Helping A Low Birth Weight Baby by Dr Lathiesh Kumar Kambham

What is Considered a Low Birth Weight?

When the birth weight of a baby is less than 2.5 kg (5 pounds, or 8 ounces), the baby is called a low birth weight baby or LBW baby, regardless of when during the pregnancy the baby is born. A study conducted in India shows out of 10 full-term babies, 2 babies are born with LBW. A low birth baby will look smaller than other babies who have normal birth weight.

The baby may look thin, and the head may appear to be larger than the rest of the body. Babies who weigh 1,500-2,499 gm can be managed safely after discharge from the hospital with special care and support. Babies who are born with a birth weight of fewer than 1500 gms need special hospital care facilities with advanced life support

How Much Does a Baby Have to Weigh Before it Can Leave the Hospital?

If the baby’s weight is less than 2.5 Kg but more than 2 kg, then it generally doesn’t need special neonatal care at the hospital and can go home when the mother is ready. But, if the baby is below 2 kg, it needs specialized neonatal care at the hospital and will be allowed to go home only after two weeks to one month, when the baby is strong enough to go home.

However, this might be different for each hospital and the neonatal experts may even take into consideration the early arrival of the baby if so be the case. In both cases, though, special care should be given to the babies till they retrieve their immunity.

Why Should We Give Special Care to Low Weight Babies?

Low birth weight children are at an expanded danger of passing on from hypothermia, different types of infections, breathing issues, and immaturity of their fundamental organs. Therefore, they might be not able to adjust to living outside the uterus. These are the key reasons why they require special consideration.

You should make sure the baby is been subjected to all the growth and development checkups, which can help your child’s doctor to detect any issues in its early stage itself.

What Causes Low Birth-Weight in Babies?

The below factors pose a risk of a baby being born with low birth weight:

1. Premature Birth

A baby gains most of the weight during the last stages of pregnancy, so babies who are born before completing 37 weeks of gestation, that is, being born prematurely is the main cause of low birth weight. This so happens because the baby does not get sufficient time to put on layers of fat in the womb itself.

2. Intrauterine Growth Restriction (IUGR)

Another cause of low birth weight is intrauterine growth restriction (IUGR)– which can be due to problems with the placenta, the mother’s physical condition, or the baby’s health. A baby can be born at full term, even with IUGR, but he will be physically weak. Babies who are born prematurely and have IUGR are both very small and physically weak.

[Read: Intrauterine Growth Retardation]

3. Age of the Mother

Babies born out of teen pregnancies have a high risk of being premature and having a low birth weight.

4. Multiples

A multiple pregnancies can also cause the babies to be of low birth weights as babies may have to struggle to get adequate nutrition, and are likely to be born early.

5. Mother’s Health

Women who develop pregnancy complications, or do not receive proper prenatal care or pregnancy nutrition are at a high risk of giving birth to premature babies. Additionally, exposure to drugs, smoking, alcohol, etc. can also make a woman’s baby have a low birth weight.

To know about the factors that influence the ideal weight of a baby, click here.

How Can a Low Birth Weight Affect the Baby?

The impact of low birth weight relies on the cause. If the low birth weight is due to preterm birth, there will be issues. The issues can vary with the full-term baby having low birth weight or if the low birth weight is due to intrauterine growth restriction (IUGR).

Again, it varies from one baby to another. Whatever may be the cause, one thing is certain – a baby with LBW possesses an increased possibility of complications. Most of the low birth weight babies possess:

1. Difficulty Staying Warm

As they have very little body fat, almost every low birth weight baby shows the difficulty to maintain body temperature. This is so because they lay still and do not move much to generate heat.

2. SIDS

Sudden infant death syndrome (sudden and unexpected death of the baby before the first birthday. 90% occurs by the age of six months) is more common among babies with low birth weight.

3. Low Oxygen Level

The oxygen level of the low birth weight baby is found to be very low. This is because their body surface area – body weight ratio is high and consequently the oxygen consumption of the body also elevates.

4. Respiratory Distress Syndrome

This is the breathing problem caused due to immature lungs.

5. Necrotizing Enterocolitis (NEC)

It is a significant gastrointestinal problem of which the consequence is the death of the baby’s intestinal tissues. Around 10% of babies with low birth weight are found to possess this issue. To know more on Necrotizing Enterocolitis click here.

6. Infections

As their immunity is much lower than a normal weighed newborn, babies with low birth weight are more prone to infections.

7. Difficulty in Feeding

As their lung capacity is lower, babies with low birth weight always find it difficult to suck the breast milk and therefore, find trouble in gaining weight.

What is the Difference Between a Premature Baby and a Baby With Low Birth Weight?

Babies born prematurely between 32-37 weeks are premature babies and they may likely have a low birth weight. Babies born before 32 weeks are highly premature and need extra special care at the NICU of specialized hospitals. Further, babies born at 37-42 weeks, but having weight less than 2500 gms are low birth weight babies, and may just need a few days at the NICU.

Thus, a premature baby can always be a baby with low birth weight. But LBW babies are not always preterm babies.

How Can I Help My Low Birth Weight Baby With Breastfeeding?

