At a population level, the proportion of infants with a low birth weight is an indicator of a multifaceted public health problem that includes long-term maternal malnutrition, ill-health and poor health care in pregnancy. Low birth weight is included as a primary outcome indicator in the core set of indicators for the Global Nutrition Monitoring Framework. It is also included in the WHO Global reference list of 100 core health indicators. Low birth weight has been defined by WHO as weight at birth of < 2500 grams (5.5 pounds). Low birth weight is caused by intrauterine growth restriction, prematurity or both. It contributes to a range of poor health outcomes; for example, it is closely associated with fetal and neonatal mortality and morbidity, inhibited growth and cognitive development, and NCDs later in life. Low birth weight infants are about 20 times more likely to die than heavier infants. Low birth weight is more common in developing than developed countries. However, data on low birth weight in developing countries is often limited because a significant portion of deliveries occur in homes or small health facilities, where cases of infants with low birth weight often go unreported. These cases are not reflected in official figures and may lead to a significant underestimation of the prevalence of low birth weight.

1. LOW BIRTH
WEIGHT
PRESENTED BY:
REVATHI MAROJU

2. Contents
Introduction Low Birth
Weight
Causes
of LBW
01
03
02
04
Problems
of LBW

3. Contents
KMC
Prevention
of LBW
References
05
07
06
Care of LBW
babies
08

4. Birth weight is the single most
important determinant of chances
of child survival, healthy growth
and development.
Introduction

5. Birth Weight:
1st weight of fetus or new born obtained after birth.
Importance of birth weight:
• Reflects health status of mother during adolescence
and pregnancy.
• Also reflects quality of antenatal care.

6. Low birth
weight
babies
Pre-term
SFA/D term
Introduction:

7. LOW BIRTH
WEIGHT

8. Low Birth Weight (LBW):
• In countries like India, where the proportion of LBW is
high, majority of LBW is due to SFA (Small for Age).
• By international agreement Birth Weight is considered
as:
(1) Low Birth Weight (LBW):
Any neonate weighing less than
2500 gm at birth irrespective of
gestational age.

9. Low Birth Weight (LBW):
(2) Very Low Birth Weight baby (VLBW):
Any neonate weighing less than 1500 gm at
birth irrespective of gestational age.
(3) Extremely Low Birth Weight baby (ELBW):
Any neonate weighing less than 1000 gm at
birth irrespective of gestational age.

10. Low Birth Weight (LBW):
Besides this babies are also classified according to the
gestational age
(1) Pre-term Baby :
Babies born before 37 completed weeks (<259 days)
of gestation irrespective of the birth weight.

11. (2) Term baby :
Babies born between 37 to 42 weeks of pregnancies
(259-294 days) irrespective of the birth weight.
(3) Post-term baby:
Babies born at 42 completed week or thereafter
(>294 days of gestation).

12. PRE-TERM
BABIES

13. Pre-Term Babies:
Preterm is defined as babies born alive
before 37 weeks of pregnancy are completed.
There are sub-categories of preterm birth, based on
gestational age :
- extremely preterm ( <28 weeks)
- very preterm (28 to <32 weeks)
- moderate to late preterm (32 to 37 weeks).

14.  Even though born early, PRE-TERM baby’s intrauterine
growth may be normal according to the gestation.
 Given good care ---- catch up good growth ---- 2 to 3
years of age ---- normal size and performance.

15. CAUSES OF
LBW

16. Pre-term births
(< 37 weeks)
Intrauterine Growth
Restriction (IUGR)
(a) Spontaneous pre
term birth
(b) Provider initiated
pre term birth
(a) Medical causes
(b) Social causes
LOW BIRTH WEIGHTS
Low birth weights includes 2 groups:

17. Causes of Pre- Term Births
(a) SPONTANEOUS PRE-TERM BIRTH:
Spontaneous onset of labor or following
pre-labor pre-mature rupture of
membranes (pPROM)
(b) PROVIDER INITIATED PRE-TERM BIRTH:
Induction of labor or elective caesarean
birth before 37 completed weeks of
gestation for maternal or fetal indications
(both "urgent“ or "discretionary"), or other
non-medical reasons .

19. Causes of IUGR:
Maternal causes
Placental causes
Fetal causes
Poverty,
Illiteracy,
Poor standard of living,
Lack of knowledge on
family planning,
Early marriages,
Smoking etc
Medical
causes
Social
causes
 In nearly 50% of cases of LBW the cause is not known.
 In remaining 50% the causes are grouped into:

21. Leading causes of death in LBW babies:
Atelectesis
Malformation
Pulmonary hemorrhage
Intracranial hemorrhage
Pneumonia and other infections

22. PROBLEMS
OF LBW

23. What problems do a low birth weight
babies have??
 Breathing problems at birth and later.
 Low body temperature because there is little fat on
the body and the newborn’s temperature regulating
system is immature.
 Low blood sugar because there is very
little stored energy.

24.  Feeding problems because of their small size,
lack of energy, small stomach and inability to
suck.
 Infections because the infection fighting
system is not mature.
 Jaundice (high bilirubin) because the liver is not
mature.
 Bleeding problems due to immature clotting
ability at birth.

