Low Birth Weight

14April 2023

What is considered a low birth weight?

Low birth weight is whenthe weight of a new born baby is less than 2500 grams (or 5 pounds, 8 ounces). On an average 15% of the low birth weight babies are born worldwide.

Can low birth weight affect the health of a baby?

Low birth weight (LBW) can lead to numerous health problems in babies. However, there are some exceptional cases wherein despite being small the babies have no health issues.

Some of the problems a baby with low birth weight may face include trouble with:

Eating
Gaining weight
Fighting off infections

Some babies may even face long term health problems. Therefore birth weight is a very important determinant of:

Neonatal survival
Infant survival

How do the doctors calculate the baby weight in the womb?

During pregnancy, your healthcare provider will measure your belly and ultrasound to check your baby's growth and keep track of it.

An ultrasound uses the sound waves to generate the image of the baby. The doctor can show you this image of the baby.

If your doctor thinks that your baby's growth is restricted, you may have to undergo frequent ultrasound tests (every 2 to 4 weeks). The regular ultrasound tests allow your health care providers to follow and keep track of the baby’s growth.

In addition to ultrasound, you may have to go through other tests as well. These include:

Heart rate monitoring
Tests to check infections

In some cases, a baby's growth may improve if the mother's existing health conditions are treated during pregnancy.

What causes low birth weight in babies?

Low birth weight in babies is caused primarily for the following two reasons:

Premature birth: If the delivery happens too early – before 37 weeks of pregnancy, it is designated as premature birth. Due to a premature birth, the baby is not able to gain the proper amount of weight in the womb. The earlier the baby is born, the lower would be its birth weight.
Foetal Growth Restriction: Also known as FGR or SGA (small for gestation age) or growth-restricted. In this condition, the baby doesn’t gain the weight it should have before delivery. The reasons forlow birth weight among growth-restricted babies include:
- Something slowed or stopped the growth of the baby in the womb
- The parents of the baby are small.

The causative factors of both premature birth and Foetal Growth Restriction affect the baby in the womb. These conditions include:

Infections
Birth defects – these are health conditions present at the time of birth. Also referred to as congenital disabilities, these defects change the shape or function of one or more parts of the body. They cause problems in:
- Overall health
- Body development
- Functioning of the body

Babies with birth defects are more likely to be born prematurely.

How can I help my baby with low birth weight?

The presence of certain risk factors increases the chances of your baby being born with low birth weight. Even though a risk doesn't necessarily guarantee that your baby will have a low birth weight, they surely increase the chances.

Note: Since many premature babies are born with low birth weight, many risk factors are the same for preterm labour, premature birth and low birth weight baby.

Medical risk factorsfor having a low-birth baby

If possible, your doctor can will you about the ways to reduce these medical risk factors:

Preterm Labour: If the labour starts early – before 37 weeks of pregnancy.
Taking medication to treat other health conditions: Be sure to inform your doctor about any prescription medicine you take for health conditions like blood pressure, epilepsy and blood clots. Your doctor may advise you to stop taking these medicines during pregnancy or switch to safer medication during pregnancy.
Earlier Pregnancies: If you have had a premature baby or a growth-restricted baby in your previous pregnancies.
Chronic Health Conditions: are those that last for a very long time or that reoccur over a long period. Some of the chronic health conditions that may lead to a baby having a low birth weight include:
High Blood Pressure
Diabetes
Heart Problems
Lung Problems
Kidney Problems

You may need treatment from a health care provider for these chronic conditions.

Placenta related problems: Placenta grows in the uterus. It is responsible for supplying food and oxygen to the baby through the umbilical cord. If any problem limits the supply of proper amounts of oxygen and nutrients to the baby, this can affect the baby's growth.

Alert: The following symptoms implicate that there might be some problem with your placenta:

Vaginal bleeding
Back Pain
Uterine contractions
Abdominal pain

Consult with your doctor immediately if you are noticing any of the above mentioned signs.

Multiple Pregnancies (twins, or more): More than half of multiple birth babies have been known to be born with low birth weight
Infections: A baby’s growth can be slowed by certain infections, especially if it is in the womb during pregnancy. Such infections include:
- Cytomegalovirus
- Rubella
- Chickenpox
- Toxoplasmosis
- Sexually Transmitted Infections (STI) and Sexually Transmitted Disease (STD)

Everyday life risk factors for having a low birth weight baby:

These can be avoided with precautionary measures and some effort on your part.

Pollution and poor air quality: Exposure to air pollution or Lead
Domestic Violence: This includes, physical, sexual and emotional abuse
Smoking, alcoholism and abusing street drugs and prescription drugs: These activities can:
- slow the baby’s growth in the womb
- lead to premature birth
- increase the chances of birth defect
Low Socioeconomic status: this is reflective of things like literacy/education, income and social surroundings.

Can age and race affect the birth weight of a baby?

If the mother’s age is less than 15 or greater than 35, then it is highly likely that the baby will have a low birth weight.

