low birth weight baby and kangaroo mother care

1. Low Birth Weight baby
&
Kangaroo Mother Care

2. • Infancy is the first year of life and has greatest threat to survival
and therefore is a good measure of the progress in the fields of
socio-economic, medical and healthcare development in a
country.
• Perinatal Period : extends from 28th weeks of gestation to less
than 7 days of life, after birth.
• Neonate : A child in 1st month [under 4 weeks of age (<28 days)].
Early Neonatal Period- First week of life (<7days or <168 hours).
Late Neonatal period extends from 7th to 28th day.
• Post-Neonatal period : infancy from 28 days to under 365
days(1yr)
• Live born : a product of conception, irrespective of weight or
gestational age, that after separation from the mother, shows
any evidence of life such as breathing, heart beat, pulsation of
umbilical cord or definite movement of the voluntary muscle.

3. • Still birth : The WHO has recommended for international
comparisons, a weight of 1000gm is to be used which frequently
measures to 28 weeks of gestation. Still birth rate is the number of
foetal deaths (>1000gm weight at birth) occurring in a year per
1000 total births (live births + stillbirths).
• Pre-term Baby : Any neonate born before 37 completed weeks
(<259 days) of gestation irrespective of the birth weight.
• Term baby : A neonate born between 37 and 42 weeks of
pregnancies (259-294 days) irrespective of the birth weight.
• Low Birth Weight (LBW) : Any neonate weighing less than 2500 gm
at birth irrespective of gestational age.
• Very Low Birth Weight baby (VLBW) : Any neonate weighing less
than 1500 gm at birth irrespective of gestational age.
• Extremely Low Birth Weight baby (ELBW) : Any neonate weighing
less than 1000 gm at birth irrespective of gestational age.

4. • Perinatal Mortality Rate : This includes both late foetal deaths
(stillbirths) and early neonatal deaths.
• Small Babies (LBW)- Neonates weighing <2500 gm at birth . One
third of the births in India are estimated to be LBWs.
Two groups- Preterm and SFA (small for gestational age) term
infants. These LBWs face many risks at birth and are prone to
many conditions like infections, respiratory difficulty and
metabolic disturbances.
• Hazards for LBW - Birth asphyxia , Hypothermia, Hypoglycemia,
Infections, Meconium aspiration, Hyperbilirubinemia.

6. • Principles of Management of LBWs
• Care at Birth - All ‘at risk’ pregnancies should be delivered in
hospitals. All arrangements for resuscitation of newborn
should be available.
• Appropriate place of care - Depending on the birth weight
the LBW can be cared for at home (>1800 gm) and if <1800, at
the hospital till the child gains weight and if <1500 gm, these
babies will need tertiary level care.
• Thermal protection - Being prone to hypothermia, adequate
precautions must be taken by maintaining a ‘Warm chain’.
delaying bathing, maternal contact by Kangaroo mother care
and external heat source if required. Fluids and feeds - Breast
feeding, expressed breast milk, nasogastric feeding and IV
fluids if required. Monitoring for early detection and
management of complications like respiratory difficulty,
metabolic disturbances, infections etc.

7. • Kangaroo Mother Care (KMC) : first presented by Rey and
Martinez in Colombia. Applies well in all babies. Features are :
• Early, continuous and prolonged skin-to-skin contact between
the mother and baby.
• Exclusive breast feeding
• It is initiated in hospital and continued at home
• Small babies can be discharged early
• Mothers at home require adequate support and follow up.
It was developed as an alternative to inadequate and
insufficient incubator care. Effective for thermal control, breast
feeding and bonding in all newborn infants. The support binder
is the only special item required for KMC. The baby is placed
between the mother’s breasts in an upright position, chest to
chest. The position allows mother with both hands free and
ability to move around.

8. • Preventive Strategies to Tackle the Problem of LBW
• Direct- Maternal nutrition- by improving the pre-pregnancy & during
pregnancy wt of woman. Good antenatal care. Prevention of
infection in the mother. Early diagnosis and management of maternal
factors like anaemia, malaria, hypertension etc.
• Indirect- Delayed marriage and childbearing, Adequate spacing,
Family planning, Improved socio-economic status, Women
empowerment.
• (1) Exclusive breast feeding from birth to six months.
• (2) Complementary feeding : can prevent 10 per cent of deaths from
diarrhoea and acute respiratory infections, pneumonia; and increase
resistance to measles and other illnesses.
• (3) Micronutrient Supplementation : Improving the intake of vitamin
A through diet or supplements reduce mortality by 20 per cent.
• (4) Hygiene : hand washing with soap (or ashes) and the safe disposal
of excreta could reduce the incidence of diarrhoea by 35%.
• (5) Immunization : against preventable diseases

9. • (6) Malaria prevention : The use of insecticide-treated mosquito
nets could lower malaria-related child deaths by as much as 23 per
cent.
• (7) Psychosocial care and development: by talking, playing and
providing a stimulating environment.
• (8) Feeding and fluids for sick children: Continue to feed and offer
more fluids, including breast milk.
• (9) Home treatment: Give sick children appropriate home treatment.
• (10) Recognize when sick children need treatment outside the
home, and seek care from appropriate providers.
• (11) Follow the health worker’s advice about treatment, follow-up
and referral.
• (12) Every pregnant woman should have adequate antenatal care.
• Providing appropriate care for those who are affected by HIV and
AIDS, especially orphans and vulnerable children; protecting from
injury and accident, abuse and neglect; and involving fathers in the
care of their children