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Management of Premature and Low Birth Weight Infants

Article information

J Korean Med Assoc. 2008;51(8):745-754
Publication date (electronic) : 2008 August 31
doi : https://doi.org/10.5124/jkma.2008.51.8.745
Young Youn Choi, MD
Department of Pediatrics, Chonnam National University College of Medicine, Korea. yychoi@chonnam.ac.kr

Abstract

Premature (gestational age < 37th week) and low birth weight (LBW, birth weight < 2,500g) infants are very sensitive to small changes in respiratory management, blood pressure, fluid administration, nutrition, and virtually all other aspects of care because of physiological immaturity. The most important principle in the care of those babies is the 'maximum observation and minimum handling' during their initial adaptation from intrauterine to extrauterine life. At birth, the measures needed to clear the airway, initiate breathing, care for the umbilical cord and eyes, and administer vitamin K are the same for term and normal weight infants. However, special care is required to maintain a patent airway and avoid potential aspiration of gastric contents. Additional considerations are needed for thermal control and monitoring of the heart rate, respiration, and nutrition. Safeguards against infection can never be relaxed. The effective care based on currently available evidence is best ensured through the implementation for standardized protocols for the care of those infants within individual nursery or neonatal intensive care unit (NICU). The need for regular and active participation by the parents in the infant's care during hospital stay, the need to instruct the monitor in at-home care of her infant, and the question of prognosis for later growth and development require special consideration. Effective discharge planning and follow-up visiting also promote continuity of care from hospital to home.

Keywords: Premature; Low birth weight infant; Intensive care; Discharge planning; Follow-up

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Article information Continued

Copyright © 2008 Korean Medical Association

Figure 1

Figure 1

Flow diagram from birth to discharge in premature and low birth weight infants.

Table 1

Standardizing care of the premature and low birth weight infants

Table 1

Table 2

Clinical Problems in Premature and Low Birth Weight Infants

Table 2

Table 3

Oral dietary supplements for premature and low birth weight infants

Table 3

Table 4

Initial fluid therapy in humidified incubators

Table 4

Infants under radiant warmers usually require higher initial fluid rates