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 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
Abnormal body temperature
Breathing difficulty

Retinopathy of

prematurity

Necrotizing enterocolitis

Apnea of Prematurity

Jaundice

Bronchopulmonary

Intraventricular bleeding
Anaemia
Low blood glucose
Retinopathy of prematurity
Apnea of Prematurity

dysplasia
Osteopenia of

Prematurity

 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

7+

ml/kg body weight of

feed and/or fluid

60

80

100

120

140

150

160
+

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 babys growth

Easily digested and efficiently used by the babys 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

13

 Include the mothers 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

14

Signs of correct attachment

CALM

Babys chin touches the breast

Babys 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

15

 Established an IV line
Reassess the baby after 12 hours :
If the babys condition is improving restart feeds,

observing carefully
If the babys 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
Feed volume every
3 hours (ml/feed)

12

18

22

26

30

33

35

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 babys growth

Table Volumes of breast milk for a by weighing 1,25-1,49 kg

without major illness
Day of life
Feed volume every
3 hours (ml/feed)

10

15

18

22

26

28

30