Low Birthweight and IUGR Babies Flashcards
Define a LBW baby (with reference)
WHO (2018) cites LBW babies as those weighing below 2.5kg
Fact about LBW and neonatal death (with reference)
WHO (2018) - 60-80% of neonatal deaths can be attributed to complications of LBW
List 6 maternal risk factors for having a LBW baby with (with reference)
(WHO, 2018) Lifestyle Age Malnutrition Illness/injury Multiples Hypertension OR 25% no reason.
What complications are LBW babies at increased risk of?
Hypoglycaemia Hypothermia Respiratory Distress Syndrome Organ Failure Polycytheamia and Jaundice
List the main differences between premature babies and LBW babies
Although they may both be the same size:
LBW babies may have a suck, swallow, breathe reflex; skin creases; loose skin; be very hungry; better muscle tone.
Discuss the importance of the metabolic triangle in caring for LBW babies (reference)
(Aylott, 2006)
The metabolic triangle links hypothermia with hypoglycaemia and hypoxia and argues that LBW babies are suseptible to all of these things.
-LBW babies have low subcutaneous fat and are more likely ot become hypothermic. Hypothermia uses up glycogen reserves faster meaning that a baby is at increased risk of hypoglycaemia
-hypothermia also increases demand for O2 which may cause baby to start using anaerobic metabolism which lowers PH due to lactic acid production and may cause hypoxia.
-Hypoglycaemia also reduces the energy a baby has available to produce surfactant in the lungs and may cause breathing difficulties.This can lead to hypoxia.
Describe a care plan for LBW babies
With this in mind, care for LBW should include:
Warm delivery room (Lyon, 2004)
Thermoneutral temperature (appropriately dressed and skin to skin)
Feeding plan - avoid weightloss
Regular observations done according to local policy
Monitor output
Monitor blood sugars
Monitor Jaundice
Assess for signs of infection.
Refer to pediatrician if any concerns.
Why do LBW babies get cold? (with reference)
(Lyon, 2004) Low birthweight babies get cold due to: Low levels of subcutaneous and brown fat Increased water content Immature skin Immature cold stress response (inability to maintain vasoconstriction)
What is the difference between SGA and IUGR babies?
SGA babies are below the 10th percentile
Not all SGA babies have growth problems. Some are supposed to be small. However, some babies are small because of growth problems. If the placenta stops functioning effectively babies will not continue to grow at a good rate which, in severe cases can cause brain damage. IUGR is either symmetrical or assymetrical.
What AN care would you give to IUGR babies?
Routine AN care including FH, FMs, Blood pressure, Temp, pulse, PV loss, stress
Individualised growth chart.
Additional USS to assess growth of baby and a doppler USS to assess blood flow through the placenta. Close monitoring will be required. Obstetric care.
Good diet encouraged. Stop smoking,
Possible steroids given 24-34 weeks if baby needs to be delivered early.
What increases the risk of IUGR?
Smoking Malnutrition Pre-eclampsia Anaemia Alcohol Drug abuse Infection
What scoring system is used to differentiate IUGR baby from premature baby?
Ballard scoring
