A baby born at an extremely low birth weight (ELBW), is considered a weight less than 1000 grams or five pounds and eight ounces. NRS-434VN Topic 1 DQ 1 On average, babies born with ELBW make about 8 percent of all births in the United States (March of Dimes, 2018). Reasons for a baby to be born with ELBW are due to a premature birth or fetal growth restriction (FGR), which may be caused by chronic medical conditions, infections, use of certain medication, illicit drug use or smoking.Having a ELBW baby is an added stress to families since babies tend to have a higher morbidity rate than babies born with a normal birth weight. Other common conditions with ELBW is respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), patent ductus arteriosus, necrotizing enterocolitis, retinopathy of prematurity and jaundice. These conditions or diagnosis may require longer hospitalizations, follow up by specialists, surgical intervention, additional tests, or procedures and of course costly to the baby’s family and/or the community. Long term effects found in these infants is that they may have intellectual developmental disabilities, metabolic syndrome, hypertension, diabetes, obesity, and heart disease. Age factors noted are in mothers under the age of 15 and over the age of 35 years of age that are at risk to have a ELBW baby NRS-434VN Topic 1 DQ 1. Racial minority mothers are at a higher risk as well due to health disparities of insufficient health care access or prenatal care, lack of health insurance, financial unavailability to healthy foods, education, and social services resources.March of Dimes is a great resource for premature babies and families to optimize overall health and minimize health risks. They have hospital based resources to educate and promote wellness also through community programs that include patient navigation/care coordination, hospital quality improvement to reduce early elective deliveries, group prenatal care, and smoking cessation, prevention of repeat preterm births, and infection diagnosis and treatment. We also have Early Child Intervention (ECI) is a statewide program within the Texas Health and Human Services Commission for families with children birth up to age 3, with developmental delays, disabilities or certain medical diagnoses that may impact development. ECI services support families as they learn how to help their children grow and learn. A team of licensed or credentialed providers evaluates the child and plans and provides services. The team may include: Early intervention specialists, Speech and language pathologists, Physical and occupational therapists, Psychologists, Registered nurses, Dietitians, Social workers and Counselors.
Kanitkar M., Mrs (1999). EXTREMELY LOW BIRTH WEIGHT BABIES: (A report of two cases). Medical journal, Armed Forces India, 55(4), 364–366. https://doi.org/10.1016/S0377-1237(17)30377-5
March of Dimes. (2018). Low Birthweight. Retrieved on January 13, 2021 from, https://www.marchofdimes.org/complications/low-birthweight.aspx
Ratnasiri, A.W.G., Parry, S.S., Arief, V.N., Ian H. DeLacy, Laura A. Halliday, Ralph J. DiLibero & Kaye E. (2018). Recent trends, risk factors, and disparities in low birth weight in California, 2005–2014: a retrospective study. matern health, neonatol and perinatol 4, 15. https://doi.org/10.1186/s40748-018-0084-2 NRS-434VN Topic 1 DQ 1
Topic 1 DQ 1
Describe the effect of extremely low birth weight babies on the family and community. Consider short-term and long-term impacts, socioeconomic implications, the need for ongoing care, and comorbidities associated with prematurity. Explain how disparities relative to ethnic and cultural groups may contribute to low birth weight babies. Identify one support service within your community to assist with preterm infants and their families and explain how the service adequately addresses the needs of the community, or a population in your community. Provide the link to the resource in your post. NRS-434VN Topic 1 DQ 1
Babies who have extremely low birth weights require hospitalization. They are usually physiologically immature and have complications that require extensive technological and pharmacological interventions. They are likely to have respiratory issues due to deficient surfactant levels, greater risk of collapsed lungs, and immature capillaries in the lungs. These babies are unable to maintain their body temperature and are at a greater risk for hypothermia because they have a limited amount of brown fat and minimal insulating subcutaneous fat, and at risk for infections. For the families of low-birth-weight babies, parents often have difficulty bonding because babies are taken to the NICU or they may have received a poor prognosis; thus, distancing themselves to protect from hurt and grief. Parents must also be given time to grieve over not having the birthing experience that they imagined, planned and hoped for. The birth of extremely low birth weight babies affects the whole family and even grandparents are saddened at the effects of watching their own children experiencing such difficulties. Mothers are prone to post traumatic stress that can hinder their ability to interact with or care for their infant (Forcada-Guex, Borghini, Pierrehumbert, et al., 2011). NRS-434VN Topic 1 DQ 1 Extremely low birth weight survivors are at high risk for neurological and cognitive disabilities in varying degrees of severity such as cerebral palsy, borderline intelligence, and learning disabilities (Daily, Carter, & Carter, 2011) This can have a financial impact on the family as the baby may need medical equipment at home, extra caregivers, and medications etc. These can be short- or long-term impacts. Even short-term impacts can have negatives effects emotionally and mentally on the entire family.The World Health Organization estimates that 9.6% of all births worldwide in 2005 were preterm. The rate of preterm birth is highest in Africa and North America and lowest in Europe (Simhan et al., 2012) In the U.S., non-Hispanic black women have the highest rate of preterm infants, with Hispanic women having a high rate as well but still lower than black women and white women having the lowest rate of preterm infants. Many factors influence the direction in which a pregnancy will progress, such as environment exposures, access to clean water, access to prenatal care and vitamins, access to healthy nutritious food, exposure to lead, smoke and drugs. Cultural aspects and beliefs may also contribute to the importance of prenatal care. For example, in the Mexican Heritage, advice for health care regarding pregnancy come from family members and may delay the patient from seeking prenatal care (Purnell, L. 2014). NRS-434VN Topic 1 DQ 1A support service I was able to find to assist with support of preterm infants and their families is called March of Dimes. Their mission is helping mothers have full term pregnancies and healthy babies. They offer prenatal education, support and care, resources for pregnant moms and new moms of preemie babies, a My NICU baby app where supportive resources can be found such as NICU initiatives and on line communities that offer support to parents of premature babies. NRS-434VN Topic 1 DQ 1
Crum, K. A., Lowdermilk, D. L., Perry, S. E., Cashion, K., & Alden, K. R. (2012). Chapter 32 Labor and Birth Complications. In Virtual clinical excursions-obstetrics: for Lowdermilk, Perry, Cashion, and Alden: Maternity & women’s health care (11th ed., pp. 759-760). Elsevier. NRS-434VN Topic 1 DQ 1
Hockenberry, M.J., Wilson, D., & Rodgers, C. C. (2019). 9 The High-Risk Newborn and Family. In Wong’s nursing care of infants and children (11th ed., pp. 270-330). Essay, Elsevier.
Purnell, L. D. (2009). 22 People of Mexican Heritage. In Guide to culturally competent heath care (3rd ed., pp. 309-321). Essay, F.A. Davis Co. NRS-434VN Topic 1 DQ 1