Definition:

Babies with birth weight of less than 2.5 kg (irrespective of gestational age) are known as LBW babies. They include- preterm, term, post term, small for date(SFD), small for gestational age(SFGA), intra – uterine growth retardation(IUGR) babies.

Classification of Low Birth Weight Babies:

Classification of Low Birth Weight Babies are-
a) LBW babies: Babies with birth weight of less than 2.5 kg but not less than 1.5 kg
b) Very low birth weight (VLBW) babies : Babies with birth weight of less than 1.5 kg but not less than 1 kg
c) Extreme low birth weight (ELBW) babies : Babies with birth weight of less than 1 kg.

Management of Low Birth Weight babies:

1. Airway clearance

2. Establishment of respiration

3. Maintenance of circulation

4. Control of body temperature :

Following measures should be taken –
i) Wrapping of the whole body with warm cotton & the head by double cap after drying the baby
ii) Keeping the newborn baby in incubator
iii) Using radiant warmer, if baby is born at home- electric heater should be used
iv) Delayed bathing
v) Kangaroo mother care (KMC) – for the babies with birth weight 1.2 kg to 1.8 kg

5. Feeding management:

Feeding of a LBW baby is managed according to following-

Feeding should be started at a rate of 1 ml/kg/ 2- 3 hrs with daily increment of 10 – 15 ml/kg/day (not more than 20 ml/kg/day) until 150 ml/kg/day. Inj. Konakion 2 mg should be given twice weekly till enteral feeding is fully established.

6. Management of fluid and electrolyte:

Fluid should be given according to following table-

The amount of fluid should be increased at a rate of 15-20 ml/kg/day upto 180ml/kg/day by day 10 and up to 200mg/kg/day by day 14.

Fluid requirement is increased in-
1. Fever
2. Increase Respiratory rate
3. Skin injury/ burn
4. Phototherapy
5. Use of radiation warmer.
Fluid requirement is decreased in-
1. Perinatal asphyxia
2. Neonatal sepsis
3. Heart failure
4. NEC
5. Renal failure.

7. Prevention of infection:

•  Aseptic precaution for all sorts of procedures
• Minimum visitors
• Hand washing before nursing the baby
• Less handling of the newborn
• Care of umbilical stump
• Care of the skin to maintain its integrity.

8. Prevention of vitamin and mineral deficiencies –

•  Vitamin K- 2 mg orally at birth and again after 4-7 days
• Multivitamins and Folic acid- from 2nd week
• Iron- after 6-8 weeks – at a rate of 2-3 mg/kg/day

9. Early identification and treatment of complication (if any)

10. Regular monitoring of growth and development.

Complications of low birth weight babies:

Complications of low birth weight babies are-

1. Respiratory complications-

• Neonatal asphyxia
• Meconium aspiration
• Hyaline membrane disease

2. Hyperbilirubinemia
3. Hypoglycemia
4. Hypothermia
5. Infection
6. Feeding disorders-

•  Food aspiration
• Inability to suck or swallow

7. NEC (Necrotizing enterocolitis)
8.PDA (Patent ductus arteriosus).