Nursing
management
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of
low birth
weight baby
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INTRODUCTION
Low Birth Weight (LBW): A newborn with a birth
weight of less than 2.5 kg, irrespective of
gestational age (WHO definition).
Classification based on Birth Weight (WHO):
1. Low Birth Weight (LBW): < 2500 g
2. Very Low Birth Weight (VLBW): < 1500 g
3. Extremely Low Birth Weight (ELBW): < 1000 g
Preterm babies – born before 37 completed weeks.
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OBJECTIVES
1. To maintain normal temperature, respiration,
and circulation.
2. To ensure adequate nutrition and growth.
3. To prevent infection.
4. To provide emotional support to parents.
5. To detect early complications and manage
promptly.
HYLINE MEMBRANE DISEASE (HMD)
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Also called Respiratory Distress Syndrome –
RDS of the newborn
Hyaline Membrane Disease is the most
common cause of respiratory distress in
preterm newborns.
It occurs due to deficiency of pulmonary
surfactant, leading to alveolar collapse and
impaired gas exchange.
PATHOPHYSIOLOGY
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Surfactant deficiency → alveoli collapse after
expiration (atelectasis).
Results in:
Decreased lung compliance
Decreased oxygen exchange → hypoxemia
Carbon dioxide retention → respiratory acidosis
Damaged alveoli get lined with hyaline
membranes (fibrin + cellular debris), further
blocking gas exchange.
MANAGEMENT
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Surfactant Therapy
Exogenous surfactant via endotracheal
tube.
Given prophylactically (very preterm) or
therapeutically.
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Nursing
Management
1. Thermal Protection
(Prevention
z of Hypothermia)
•Place baby in radiant warmer/incubator or
practice kangaroo mother care (KMC).
•Maintain room temperature 26–28°C.
•Keep baby dry and well-covered (cap, socks,
mittens).
•Avoid frequent exposure during procedures.
•Monitor axillary temperature frequently (36.5–
37.5°C normal).
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RADIENT
WARMER
KANGAROO
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MOTHER CARE
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2. Airway and Breathing
Assess respiratory effort (watch for apnea,
retractions, grunting).
Provide oxygen therapy if required.
In case of respiratory distress – CPAP or ventilator
support as per medical order.
Suction airway gently when needed.
3. Nutrition and Fluid
z Management
Early feeding is essential to prevent hypoglycemia.
Preferred feed: mother’s breast milk (expressed breast milk if baby
cannot suck).
For very LBW/preterm: feed via gavage (tube feeding) or cup and
spoon.
Monitor for feeding intolerance (vomiting, abdominal distension,
regurgitation).
Maintain fluid balance: prevent both dehydration and fluid
overload.
Monitor weight daily.
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4. Infection Prevention
Strict handwashing before handling baby.
Use aseptic techniques for all procedures.
Restrict visitors and minimize handling.
Keep cord stump clean and dry.
Monitor for signs of sepsis: poor feeding, lethargy,
temperature instability, respiratory distress.
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5. Skin Care
Skin of LBW babies is thin and fragile → avoid
adhesive tapes.
Gentle handling.
Use warm water and mild cleansers for cleaning.
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6. Monitoring
Regular assessment of:
Temperature
Respiratory rate & pattern
Heart rate
Oxygen saturation
Weight gain
Detect early signs of complications (hypothermia, apnea,
hypoglycemia, sepsis).
7. Parental Education &
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Support
Teach mother about Kangaroo Mother Care
(KMC).
Educate on feeding techniques, burping,
recognizing danger signs.
Encourage exclusive breastfeeding.
Provide psychological support to parents
(anxiety due to baby’s small size).
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Complications to Watch For
Hypothermia
Hypoglycemia
Respiratory distress/apnea
Sepsis
Feeding intolerance
Growth retardation
SUMMARY
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Care of LBWB baby → “WARMTH”
W: Warmth
A: Assess breathing
R: Rest / minimal handling
M: Mother’s milk
T: Touch (KMC, bonding)
H: Hygiene
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CONCLUSION
Low birth weight babies require specialized
and meticulous nursing care to ensure
survival, prevent complications, and promote
growth. With early detection, proper thermal
control, infection prevention, adequate
nutrition, and parental involvement (especially
KMC), morbidity and mortality in LBW infants
can be significantly reduced.
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“Every low birth weight baby is a
fighter; with proper nursing care, we
give them a chance at life.”
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