As we already discussed, due to poor suck-swallow coordination, weak suck reflex, and many other factors, the baby finds it very hard or totally unable to feed the breast. Breastfeeding a baby with low birth weight is a challenge, especially if the baby is born preterm. LBW babies who can breastfeed ought to be put to the bosom at the earliest opportunity after birth when they are clinically steady, and ought to be solely breastfed until six months of age.

• You can definitely try to breastfeed the baby if the baby is above 1.5 Kg or completed 34 weeks of gestation. Squeeze out a few drops of milk to the baby’s lips and encourage him patiently to suckling. At first, you should give extra support by squeezing your breast lightly while the baby sucks.
• If direct breastfeeding doesn’t work, you can try cup feeding. If the baby is born before 34 weeks, he can’t suckle sufficiently. In that case, the baby can be fed expressed breast milk of the mother with a small, sterilized cup.
• Sometimes, cup feeding can end up with spitting more milk than swallowing. In that case, you can use a feeding bottle designed for preterm babies.
• Always feed the baby every two hours till the baby gain his normal healthy state.

How Can I Keep Low Birth Weight Baby Warm?

Low birth weight babies have awesome trouble in keeping up their body temperature. They effectively lose warmth, and hypothermia is life-debilitating in their sensitive condition. The heat loss from the baby’s body can be restricted by:

• Straight away after the birth put the child in skin-to-skin touch with the mother.
• Additional covers or any additional cloth preferably made of cotton should use to cover both the mother and the infant
• Never leave the baby in an open room (room with open doors and windows).
• There ought to be an additional warmth source in the room where the baby with low birth weight is taken care of
• Never attempt to bathe the baby without the doctor’s instruction.
• Make sure the head of the baby is well covered. This is on the grounds that more than 90% of the heat loss occurs through the head when it is left uncovered.
• Never undress the baby completely to change the diaper.

What is Kangaroo Mother Care?

Kangaroo mother care is a method of care practiced on babies who are usually born preterm. It is called after the way that kangaroo care for their young, has been appearing to be a great method for watching over preterm and low birth weight babies.

It includes holding an infant in skin-to-skin contact, close to 24 hours a day, throughout day and night, inclined and upright on the chest of the mother, or another capable individual of the family (preferably father) if the mother can’t do it constantly due to some health issues.

What are the Advantages of Kangaroo Care?

Kangaroo Care is known to have its own merits:

• As the infant is kept in skin-to-skin contact day and night, which gives effectual warmth and temperature control.
• The infant sustains better and puts on weight all the more quickly (so it grows more muscle and fat to keep it warm).
• As the child is just expelled from skin-to-skin contact for particular purposes (changing its diaper, checking whether the cord stump is drying as per rule), so there is little chance the baby is being left at a room temperature which is ‘freezing cold’ for the little one.
• The benefit of KMC can be given by different individuals from the family if the mother is not well or in the necessary to have a break.

How Long Should Kangaroo Mother Care Continue?

At the point when the mother and child are OK with the procedure, KMC ought to proceed for whatever length of time that the mother thinks she can do, or until the baby completes the term (40 weeks), if the baby is preterm or the infant’s weight achieves 2,500 gm.

Yet, in the event that the baby’s temperature is steady and if there are no respiratory issues, the child can be weaned from KMC before 40 weeks. What’s more, when the infant has had enough and ‘done’ of being in KMC, it begins to speak with the mother in its own particular manners. They start wriggling, moving restlessly, and tries to throw the limbs out of the wrapping.

How to Accelerate Weight Gain in a Baby Born With a Low Weight?

In the event that keeping an eye on the baby’s weight gain is significant in normal birth weighed baby, watching the weight gain of the baby born with low weight is of high priority. More frequent breastfeeding is the only way to attain adequate weight. If the breast milk is too low, in spite of trying out a different method to increase the breast milk, you can go for formula feeding according to the doctor’s instruction.

Before giving birth to your little one you might always consider yourself an able woman. But after the little one enters your world, your ‘can do’ perspective can disappear like a vanishing act of a magician. It is not that you don’t have cherished moments with your little one, but, nothing to wonder if you are equally anxious and overwhelmed by the little life that is solely dependent on you.

FAQ’s

1. Can I Start Solids Early to Increase my Baby’s Weight?

No, please don’t babies have a very sensitive digestive system that needs time to develop enough to digest solids. Rushing this stage will only hurt them instead of helping them.

2. Can I Feed my Underweight Baby Ghee and Butter to Help Gain Weight?

Ghee is a good option to increase your baby’s weight. However, do not start this until they are 7 months old. Check with your doctor regarding how much you can give your baby.

3. Does my Baby Need Neonatal Care if the Birth Weight is Low?

Yes, in some cases they might. If your baby is full-term but less than 2 kgs, then doctors will advise extra care. The baby will be under observation until doctors feel it is safe to let them go home.

4. Should I Give Formula for my Unweight Infant?

No, this will not be necessary. If your doctor suggests this, do find out why and get your doubts cleared. In most cases, breast milk and extra care is enough to nurture an underweight baby.

Read Also: Top 12 Causes Of Low Birth Weight In Babies