Till date home delivery is common at rural India. According to UNICEF ... 2.5 kg- 1.5 kg Very Low Birth Weight (VLBW) 1.5 kg â 1 kg and ELBW[Extremely Low.
LOW BIRTH WEIGHT Till date home delivery is common at rural India. According to UNICEF, the total incidence of Low Birth Weight (LBW) is 30% in India .This is divided as : LBW, who is < 2.5 kg- 1.5 kg Very Low Birth Weight (VLBW) 1.5 kg – 1 kg and ELBW[Extremely Low Birth Weight} < 1 kg. Only 32.8% of this baby get birth in tertiary centre out of which 14% is < 2kg . According to international data neonatal mortality rate [NMR] is 5 in developed country and 53 in least developed country. NMR is 61% of infant mortality rate and half of child mortality rate is developing country. So to minimize IMR[Infant Mortality Rate], NMR must to be reduced. Both are linked together. And IMR is one of the three parameters of Human Development Index[HDI] of a country. So to become developed country IMR must be reduced. 83 % of new born in rural India are born at home . Standard advice is to admit in hospital for the high risk pregnancy and ill newborn . But at rural area this is not always possible. 1. Poor motivation ,2.illiteracy,3.religious beliefs,4. poverty ,5.lack of well established hospital care at periphery are the factors for home delivery . Hence to improve the neonatal survival and to become a developed country, home based management must be developed in India. Here are inter e s ti n g point s reg a r di n g this with pictu r e s .
Pictu r e- 106 Low birth weight In this pictu r e abdo m e n is diste n d e d . Legs are addu c t e d with exte n d e d toes.
Pictu r e107 Low birt h weight Hom e base d man a g e m e n t in LBW should care for infection s. This pictu r e shows the social custo m with a Ghunsi at waist ,Mala at neck and Bala at hand might caus e skin infection .
Pictu r e-
108
Low birth weight [at birth]
Pictu r e- 109
Low birth weight [At Birth]
Pictu r e- 110
Low birth weigh t
[a few days latte r with hom e bas e d man a g e m e n t ]
Pictu r e- 111
Low birth weight
[grad u al weigh t gaining]
Pic- 112 [sam e new bo r n with weigh t gain]
Pictu r e- 113
Low birth weigh t
[neck ‘s and waist’s thre a d s / g h u n s i are const a n t –a sourc e of infection]
Pictu r e- 114 Low birt h weight [afte r good catc h up grow t h]
Pictu r e- 115 Low birth weight [Look the thre a d s in neck]
Pictu r e- 116
Low birth weight
Pictu r e- 117 Low birt h weight [Hom e delivery but well maint ai n e d hygien e]
Pictu r e- 118 Low birth weight [Low Birth Weight but well maint ai n e d hygien e]
Pictu r e- 119
Low birth weigh t
Abdomin al diste n tio n is an ominou s sign in Low birt h weight baby. This can leads to Necro ti si n g Ente r o c olitis. [NEC].A dre a d e d condition Urge n t admis sio n may be
req ui r e d for cuttin g down the feeds. And to cont r ol the infection and gast r o- ente ric inflam m a t i o n .
Pictu r e- 120
Low birt h weight
NEC
Pictu r e – 121 Low birth weight [Twin baby]
Pictu r e-
122
Low birth weigh t
[look the puffy eye lids]
Pictu r e- 123
Low birth weigh t
Cry- the com m o n e s t caus e of their cry is hung e r and next is pain. The hun g e r and prop e r feed is the one of the most impor t a n t point for LBW man a g e m e n t at hom e. Impro p e r feed can leads to poor weigh gain . And ther efo r e catc h growt h, poor orga nic mat u ri ty and poor immu nity powe r will happ e n . Only carbo hy d r a t e base d feed can lead to complic a tio n like PEM[Pro t ei n Ener gy Malnu t ri tio n]. In the latte r pictu r e s ther e are two such exam pl e s.
PEM – CASE- 1
Pictu r e-
124
Low birt h weight [PEM]
The moth e r cam e with the complain t s of baby’s ches t infection.S h e was feedin g only Sago[c h a r b o h y d r a t e ] for not enou g h milk and poor condition and ignor a n c e . The bay was sufferin g from Kwashio r ko r .
Pictu r e- 125 Low birth weigh t [PEM] [look the puffy face, spa r s e hairs.]
Pictu r e - 126 Low birth weight [PEM] [skin chan g e- mosaic patt e r n ]
Pictu r e- 127 Low birt h weight [PEM] [after prop e r feedin g]
LBW. CASE -2
Pictu r e- 128 Low birth weight [PEM] [Kwashio rk o r- chub by look]
Pictu r e- 129 Low birth weigh t [PEM] [ hair’s chan g e- color,p a u ci ty,b ri t tl e n e s s ]
Pictu r e- 130
Low birth weight [PEM] [skin chan g e ]
Pictu r e- 131 Low birth weigh t [PEM] [ durin g tre a t m e n t - gra d u a l corr e c tio n of ede m a ]
Pictu r e- 132 Low birth weigh t [PEM] [ rem e m b e r the prior face]
Pictu r e- 133
Low birt h weight [PEM] [After tre a t m e n t ]
Pictu r e-
134
Low birth weight [PEM] [sam e child]
Pictu r e- 135 Low birth weight [ Prot ein Ener gy Malnu t ri tio n secon d a r y to Hydroc e p h a l u s ]
