BBLR
BBLR
BBLR
Preterm/prematur Small-for-date
(SFD) / (IUGR)
3200
APPROPRIATE FOR DATE
2800
2400
10th percentile
2000
1600
SMALL FOR DATE
1200
Preterm Term
Preterm Term
Preterm LBW
Male genitalia
Preterm
Preterm Term
Term
Preterm LBW
Female genitalia
Preterm Term
Preterm LBW
Sole creases
Preterm Term
Preterm LBW
Ear Cartilage
Preterm Term
LBW: Identification of
types
SFD / IUGR
• Intrauterine growth chart
• Physical characteristics
– Emaciated look
– Loose folds of skin
– Lack of subcutaneous tissue
– Head bigger than chest by > 3cm
Identification: SFD /
IUGR
2.1 Kg - IUGR 3.2 Kg - AFD
LBW (Preterm) :
Problems
• Birth asphyxia • Retinopathy of
prematurity
• Hypothermia
• Apneic spells
• Feeding difficulties
• Intraventricular
• Infections
hemorrhage
• Hyperbilirubinemia
• Hypoglycemia
• Respiratory
distress • Metabolic acidosis
LBW (SFD) : Problems
• Birth asphyxia
• Meconium aspiration syndrome
• Hypothermia
• Hypoglycemia
• Infections
• Polycythemia
LBW: Issues in delivery
1.0 – 1.5 34 – 35
1.5 – 2.0 32 – 34
2.0 – 2.5 30 – 32
Skin-to-skin contact > 2.5 28 - 30
Convection
Evaporation
Radiation
Conduction
Radiant warmer
Overhead
Radiant warmer
Nutritional problem of preterm infant
Greater Organ
morbidity immaturit
y
NEC • Gavage feeding
• Motility &
absorption
Smaller
Greater nutritional
nutritional
requirement and IWL reserve
Question ??
• Route chosen : parenteral, enteral / oral
feeding ?
• When to begin feeds ?
• Formula type?
• Frequency of feeding ?
• Amount given ?
• Rate of advancement ?
When to begin feed ?
• Adequate warmth
• Life support
• With mother
• Referral note
Prognosis
• Mortality
– Inversely related to birth weight and
gestation
– Directly related to severity of
complications
• Long term
– Depends on birth weight, gestation and
severity of complications