Low Birth Weight New Born Care and Nursing Assessment

Low Birth Weight Newborn Care and Nursing Assessment

Low Birth Weight  New Born care is very essential to preserve LBW baby 

Low Birth Weight

 Neonates Weighting less than 2500 gm irrespective of gestational age at birth are termed  as Low Birth Weight .

These includes Preterm and Term babies

Causes of Preterm Birth

 

(a) Maternal factors

1 Medical disease of the mother during pregnancy

2 Complications of pregnancy e.g., placenta previa and antepartum hemorrhage.

3 Incompetence of cervix,

4 Maternal infections,

5 Previous premature delivery.

(b) Fetal factors

1 Multiple pregnancy.

2 Congenital malformation,

(c) Medical factors,

The delivery of the fetus may have to be induced before

full term on medical grounds under the following circumstances:

1. Uncontrolled diabetes mellitus in the mother,

2. Severe cardiac illness.

3. Hypertension, toxemia,

4. Fetal hypoxia and fetal distress,

5. Severe rhesus iso-immunization in the mother or hydrops fetalis,

6. Severe intrauterine growth retardation,

(d) Latrogenic

Improper diagnosis of maturity in elective deliveries

Major Problems in Low Birth Weight Babies

Hypothermia,
Perinatal Asphyxia,
Hylane Membrane Desease,
Pulmonary Hemmorrage,
Pneomonia,
Pneumothorax,
Brochopulmonary Dysplasia,
Bacterial Sepsis,
Hypoglycemia,
Hypocalcemia
Apnea,
Anaemia,
Hyperbilirunemia,
Meconium Aspiration,
Polycythemia,
Fedding Problems,
Poor Weight Gain,

Low Birth Weiht Baby Care at Birth

High Risk Mothers should be early identified as early as possible during the course of pregnancy and plan for right place to treat mother and child as well health care felicities available i.e, Good quality Maternity and Neonatal Care felicities   

Suitable place of delivery ‘in utero’ tranfer to a  Place with optimum facilities if a LBW delivery is anticipated.

Prevention of hypothermia

Efficient resuscitation

Appropriate place of care

Birth weight>1800gms home care KMC – Kangoaroo Mother care

if the baby is Otherwise well Birth weight 1500-1800gms secondary level new Born unit

Birth weight<1500gms tertiary levels newborn care intensive car

Thermal protection:

Delay bathing 

Maternal contact

Warm room 

External heat source (incubator radiant warmer)

Fluids and feeds:

IV fluids for very small babies and those who are 

Sick Expressed breast milk with gavages or katori  spoon 

Direct breast feeding

Monitoring and early detection of complication

Weight and other clinical signs

Electronic monitoring

Bio chemical monitoring

Principles of management for low birth weight neonates:

Although the preterm and SFD neonates have 

Physiological differences, the principle of management are common.

Physical assessment of the new born.

Physical assessment (head to toe assessment):

The first assessment of newborn is done immediately after birth

second more detail examination is lobe within 1st hour or during admission

Third assessment before discharge .Brief assessment in each shift.

Nursing Assessment for Low Birth Weight babies

General Measurement :

I.Vital signs :

Respiration determine rate, rhythm.

Technique:

Observe abdominal movement for one minute 

Normal findings: 

R.R:40-60 breath\minute Cry R.R.

sleep R.R.

Abnormal finding: 

Tachypnea R.R>60\min, Apnea, 20 seconds or more.

Weighing the baby 

Weight the baby before Transfer from the delivery Room,

Initiate breast feeding within 30 minutes of Birth,

What are the danger signs of New born?

Who are giving to Care of New Born Baby they

Need to aware that baby can get sick and die,

Difficulty in breathing,

Chest In drawing 

Very Cold, Bluish Dislocation of Palms and Hands,

Fever,

Convulsions and Fits,

Difficulty in Sucking or Breast feeding,

Redness of Umbilical Card or Pus Discharge, Swelling,

Redness of eyes or Pus,

Yellowish Skin, Rash on the Skin, Pustules,

A guide for Parents New born Care at Home,

You are ready to care of the new born at home and start life with your new baby,

These Baby Care tips help parents get confident about new born caring, 

Handling of Newborn baby

Reduce Prevent cross infection by 

Hand wash before Touching the baby with Soap and Water or Sanitizer, 

Make sure Hand Wash that who are caring your baby,

Support baby’ s Neck and Head who your lifting the baby every Time,

Keep Baby Head Upright position when transferring to the credil or Crib,

Never shake your baby 

Remember your baby is Not a Doll, Shacking of Baby can cause bleeding in Brain it lead to death,

List out common neonatal disorders ?

Hyperbilirubinemia

Pathological jaundice

Physiological jaundice

Haemolytic disorder of Newborn

ABO incompatibility

Rh incompatibility

Neonatal hypoglycemia

Neonatal sepsis

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