LOW BIRTH WEIGHT

& PREMATURITY
Birth weight < 2500 g, gestational age is not taken
into account.

LBW could be :
 Term
 Preterm
 Postterm
Based on BW:
Low birth weight (LBW) : BW 1500 - < 2500 g
Very Low Birth Weight (VLBW): BW 1000 g -
<1500 g
Extremely LBW (ELBW) : BW < 1000 g

Based on GA:
Preterm baby Appropriate for gestational age
(AGA)
Small for gestational age (SGA):
Preterm
Aterm
Post-term
PRETERM BABY
 Preterm baby  born before 37 weeks gestation

 Have more problems than term babies who are small

( less than 2,5 kg at birth)

 The more preterm the baby is, the more likely the baby

is to have problem
 Preterm baby may have a problem that is specific 

jaundice of prematurity, but may have any other problem

that a full-size, term baby can have( jaundice associated
with sepsis)
 Feeding difficulty
 Retinopathy of
 Abnormal body
prematurity
temperature
 Apnea of Prematurity
 Breathing difficulty

 Necrotizing enterocolitis  Bronchopulmonary

 Jaundice dysplasia
 Intraventricular bleeding  Osteopenia of

 Anaemia Prematurity
 Low blood glucose
 Regardless of what other problems they may have

 all preterm babies require special considerations for

feeding, fluid management and maintenance of normal
body temperature (ideally using kangaroo mother care)
 Ensure the baby is fed as soon as possible after birth

(within one hour if possible)

 Encourage the mother to breastfed the baby or to give

expressed breast milk

Total daily feed and fluid volumes for babies from birth
Day of life 1 2 3 4 5 6 7+
ml/kg body weight of feed 60 80 100 120 140 150 160+
and/or fluid
General principles of feeding preterm babies
 Difficulty feeding  the babies are not mature enough

to feed well.
 Good feeding  established by 34 – 35 weeks post-

menstrual age.
 Provide special support & attention to the mother

during this difficult period

 Her breast milk is the best food for the baby

 Breastfeeding is especially important for preterm baby.

 It is usually normal if the baby :

 Tires easily & suckles weakly at first

 Suckles for shorter periods of time before resting

 Falls asleep during feeding

 Pause for long periods between suckling

 It may take longer for a preterm baby to establish

breastfeeding
 Assure the mother that breastfeeding will become

easier once the baby becomes bigger.

 The mother follow the general principles of exclusive

breastfeeding
 Encourage early and exclusive breastfeeding whenever
possible
 Explain to the mother and her family the benefits of early
and exclusive breastfeeding :
 Breast milk contains the exact nutrients the baby needs

and promotes the baby’s growth

 Easily digested and efficiently used by the baby’s body

 Protects the baby from infection

 Used as a contraceptive method 12

 Encourage mother to breastfed the baby on demand

(eight or more times in 24 hours) for as long as the baby

wants
 Advise the mother that she should not :

 Force the baby to feed

 Interrupt a feed before the baby is done

 Use artificial teats or pacifiers

 Give the baby any other food or drink

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 Include the mother’s family

 Ensure the mother eats nutritious food and has enough

to drink
 Avoid washing or wiping her nipples before breastfeeding

 If the mother is too ill or she chooses not to breastfed 

a breast milk substitute

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Signs of correct attachment CALM
 Baby’s chin touches the breast

 Baby’s mouth is wide open with the

lower lips curled out

 More of the areola is visible above

than below the mouth

 Baby suckles with slow, deep

sucks and pauses sometimes

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 Established an IV line

 Reassess the baby after 12 hours :

 If the baby’s condition is improving  restart feeds,

observing carefully
 If the baby’s condition is not improving  IV fluid at

maintenance volume for another 12 hours

 Preterm babies  require different feed and fluid

volumes based on their condition and weight

 Babies without major illness

 1,75 – 2,5 kg

 Allow the baby to begin breastfeeding.

 If the baby cannot be breastfed  expressed
breast milk using an alternative feeding method
Table Volumes of breast milk for a by weighing 1,5-1,748 kg
without major illness
Day of life
1 2 3 4 5 6 7
Feed volume every 12 18 22 26 30 33 35
3 hours (ml/feed)
If the baby weighs 1,25 – 1,5 kg  at least 8 times in
24 hours

If the baby weighs less than 1,25 kg  at least 12 times

in 24 hours

Ensure the baby is receiving enough milk by assessing

the baby’s growth
Table Volumes of breast milk for a by weighing 1,25-1,49 kg
without major illness
Day of life
1 2 3 4 5 6 7
Feed volume every 10 15 18 22 26 28 30
3 hours (ml/feed)