PRETERM AND LOW BIRTH WEIGHT INFANTS

 

PRETERM AND LOW BIRTH WEIGHT INFANTS

Different conditions that pose threats for newborns have been given different labels. We will examine these conditions and discuss interventions for improving outcomes of preterm infants.

Preterm and Small for Date Infants

Three related conditions pose threats to many newborns: low birth weight, being preterm, and being small for date. Low birth weight infants weigh less than 5½ pounds at birth.Very low birth weight newborns weigh under 3½ pounds, and extremely low birth weight newborns weigh under 2 pounds. Preterm infants are those born three weeks or more before the pregnancy has reached its full term—in other words, before the completion of 37 weeks of gestation (the time between fertilization and birth). Small for date infants (also called small for gestational age infants) are those whose birth weight is below normal when the length of the pregnancy is considered. They weigh less than 90 percent of all babies of the same gestational age. Small for date infants may be preterm or full term. One study found that small for date infants had more than a fourfold risk of death (Regev & others, 2003).

Consequences of Preterm Birth and Low Birth Weight

Although most preterm and low birth weight infants are healthy, as a they have more health and developmental problems than normal birth weight infants (Minde & Zelkowitz, 2008). For preterm birth, the terms extremely preterm and very preterm are increasingly used (Lowdermilk, Perry, &Cashion, 2011). Extiemely preterm infants are those born less than 28 weeks preterm, and very preterm infants are those born less than 33 weeks of gestational age.

The number and severity of these problems increase when infants are born very early and as their birth weight decreases. Survival rates for infants who are born very early and very small have risen, but with this improved survival rate have come increases in rates of severe brain damage (Casey, 2008).

Children born low in birth weight are more likely than their normal birth weight counterparts to develop a learning disability, attention deficit hyperactivity disorder, or breathing problems such as asthma.

Nurturing Low Birth Weight and Preterm Infants

Two increasingly used interventions in the neonatal intensive care unit (NICU) are kangaroo care and massage therapy. Kangaroo care involves skin-to-skin contact in which the baby, wearing only a diaper, is held upright against the parent's bare chest, much as a baby kangaroo is carried by its mother (Ludington-Hoc & others, 2006). Kangaroo care is typically practiced for two to three hours per day, skin-to-skin over an extended time in early infancy.

Why use kangaroo care with preterm infants? Preterm infants often have difficulty coordinating their physical contact with the parent provided by kangaroo care can help to stabilize the preterm infant's heartbeat, temperature, and breathing. Preterm infants who experience kangaroo care also gain more weight than their counterparts who are not given this care. A recent study also revealed that kangaroo care decreased pain responses in preterm infants.