having an infection during your pregnancy.
• Taking certain medications during your pregnancy.
• Using substances such as alcohol or tobacco during your pregnancy.
• Not gaining or maintaining enough weight during your pregnancy.
• Being pregnant with multiples.
• Exposure to lead or air pollution.
• Being Black or African American.
• Being 17 or younger or 35 or older.
• Preterm labor.
 SYMPTOMS
• Thin appearance, with little body fat and hair.
• Dry, scaly skin with possible meconium stains.
• Scarce panniculus adiposus; poor musculature; difficulty maintaining
body temperature.
• Alert, but with less activity; hypotonic with less capacity to respond to
the demands of the environment.
• Absence of urination during the first hours of life.
 complications of this condition

• Low oxygen levels at birth

• Inability to maintain body temperature
• Difficulty feeding and gaining weight
• Infection
• Breathing problems, such as infant respiratory distress syndrome (a respiratory
disease of prematurity caused by immature lungs)
• Neurologic problems, such as intraventricular hemorrhage (bleeding inside the
brain)
• Gastrointestinal problems, such as necrotizing enterocolitis (a serious disease of
the intestine common in premature babies)
• Sudden infant death syndrome (SIDS)
 DIETARY PRINCIPLES
Proteins
• 10% of daily calories should be derived from proteins.
• Recommended allowance for LBW neonates is 3-4 gms/kg/day.
Carbohydrates
• Should provide 40% energy.
• Recommended allowance is 10-15 gms/kg/day.
Fats
• Should provide 50% of total energy.
• Recommended allowance is 5.4- 7.2 gms/kg/day.
Electrolytes
• Sodium, Potassium, Chloride requirement may be considerably higher
in ELBW infants because of significant renal losses.
• However their supplementation is not required for the first 24 to 48
hours.
• Recommendations are 2.5 to 3.5 meq/ kg/ day each.
• Mature Human milk contains 1.1 meq/100 kcal of sodium and
premature milk contains 1.9 meq /100 kcal which is often insufficient
for VLBW infants.
TREATMENT
 REFERENCES

• Text book on Care of Newborn – Meharban Singh, VI Edition 2004.

• Ghai Essential Pediatrics- VI Edition- 2004.
• Manual of Neonatal care – John P. Cloherty V Edition 2004.
• Nelson Text Book of Pediatrics – 17th Edition 2004.
• Managing Newborn Problems. A guide for doctors, nurses, and
midwives: WHO Publication, 2003.