Low Birth Weight Infants
The low birth weight infants (LBW) are infants weighing 2500 grams (5.5 lbs) or less at birth. These children due to their weak physiological make-up demand special care; and according to this definition the proportion of such infants in developing countries is around 20-30 percent or even higher. In developed countries around 3-5% babies born are LBW. In the USA the LBW rate in 1984 was 6.7%. The more appropriate place for care of these children is a specialized intensive care unit in a hospital. At present in the developing countries such special care is not available to the majority. Therefore, in these countries efforts have to be made to adapt to and improvise the locally available facilities to meet the special needs of these children.
The low birth weight infants comprise of two groups of new-born; (1) babies who are born before 37 weeks of pregnancy and (ii) babies born after 37 weeks of gestation but having weight lower than that appropriate for their age. Among these babies. those having weight below the 10th percentile for a given gestational age are given the special name ‘small for date’ .
In addition to genetic and geographic factors, the common causes of low birth weight are rnaternal malnutrition, obstetric or medical complications associated with pregnancy,* congenital malformation of the foetus and socioeconomic factors like’ heavy work during pregnancy • pregnancy in quick succession or’ pregnancy at a very young age. Very often a combinadon of several factors is present. The causes of low birth weigth in developed countries are different from those found in developing countries. In the latter, maternal malnutrition, anaemia and short birth intervals are more commonly seen. In the western countries specially in USA, teenage pregnancies, racial and life style factors play a greater role.
Low birth weight should be prevented rather than treated. Direct methods including prenatal treatment of pregnancy complications, nutritional care of the mother, treatment of anaemia and use of folic acid as supplements have been shown to be effective. Indirect methods include health education for proper spacing of pregnancies and avoidance of physical labour.
The principles of management and care of Low Birth Weight infants
These are similar to those for care of normal newborn with the important difference that these have to be instituted more intensively. In the hospitals, nurses should be specially trained for the job and a special unit should be responsible to carry out care of these infants. In places where it is not possible to provide institutional care, the mother and other intelligent members of the family should be trained by the health worker in the basic care of LBW infants. It should be remembered that low birth weight, in most cases, is preventable and good prenatal care, treatment for anemia and nutritional supplementation can help to reduce incidence of low birth weight in developing countries. The chief risks to the low birth weight infant are: (a) intracranial birth injury, (b) asphyxia, (c) infections, and (d) hypothermia. A large number of Perinatal deaths are contributed by low birth weight infants due to these causes.