using the new uk-who growth charts with new born babies and preterm infants presentation f
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Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F. Adapted from training materials of the Royal College of Paediatrics and Child Health [RCPCH]. Plotting in the first 2 weeks. Birth weight centiles based on UK 1990 data WHO charts start from 2 weeks - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/1.jpg)
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Using the new UK-WHO growth charts with new born babies and preterm infants
Presentation F
Adapted from training materials of the Royal College of Paediatrics and Child Health [RCPCH]
![Page 2: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/2.jpg)
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Plotting in the first 2 weeks
• Birth weight centiles based on UK 1990 data
• WHO charts start from 2 weeks
• No centile lines between birth (0 weeks) and 2 weeks
• Allows for weight loss and regain before week 2
![Page 3: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/3.jpg)
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Plotting in thefirst 2 weeks
Plot all term infants (37 or more weeks)
at age 0 weeks
![Page 4: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/4.jpg)
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Weighing in the neonatal period• Weigh within the first week as part of the
assessment of feeding…
– Early weighing does not discourage breast-feeders and may help identify problems in a timely manner
– Weigh thereafter as needed
• Assess early weight gain relevant to birthweight…
– Most babies lose some weight after birth– Recovery of birthweight indicates that feeding is
effective and that the child is well– If large weight loss or still below birthweight at 2
weeks, calculate % weight loss
![Page 5: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/5.jpg)
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Calculating Percentage Weight Loss
It is good practice to calculate percentage weight loss on order to check exactly how much weight an infant has lost
Weight Change
= current weight – birth weight
e.g. (2.700 kg – 2.900kg )=-200kg A fall of 200g.in weight
Percentage Weight Loss
= Weight loss ÷ Birth weight x 100%
e.g.(200 ÷ 2.900g) x 100 = 6.9% A weight loss of 6.9%
![Page 6: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/6.jpg)
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Assessing neonatal weight loss
• Most babies lose some weight after birth– 80% will have regained this by 2 weeks of age
• Fewer than 5% of babies lose more than 10%– Only 1 in 50 are 10% lighter at 2 weeks
• A baby 10% or more below birth weight at or before 2 weeks needs careful assessment for:– feeding problems– unrecognised illness
![Page 7: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/7.jpg)
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Summary
• Plot birthweight at age 0 for all infants born 37 + weeks,
• Weigh within first week as part of the assessment of feeding as early weighing...– does not discourage breast-feeders– allows timely identification of feeding problems
• Assess early weight gain relative to birthweight…– Recovery of birthweight by 2 weeks suggests that
feeding is effective and that the child is well– If large weight loss at any time, or still below
birthweight at 2 weeks, calculate % weight loss• 10% weight loss needs careful assessment
![Page 8: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/8.jpg)
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Plotting pre-term infants using the new UK-WHO growth charts
Plotting Per-term infants
Adapted from training materials of the Royal College of Paediatrics and Child Health [RCPCH]
![Page 9: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/9.jpg)
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Background
• A child born before 37 weeks completed weeks gestation is preterm
• The WHO standard does not include data for preterm babies
• The “preterm” section of the UK/WHO chart has been compiled using UK reference data for size at birth
![Page 10: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/10.jpg)
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Plotting on the preterm section• Use the preterm section of the UK-WHO 0-4 years
chart– For infants born 32-36 weeks gestation– Up till EDD (term) plus 2 weeks
• Use the Neonatal and Infant Close Monitoring (NICM) low birthweight chart – For infants<32 weeks– For any neonate needing close monitoring
• After EDD plus two weeks move over to 0-1 chart with gestation age correction
![Page 11: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/11.jpg)
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What is Gestational Correction?
• Gestational correction adjusts the plot of a measurement to account for the number of weeks a baby was born early
• Number of weeks early = 40 weeks minus gestational age
• Should not be used for term infants (37 weeks+)• Should be continued till
– 1 year for infants born 32-36 weeks– 2 years for infants born before 32 weeks
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Plotting with gestational correction
Plot measurement at actual age
Draw a line back the number of
weeks the baby was early and mark this with a arrow.
The arrow point should show the gestationally corrected centile
When measuring frequently, plot all actual or corrected age and use arrow for a section to avoid crowding on page.
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Transfer preterm to infancy section
Born 6 weeks preterm plot on preterm section of chart until 43 weeks (EDD +2)
Then plot on infancy section using gestational correction
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Weight
faltering in
infant born at
34 weeks?
or are the
plots in the
wrong place?
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Failure to allow for gestation
• Need to be clear which plots are adjusted for gestation
• Other users may not adjust
• Could place the child at risk
![Page 16: Using the new UK-WHO growth charts with new born babies and preterm infants Presentation F](https://reader036.vdocuments.us/reader036/viewer/2022081519/56813561550346895d9cc75c/html5/thumbnails/16.jpg)
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Summary• Preterm = birth before 37 weeks completed
weeks gestation• Infants born before 32 weeks, plus any sick
neonate, should be plotted on Neonatal and Infant Close Monitoring (NICM) low birth weight chart
• Well preterm infants born after 32 weeks should be plotted in preterm section until 42 weeks gestation
• Then plot on the 0-1 year chart using arrow drawn back method of gestational correction
• Continue gestational correction till 12-24 months
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Plotting term infants: Activity 1 Answers
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Plotting term infants: Activities 2 to 4 Answers
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Plotting term infants: Activities 2 to 4 Answers