preterm common problem
DESCRIPTION
kuliah anakTRANSCRIPT
LOW BIRTH WEIGHT& PREMATURITY
Birth weight < 2500 g, gestational age is not taken into account.
LBW could be :Term Preterm Postterm
Based on BW:Low birth weight (LBW) : BW 1500 - < 2500
gVery Low Birth Weight (VLBW): BW 1000 g -
<1500 gExtremely LBW (ELBW) : BW < 1000 g
Based on GA:Preterm baby Appropriate for
gestational age (AGA)Small for gestational age (SGA)
PRETERM BABY
Preterm baby born before 37 weeks gestation
Have more problems than term babies who are small
( less than 2,5 kg at birth)
The more preterm the baby is, the more likely the baby
is to have problem
Preterm baby may have a problem that is specific
jaundice of prematurity, but may have any other problem
that a full-size, term baby can have( jaundice associated
with sepsis)
Feeding difficulty
Abnormal body temperature
Breathing difficulty
Necrotizing enterocolitis
Jaundice
Intraventricular bleeding
Anaemia
Low blood glucose
Retinopathy of prematurity
Apnea of Prematurity
Retinopathy of
prematurity
Apnea of Prematurity
Bronchopulmonary
dysplasia
Osteopenia of
Prematurity
Regardless of what other problems they may have
all preterm babies require special considerations for
feeding, fluid management and maintenance of normal
body temperature (ideally using kangaroo mother care)
Day of life 1 2 3 4 5 6 7+
ml/kg body weight of feed and/or fluid
60 80 100 120 140 150 160+
Total daily feed and fluid volumes for babies from birth
Ensure the baby is fed as soon as possible after birth
(within one hour if possible)
Encourage the mother to breastfed the baby or to give
expressed breast milk
General principles of feeding preterm babies
Difficulty feeding the babies are not mature enough
to feed well.
Good feeding established by 34 – 35 weeks post-
menstrual age.
Provide special support & attention to the mother
during this difficult period
Her breast milk is the best food for the baby
Breastfeeding is especially important for preterm baby.
It is usually normal if the baby :
Tires easily & suckles weakly at first
Suckles for shorter periods of time before resting
Falls asleep during feeding
Pause for long periods between suckling
It may take longer for a preterm baby to establish
breastfeeding
Assure the mother that breastfeeding will
become easier once the baby becomes bigger.
The mother follow the general principles of
exclusive breastfeeding
Encourage early and exclusive breastfeeding whenever
possible
Explain to the mother and her family the benefits of early
and exclusive breastfeeding :
Breast milk contains the exact nutrients the baby needs
and promotes the baby’s growth
Easily digested and efficiently used by the baby’s body
Protects the baby from infection
Used as a contraceptive method 12
Encourage mother to breastfed the baby on demand
(eight or more times in 24 hours) for as long as the baby
wants
Advise the mother that she should not :
Force the baby to feed
Interrupt a feed before the baby is done
Use artificial teats or pacifiers
Give the baby any other food or drink
13
Include the mother’s family
Ensure the mother eats nutritious food and has enough
to drink
Avoid washing or wiping her nipples before breastfeeding
If the mother is too ill or she chooses not to breastfed
a breast milk substitute
14
Signs of correct attachment
Baby’s chin touches the breast
Baby’s mouth is wide open with the
lower lips curled out
More of the areola is visible above
than below the mouth
Baby suckles with slow, deep
sucks and pauses sometimes
15
CALM
Established an IV line
Reassess the baby after 12 hours :
If the baby’s condition is improving restart feeds,
observing carefully
If the baby’s condition is not improving IV fluid at
maintenance volume for another 12 hours
Preterm babies require different feed and fluid
volumes based on their condition and weight
Babies without major illness
1,75 – 2,5 kg
Allow the baby to begin breastfeeding.
If the baby cannot be breastfed expressed
breast milk using an alternative feeding method
Day of life
1 2 3 4 5 6 7
Feed volume every 3 hours (ml/feed)
12 18 22 26 30 33 35
Table Volumes of breast milk for a by weighing 1,5-1,748 kg
without major illness
If the baby weighs 1,25 – 1,5 kg at least 8 times in
24 hours
If the baby weighs less than 1,25 kg at least 12 times
in 24 hours
Ensure the baby is receiving enough milk by assessing
the baby’s growth
Day of life
1 2 3 4 5 6 7
Feed volume every 3 hours (ml/feed)
10 15 18 22 26 28 30
Table Volumes of breast milk for a by weighing 1,25-1,49 kg
without major illness