25. Other clinical Problems of LBW:
 Retinopathy of prematurity
 Apneic spells
 Intraventricular hemorrhage
 Metabolic acidosis

26. ROP (Retinopathy of Prematurity):
● Retinopathy of prematurity (ROP)
is an eye disorder caused by
abnormal blood vessel growth in
the light sensitive part of the
eyes (retina) of premature infants.
● ROP generally affects infants born
before week 31 of pregnancy and
weighing 1,250 grams or less at
birth.

27. Causes of ROP:
 Retinal detachment is the main cause
of visual impairment and blindness in
ROP.
 During the last 12 weeks of a
pregnancy, the eye develops rapidly.
 If a baby is born prematurely, before
the blood vessels have reached the
edges of the retina, normal vessel
growth may stop.

28. Stages of ROP is classified in
five stages, ranging from
mild (stage I) to severe
(stage V)

29. Signs & symptoms of ROP:
 White pupils, called leukocoria.
 Abnormal eye movements, called
nystagmus.
 Crossed eyes, called strabismus.
 Severe nearsightedness, called
myopia.

30. CARE OF
LBW
BABIES

31. How to take care of LBW babies??
2500 – 2000 gm Requires special care at home
<2000 gm Requires special care at hospital
<2000 gm & >1800 gm &
stable Hemodynamically
Requires kangaroo mother care
Depends upon birth weight

32. SPECIAL CARE
AT HOME
PRINCIPLES:
1. Prevention of infections
2. Prevention of hypothermia
3. Correction of malnutrition

33. 1. Prevention of Infections:
- Gentle and minimal handling.
- Handling with clean hands.
- Room must be warm, clean and dust-free.
- Immunization at right time.

34. 2. Prevention of Hypothermia:
 Avoid bath till baby attains 2500g weight.
 Cover baby with clean dry & warm cloth.
 Bottles filled with warm water & covered with
thin cloth are kept on both sides (or) baby
without blanket is kept near 60 candle bulb
burning.

35. 3. Correction of Malnutrition:
 As LBW babies cannot suck milk actively , they gets
tired faster.
 So frequent breast feeding must be given almost
every alternate hour.

36. SPECIAL CARE
AT HOSPITAL
PRINCIPLES:
● Prevention of infections
● Prevention of hypothermia
● Correction of malnutrition

37. 1. Prevention of Infections:
● Prophylactic antibiotics to
prevent septicemia.
● Separate nurses for feeding and
toilet attending.
● Barrier nursing to prevent cross
infections.

38. 2. Prevention of Hypothermia
● Child is kept under incubator – it
maintains the temperature ,
humidity and O2 supply , till weight
increases to 2000g.
● Careful monitoring of O2 supply:
low O2 - hypoxia and cerebral palsy
high O2 - retinopathy of prematurity

39. 3. Correction of Malnutrition:
● The baby is already
malnourished.
● Further malnutrition should be
prevented.
● Tube feeding is done because
baby is in incubator and it is too
young to suck mothers milk.

40. KMC

41. KANGAROO MOTHER CARE
 Introduced first in Colombia in 1979 by Dr.
Hector Martinez and Dr Edzar Rey.
 Intervention to combat high infection and
mortality rate owing to overcrowding in
hospitals.
 Now adopted across the developing world
and considered as essential element in
neonatal care.

42. Components of KMC:
The four components of kangaroo
mother care are all essential for
ensuring the best care.
They include:
 skin-to-skin positioning of a baby
on the mother's chest;
 adequate nutrition through
breast-feeding;

43.  ambulatory care as a result of
earlier discharge from
hospital;
 support for the mother and
her family in caring for the
baby

45. Benefits of KMC:
● Baby is kept warm all the 24 hours
by the mother (natural incubator).
● Baby has minimum risk of apnea.
● Baby gains physiological stability.
● Baby gets safety and love.
● Early growth is promoted.
● Reduced risk of nosocomial
infections.

46. PREVENTION

47. Prevention of LBW:
● Experts opinion is that the rates of LBW babies
could be reduced to not more than 10% in all
parts of the World.
● It is clear from the multiplicity of causes that
there is no universal solution.

48. Prevention of LBW:
• Interventions have to be cause-specific.
• Main attention has been given in recent years
to ways and means of preventing LBW through
good prenatal care and intervention
programmes, rather than "treatment" of LBW
babies born later.

49. “A new baby is
like the beginning
of all things -
wonder, hope, a
dream of
possibilities.
- Eda J LeShan

50. References:
● https://www.slideshare.net/drsrinivasraod/low-
birth-weight-50014477
● https://www.slideshare.net/jamesmacroony/low-
birth-weight
● Park K . Textbook of Preventive and Social
Medicine. 26th ed. Banarasidas Bhanot
publishers;2021.
● Image source: Google.

51. CREDITS: This presentation template was created by
Slidesgo, including icons by Flaticon and infographics &
images by Freepik
Thanks!