License Verification Tool | Care of the Extremely Low Birth Weight Neonate

When a baby is born preterm, before 37 weeks gestation, providers must closely monitor the neonate’s health and well-being, and be prepared to take swift action when complications arise. For babies born incredibly preterm, below 28 weeks gestation, there is an increased risk of complications due to prematurity. Healthcare providers must go through an expert checklist of procedures to ensure this vulnerable sub-population receives the specialized care they need. In this article, we?ll explore the importance of care for the extremely low birth weight neonate and provide a detailed outline of procedures for successful outcomes for these fragile patients.

The Risk of Prematurity

Babies born before their due date often have immature organs and organs that are not yet fully developed. This means they have difficulty regulating temperature, breathing, and reacting to environmental stimuli. Additionally, babies born preterm have immature immune systems that are at greater risk for infection. Therefore, it is crucial that healthcare providers pay special attention to the care of the baby born at less than 28 weeks gestation – the extremely low birth weight neonate – so that any problems that develop due to the extreme prematurity can be addressed quickly and appropriately.

Caring for the Extremely Low Birth Weight Neonate

When caring for the extremely low birth weight neonate, the healthcare team must be well-prepared and well-equipped to manage the neonate?s needs. This includes having knowledge of pediatric developmental standards, understanding the signs and symptoms of a preterm delivery, being aware of any risks associated with prematurity, and being equipped with the necessary tools to monitor and manage the neonate?s physical health. Additionally, the team must be prepared to provide psychosocial support to the family.

First, the healthcare teamshould assess the baby?s Apgar score, as this is a quick and efficient tool to measure the baby?s physical health. The Apgar score is based on five separate criteria: heart rate, respiratory effort, muscle tone, reflex irritability, and color. It is taken immediately after birth and then again at one, five, and ten minutes post-birth. An Apgar score of seven or higher is considered normal, but anything lower than seven necessitates the need for resuscitation.

Second, the healthcare teamshould monitor the baby?s vital signs, including heart rate, oxygen saturation, and temperature. The infant?s heart rate should be 120-160 bpm; oxygen saturation should be 94-100%; and temperature should be 36-37?C (97-99?F).

Third, the teamshould monitor the baby?s metabolic requirements, such as electrolytes, bilirubin levels, and glucose levels. The neonate will likely need fluids to maintain the levels of most electrolytes and glucose. Additionally, if the baby is severely anemic, transfusions or phototherapy may be necessary.

Fourth, the teamshould provide all necessary nutritive needs, including enteral feedings, and administer medications for additional care (such as steroids for lung development). Additionally, it is important to evaluate if the baby has any conditions or diseases that may have caused the preterm birth and should be treated, such as hypoglycemia or group B streptococcus infection.

Fifth, the teamshould attend to the psychological needs of the family. Preterm delivery is undoubtedly a traumatic experience for the parents and they may need counseling, time to be with their baby, and support. Additionally, due to the extreme vulnerability of the neonate, it is likely that the healthcare team will continuously monitor and manage the baby?s condition. Therefore, it is important for the team to provide updates to the family regularly and to be sensitive to any special requests.

Finally, the teamshould coordinate with the neonatal intensive care unit (NICU) staff to ensure that they are providing the best care possible for the baby. This includes providing continuity of care, updating the NICU on the baby?s condition, and coordinating with social workers to provide the support to the family.

Final notions

The care of the extremely low birth weight neonate requires special attention and expertise to ensure the best outcome for the baby. Healthcare providers must be familiar with all the risks associated with preterm delivery, understand the importance of assessing the Apgar score, regularly monitor the neonate?s vital signs, tend to the baby?s nutritional needs, attend to the family?s emotional needs, and coordinate with the NICU to provide the best continuity of care.


Care of the Extremely Low Birth Weight Neonate,

Apgar score,

preterm delivery