Care of Low Birth Weight Babies(LBW)
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Care of Low Birth Weight Babies(LBW) Presentation Transcript

  • 1. Care of Low Birth Weight(LBW) Babies Dr.Rajkumar Patil Asstt.Prof.,Dept. of Community Medicine A V Medical College,Pondicherry
  • 2. Low birth weight (LBW )
    • Gestational age
    • Pre-term
    • Term
    • Post term
    • LBW classification
    • Pre-term babies
    • Small for date(SFD) babies:
      • <10 th percentile for the gestational age
      • higher risk
  • 3. SFD
  • 4.  
  • 5. Problem statement Global 17% of live births India 30% of live births (but 5% less than 2 kg)
  • 6.
    • Risk factors for LBW
    • Malnutrition
    • Severe anaemia
    • Infection
    • Unregulated fertility
    • Age(<16 yr)
    • Hard physical work during pregnancy
    • Smoking
  • 7.
    • Prevention and control of LBW
    • Dietary improvements
    • IFA tablets
    • Controlling infections
    • Early detection and treatment of disorders
    • Family planning
  • 8.
    • Management of LBW babies
    • Intensive care
    • Feeding
    • Antibiotics
    • Weight <1.5 kg
    • Incubatory care(Temp.,Humidity,Oxygen)
    • Kangaroo Mother Care(>1.5 kg,normal)
    • Weight >1.5 kg
    • Incubatory care(Temp.,Humidity,Oxygen)
    • Radiant warmer
    • Kangaroo Mother Care
  • 9. NICU
  • 10.  
  • 11. Kangaroo mother care (KMC)
  • 12.  
  • 13. Infant Feeding Bottle feeding Breast feeding
  • 14.  
  • 15.  
  • 16.  
  • 17.
    • Global Recommendations for
    • Infant and Young Child Feeding (IYCF)
    • Exclusive breastfeeding for 6 months
    • Continue breastfeeding for up to 2 years or more
    • Introduce nutritionally adequate and safe
    • complementary foods after the age of 6 months
  • 18. Colostrum
    • Importance
    • Antibody -protects from infection and allergy
    • White cells - protects from infection
    • Purgative - clears meconium; helps prevent jaundice
    • Growth factors - helps intestine mature;
    • prevents allergy
    • Vitamin A -reduces severity of infections;
    • prevents eye diseases
    Nature’s way of coating the baby’s intestines with antibodies even before he starts taking anything else
  • 19.
    • Breastfeed on demand
    • Show mothers how to breastfeed
    • Tell her how to maintain lactation
    • if she is separated from the infant
    • 8-10 times or more in 24 hours
    • Breastfeed at night also
    • No restrictions on length/numbers of breastfeeds
  • 20.
    • ABCD of benefits by breast feeding
    • Available easily
    • Allergic condition reduced
    • Anti-microbial factors
    • Best food for infant
    • Bonding between mother and child
    • Body shape returns quickly back to pre-pregnancy level
    • Breast cancer risk reduced
    • Bleeding reduced
    • Biochemical advantages (Prevents hypocalcaemia & hypomagnesaemia)
    • Clean
    • Cheap
    • Development of IQ, jaw, mouth
    • Digested easily
  • 21. Human milk and cow’s milk Constituent Human milk (gm/l) Cow’s milk (gm/l) Proteins 11 33 1. Casein 4 28 2. Soluble proteins (lactalbumin, lactotransferrin,lysozyme) 7 5 Non-protein Nitrogenous substances 0.32 0.32 Lipids 35 35 Carbohydrates 70 (lactose 62) 50 Minerals 2 8 Vitamin C 60 mg 20 mg Vitamin D 50IU 25IU Energy 640-720 kC 650 kC
  • 22.
    • Some Contents of Human milk
    • Protein
    • More cysteine (essential for premature)
    • IgG,lysozymes
    • Fats
    • PUFA rich
    • Easier to digest
    • Carbohydrates
    • Lactose for brain
    • Lactobacillus growth in intestine beneficial
    • Vitamins and Minerals
    • Vitamin A,C and D
    • Low Iron better bioavailability
    • Less Ca but better absorbed
    • Less sodium,less load on kidney
  • 23.
    • Signs of correct attachment
    • mouth wide open
    • lower lip is turned outside
    • chin touching the breast
    • areola of breast not visible below the lower lip
    • areola of breast and nipple are inside baby’s mouth
    • tongue under the teat
    correct incorrect
  • 24.
    • Helping Mothers with Breast Problems
    • Fullness
    • Engorgement
    • Mastitis
    • Breast abscess
    • Cracked nipple
    • Sore nipple
    • Inverted nipple
  • 25.
    • Expression of breast milk
  • 26. Expression of breast milk
  • 27. Burping the child
  • 28.
    • Artificial Feeding
    • Not on human milk
    • Indications
    • Mother very ill/died/unavoidably absent
    • Failure of breast milk production
    • Mother rejects infant
  • 29. Principles of artificial feeding 1.Think of infants requirements: Energy:100kC/kg Protein:2 g/kg Carbohydrate:10 g/kg 2.After 4 months diluted milk can be used 3.Feeding 6-8 times (during illness more feeds)
  • 30.
    • What can be used for artificial feeding?
    • 1.Dried milk
    • Dried whole milk
    • Simple to reconstitute
    • Fortified with vitamins
    • Expensive
    • 2.Cow’s milk
    • Cheap
    • Easily available
    • Dilute with water for <4 months infant
    • (25-33% water)
    • Add sugar (5-10 gm)
  • 31. Risks of artificial feeding
    • For child:
    • diarrhoea and respiratory infections
    • allergy and milk intolerance
    • infant mortality
    • malnutrition,Vitamin A deficiency
    • chronic diseases (DM,hypertension)
    • Lower IQ
    • For mother:
    • interferes with bonding
    • pregnancy sooner
    • overweight
    • anaemia
    • ovarian and breast cancer
  • 32. Weaning Weaning is gradual process to introduce foods other than breast milk or infant formula at around 6 months Breast feeding should also be continued till 2 years
  • 33. Baby Friendly Hospital Initiative (BFHI)
    • Launched in 1991 by WHO and UNICEF
    • 10 steps to be fulfilled by the hospitals
    • Have a written breastfeeding policy that is routinely communicated to all health care staff
    • Train all health care staff in skills necessary to implement
    • this policy
    • 3. Inform all pregnant women about the benefits and management of breastfeeding
    • 4. Help mothers initiate breastfeeding within a half an hour of birth
    • 5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants
  • 34.
    • 6 . Give newborn infants no food or drink other than breast milk, unless medically indicated
    • Practice rooming-in : allow mothers and infants to remain together 24 hours
    • Encourage breastfeeding on demand
    • Give no artificial teats or pacifiers
    • (dummies or soothers) to breastfeeding infants
    • Foster the establishment of breastfeeding support groups
    • and refer mothers to them on discharge from the hospital
  • 35. Thank you...