Race does affect the birth weight of a baby. For exampleBlack women are more likely than others to have a low birth weight baby.

However, studies and researchers are yet to confirm why race plays a role in low birth weight.

The rates of babies born with the low birth weight each year across different races (in the U.S) are:

Ethnicity	Percentage (Rate)
Black babies	13% (1 in 7)
Asian babies	8% (1 in 12)
American Indian/Alaska Native babies	7% (1 in 13)
Hispanic babies	7% (1 in 14)
White babies	7%

What are the health risks of low birth weight?

In comparison to babies born with healthy birth weight, low birth weight babies are more prone to health risks as a newborn. Some are admitted in hospital’s newborn intensive care unit (NICU) to take of health problems.

Some of the health problems faced by low birth weight newborn babies include:

Bleeding in the brain: The medical term to refer to this condition is called intraventricular haemorrhage or IVH. A majority of brain bleeding cases are mild and therefore self-heal. The mild cases have no or few lasting problems. However, severe bleeding cases can put pressure on the brain. The severe cases can cause fluid to build up in the brain and cause brain damage.

Solution: In some such severe cases, the surgeon may insert a tube into the brain of the baby to drain the fluid.

Patent DuctusArterious (PDA):In this condition, an opening between two blood vessels from the heart doesn’t close properly. Due to this condition,extra blood may flow to the lungs.

Solution: In some cases, the opening closes on its own within a few days of birth. However, in other cases, medication or surgery is needed to close the opening.

Respiratory Distress Syndrome (RDS):RDS is a breathing problem. Surfactant is a protein that avoids small air sacs in a baby’s lungs from collapsing. However, the babies suffering from RDS don’t have Surfactant protein.

Solution: Treatment with Surfactant helps babies in breathing easily. Some babies who suffer from RDS may also need oxygen and breathing support to help their lungs in breathing.

Retinopathy of prematurity (ROP): This is an eye disease that afflicts a majority of premature babies. This condition occurs when the baby’s retina doesn’t develop in the follow-up weeks to the birth. It typically affects both eyes.

Solution: Treatment with medicine or laser surgery protects some babies from loss of sight.

Alert: If not checked and treated immediately, this affliction could develop rapidly, leading to permanent blindness.

Necrotizing Enterocolitis (NEC): This condition affects the baby’s intestines (part of the digestive system), and could lead to
- Feeding problems
- Swollen belly

Solution: Babies are treated with antibiotics and are fed intravenously (through the veins) instead of the mouth until the intestine heals completely. In some cases, babies undergo surgery to remove the damaged part of the intestine.

Jaundice: This condition is caused due to the presence of excessive bilirubin in the blood. In Jaundice, the baby’s skin and eyes look yellow. It happens because either the baby’s liver is not completely developed or is not working perfectly.

Solution: Babies who have severe Jaundice are treated with:

Light therapy: Baby is placed under unique lights that change bilirubin into a form that can be expelled through urine.
Exchange transfusion: This is a type of blood transfusion. After light therapy doesn’t work, your healthcare provider may try to exchange transfusion. In this procedure, your baby’s old blood is replaced with new blood in an attempt to discard the excessive bilirubin.
Intravenous immunoglobulin (IVIg): In case your and your baby’s blood types don’t match, your baby may get immunoglobulin – a blood protein, via a needle into a vein.

What are the long term effects of low birth weight?

Babies that are born with low birth weight may experience health issues later in life. Some of these include:

Heart Diseases
Obesity: Obesity refers to being overweight. A person is obese if their BMI (body mass index) is 30 or higher.
Metabolic Syndrome: It is caused by high blood pressure, diabetes and heart disease, all at once
Diabetes
Intellectual and developmental disabilities: These are the problems associated with the working of the brain that can lead to problems in physical development, learning, communicating, and taking care of themselves or getting along with others.

You should seek your doctor's consultation to find out about the things you can do to ensure good health for your baby.However, don’t forget to do your part by ensuring your baby:

eats healthy food
stays active
attends all planned health care check-ups

Can Low Birth Weight cause developmental delays?

Low birth weight can disturb a baby’s development process leading to developmental delays. Developmental delays occur when your child doesn’t reach the expected developmental milestones at the planned time.

Note: A developmental milestone is a skill or activity that most children can do at a certain age. These milestones could include sitting, walking, talking and other social and thinking skills. When a child doesn’t meet a critical physical milestone, it is referred to as either physical developmental delays or early motor delays.

If you notice developmental delays, make sure to get early intervention services for your baby as soon as possible.

Early intervention can help your child in their development whenever they fall back. They usually help children from birth until they are 3 years old.

Alert: Some red flags that indicate your baby may have developmental delays

Delayed rolling over, sitting or walking
Speech delay
Limited head and neck control
Swallowing Difficulty
Muscle stiffness or floppiness
Clumsiness
Muscle Spasms

Reference:

By -
Dr. Ruchika Singh

14-April-2023

Low Birth Weight

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