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