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CARE OF PRETERM
BABIES
PRESENTED BY
AMRUTHA R
1STYR MSc nsg
 <2500GMS
 TYPES
 VLBW
 ELBW
 PRETERMS
 IUGR
 DEFINITION
 A baby born before 37 completed weeks
of gestation irrespective of birth weight.
 Maternal factors
 socio economic factors
 Pregnancy related factors
 Medical conditions
 Anatomic issues
 Behavioral factors
 Infections
 SMALL AND SCRAWNY
 PROPORTIONALLY LARGE HEAD TO
BODY
 TRANSLUCENT SKIN
 VISIBLE BLOOD VESSELS
 FINE LANUGO HAIR
 SOFT PLIABLE EAR CARTILAGE
 SOFT BONES
 CLOSED EYES
 FEW SCROTAL RUGAE AND
UNDECENDEDTESTIS
 PROMINENT LABIA AND CLITTORIS
 INACTIVE AND LISTLESS
 EXTENDED EXTRIMITIES
 PARTIALLY DEVELOPED REFLUX
ACTIVITIES
 ABSENTWEAK OR INEFECTIVE SUCKING
 INABILITY TO MAINTAIN BODY
TEMPERATURE
 LIMITED ABILITY TO EXCRETE SOLUTES
IN URINE
 INCREASED SUSCEPTIBILITYTO
INFECTION
 PLIABLE THORAX IMMATURE LUNG
TISSUE
 IMMATURE REGULATORY CENTRE
 MORE SUSCEPT IBLE TO
HYPOGLYCEMIA AND HYPER
BILIRUBINEMIA
 POOR CONTROL OF BODY
TEMPERATURE
 RESPIRATORY DIFFICULTY
 SUSCEPTIBILITY TO INFECTION
 DIFFICULTIES WITH NUTRITION
 IMMATURITY IN RENAL FUNCTION
 HYPOTHERMIA
 BREATHING DIFFICULTY
 APNOEA
 RDS
 INTRA VENTRICULAR HAEMORRHAGE
 FEEDING DIFFICULTIES
 HYPOGLYCEMIA
 METABOLIC ACIDOSIS
 HYPERBILIRUBINEMIA
 ROP
 FLUID AND ELECTROLYTE IMBALANCES
 NECROTISING ENTEROCOLITIS
 ANEMIA
 BPD
 INFECTIONS
 INTELLECTUAL DISABILITIES
 CEREBRAL PALSY
 VISIONAND HEARING LOSS
 CARE AT BIRTH
 APPROPRIATE PLACE OF CARE
 THERMAL PROTECTION
 FLUIDS AND FEEDS
 MONITORING AND EARLY DETECTION
OF COMPLICATIONS
 APPROPRIATE MANAGEMENT
 Elective intubation of extremely LBW babies
(< 1000g) is practised in
some centers to support breathing and for
prophy lactic administration of exogenous
surfactant.
 The baby should be promptly dried, kept
effectively covered andWarm.
 Vitamin K 0.5 mg should be given
intramuscularly.
 ETTUBE
 VENTILATOR
 C PAP
 02 SUPPLEMENTATION
 MUMMIFICATION
 KMC
 NESTING
 DELAY BATH
 WARMER
 <30– IV FLUIDS, NG ,KATORI, BREAST
FEEDS
 30—34 NG ,KATORI, BREAST FEEDS
 >34 KATORI, BREAST FEEDS
 PROTEIN
 10% of daily calories should be derived from
proteins.
 • Recommended allowance for LBW
neonates is 3-4 gms/kg/day
 BREAST FEEDING
 Carbohydrates
 • Should provide 40% energy.
 • Recommended allowance is 10-15
gms/kg/day.
 Fats
 • Should provide 50% of total energy.
 • Recommended allowance is 5.4- 7.2
gms/kg/day
 • Recommendations are 2.5 to 3.5 meq/ kg/
day each.
 • Mature Human milk contains 1.1 meq/100
kcal of sodium and premature milk contains
1.9 meq /100 kcal which is often insufficient
forVLBW infants.
 VitaminA- An intake of 1500 IU/kg/day is
recommended for preterms.
 It may promote epithelial repair and minimize
fibrosis in preterm
 babies with CLD.
 •Vitamin D-Vit. D at 400 IU/day maintains
adequateVit D status and prevents Rickets.
 •Vitamin E-Vit. E is recommended for
preterm infants in 6 to 12
 IU/kg/day. One ml of Evion (E-Merck)
contains 50 IU.
 •Vitamin K-Vit K is required for hepatic
synthesis of coagulation
 factors II,VII, IX, & X. Administration at birth
of 0.5 to 1.0 mg i.m.Vit K can prevent HDN.
 EBM
 DONOR HUMAN MILK
 FORMULA FEEDS
 NG/OGT
 FREQUENCY
 POSITIONING
 VITAMIN D
 Ca and Ph
 ZINC
 IRON
 HAEMORRHAGE
 WATERAND FLUID LOSS
 RDS
 HYPOGLYCEMIA
 INFECTION PREVENTION
PROTOCOL
 IMMUNISATION
 5 CLEANS
 CLEAN HAND
 CLEAN CORD
 CLEAN CORD CLAMP
 CLEAN SURFACE
 CLEAN PROCEDURESN
 CORTICOSTEROIDS
 SYNTHETIC SURFACTANT
 VIT K
 ANTIBIOTICS
 Vital signs
 Activity and behaviour.
 Color; Pink, pale, grey, blue, yellow.
 Tissue perfusion
 Fluids, electrolytes and ABG's.
 Tolerance of feeds;Vomiting, gastric
residuals, abdominal girth.
 Look for development of RDS, apneic
attacks, sepsis, PDA, NEC, IVH
 Weight gain
 Immunisation
 Danger signs

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