care of lbw newborn in community

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CARE OF LBW NEWBORN IN COMMUNITY: PERSONAL EXPERIENCE AND INNOVATION DR. NEHAL VAIDYA MBBS,DCH POOJAN HOSPITAL BHUJ [email protected]

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this is some innovation in field of neonatal care in developing world. i invite all my pediatrician friends to add on their innovation slides to this show..

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Page 1: Care of lbw newborn in community

CARE OF LBW NEWBORN IN COMMUNITY: PERSONAL

EXPERIENCE AND INNOVATION

DR. NEHAL VAIDYAMBBS,DCH

POOJAN HOSPITALBHUJ

[email protected]

Page 2: Care of lbw newborn in community

CARE OF LBW NEWBORN IN COMMUNITY: PERONSAL EXPERIENCE AND INNOVATION

• Care of LBW newborn is a challenging task in India. The Indian neonatologists have to deal with economical and social problems of the LBW’s family apart from medical challenges. Also, there are a lot of myths both on the side of family members and at the level of GPs.

• Our unit is Level 3 care neonatal intensive care unit, located at Bhuj, a district head quarter of kachchh. Our unit is working since past 3 years. We are the pioneer of such care in the area. We have saved babies weighting up to 900gms. We give surfactant and also partial parenteral nutrition

Page 3: Care of lbw newborn in community

SIMPLE INNOVATIVE INTERVANTIONS TO SAVE LIFE!

• TEMP REGULATION:• The parents are also asked to buy

a digital thermometer.

• Mother and care taker are explained the importance of THERMONEUTRAL ENVIRONMENT [AND NOT ONLY HYPOTHERMIA].

• They are asked to maintain baby’s temp between 97 to 98 F. if temp is less mother is required to give skin to skin heat or she can switch on an air room heater.

• If temp is more baby is kept open.

• Temperature is re assessed after 30 min .The temp is measured in axilla.

Page 4: Care of lbw newborn in community

FEEDING LIFE…!

• FEEDING:• Mother and the care taker is explained the

method of tube feeding and the risks of the same. Most of our babies are discharged with tube in situ .relatives are told about aspiration technique and daily increments. we use mother’s milk only.

• If mother’s milk is not adequate, we may give partial formula feeding.

Page 5: Care of lbw newborn in community

DISCHARE POLICY

• BABIES WT IS NOT THE DISCHARGE CRITERIA. We look at the stability of vitals, skill and alertness of the relatives, distance from our place.

• Relatives are asked to come immediately if• Baby looks sick. Does not show response to touch.• Baby’s color changes to blue• Feed aspirate is more than 25% of the last given feed• Temperature remains low or high despite proper

measures.

Page 6: Care of lbw newborn in community

WHAT CAN BE DONE FOR COMMUNITY?

• For care of LBW in community

• Every mother should know tube feeding. This saves a lot as hospital stay is drastically reduced.

• Every mother should have a digital thermometer. (Even our illiterate mothers learn 97 98 99 numbers!)

Page 7: Care of lbw newborn in community

Advantages of digital thermometer

• No observer variation despite less accuracy

• No chance of brakeage as it is plastic made.

Page 8: Care of lbw newborn in community

FOLLOW UP:• Babies are followed up every week.

Their tube is changed. Vitals are assessed.

• Tube is removed only when baby is able to suck proper amount of milk orally. We ask the mother to give trial and then we aspirate immediately. If amount is the desired one, the tube is removed.

• We highly prefer tube feeding over spoon/cup feeding .the advantage we see are

• Sure and measured delivery – sure wt gain (no spillage possibility like cup or spoon)

• Less consuming on tired mother- tube feeding takes only 5-7 min while spoon may take 30 – 40 min