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

Every year, thousands of babies are born weighing less than 1.5 kg, or 3-4 pounds, classifying them as extremely low birth weight (ELBW). Providing care for these tiny babies is the most challenging aspect of neonatal medicine due to their vulnerability, immaturity, and fragile health. Neonatal nurses play an important role in the lives of ELBW babies, providing round-the-clock care and monitoring of their condition, ensuring their health, comfort, and safety.


The care of ELBW babies is complex and requires an interdisciplinary team to provide specialized medical care and monitor the baby?s condition. This team typically includes neonatal nurses, pediatricians, cardiologists, developmental specialists, nutritionists, and social workers. The main goal of the team is to provide the best quality of care for the baby while attending to the family’s needs and working closely with them.

ELBW babies require more intensive medical care and supervision than full-term babies, particularly in the area of respiratory support and nutrition. Respiratory distress is a common issue in ELBW babies due to their immature lungs, and they often require supplemental oxygen and respiratory support from a mechanical ventilator. ELBW babies also require rigorous monitoring of their oxygen saturation, respiratory rate, heart rate, and ventilation settings, among other vital signs.

Nutrition is a key concern for ELBW babies, as they often have difficulty taking in adequate nutrition due to their frustration during feedings. Additionally, the baby?s immature digestive system can be easily overwhelmed. Therefore, ELBW babies require careful individualized nutrition plans.


Neonatal nurses are the primary caregivers for ELBW babies. They are responsible for providing around-the-clock care for the baby, monitoring their condition, administering medications, and providing comfort and emotional support to the family.

Neonatal nurses must be highly knowledgeable about the baby?s medical condition and must remain vigilant throughout their shifts. They must be able to provide timely interventions and accurate assessments of the baby?s condition, and be able to quickly recognize any changes or concerns.

Neonatal nurses must be prepared to provide emergency care and interventions if needed and must have the necessary skills to administer medications, oxygen, and other treatments. They must also provide emotional support to the family and help them adjust to the demands of caring for an ELBW baby.


ELBW babies are at a higher risk of infection due to their fragility. To reduce this risk, nurses must take measures to prevent and recognize infection. This includes following proper hand hygiene, maintaining a sterile environment, and practicing meticulous care practices such as proper cleaning of needles.

Nurses must also provide education to parents and family members on proper hand hygiene and how to reduce the risk of infection in the baby. Additionally, ELBW nurses must provide education on proper infection control practices which includes proper positioning of the baby during care and interventions, proper cleaning and disposal of equipment, and proper handling and storage of medical supplies.


ELBW babies often need extra support and the family plays an important role in providing emotional support for the baby. It is the role of the nurse to connect with the family and help them adjust to the demands of caring for an ELBW baby. Through open communication, nurses can help families understand the baby?s condition and provide support to them during this difficult time.

Nurses must also provide education to the family about proper care and safety measures for the baby and provide feedback about the baby?s progress. Additionally, nurses must be mindful that every family will handle the experience of caring for an ELBW baby differently and must be respectful and compassionate during their interactions with the family.


Providing care for ELBW babies is a challenging task and requires nurses to be highly knowledgeable and vigilant. Nurses must be prepared to provide specialized medical care, emergency interventions, and emotional support to the baby and family. By connecting with the family and providing education about the baby?s condition, nurses can help the family adjust to the demands of caring for an ELBW baby.


Neonatal Care,

Neonatal Nurse,

ELBW Babies