How much a newborn baby weighs is often among the first questions asked by parents after delivery. Without a doubt, this is because a baby’s birth weight is a indicator for its general health according to medics.

Every mother dreams of giving birth to a healthy baby, but, sometimes she may deliver a baby with low birth weight.

Pediatricians explain that taking care of such a baby is not easy. Low birth weight babies are at increased risk of dying from hypothermia, infections, breathing problems and immaturity of their vital organs.

Fortunately, experts say when they get good care, babies born with low weight can defy the odds and develop normally like any other child.

Low birth weight (LBW) contributes 60 per cent to 80 per cent of all neonatal deaths. The global prevalence of LBW is 15.5 per cent, which amounts to about 20 million LBW infants born each year, 96.5 per cent of them in developing countries according to the World Health Organisation.

When to tell a baby has a low birth weight

Dr John Muganda , an obstetrician and gynecologist based in Kigali, says the average weight of a baby born full term (i.e. between 37 and 41 weeks) is 2.5kg. Babies weighing less than that are classified as low birth babies. In most cases, they are born prematurely (before 37th week of pregnancy) but also it may occur to full term born babies.

"Babies born weighting between 1.5-2.4kg can usually be managed safely at home with some extra care and support but babies born with birth weight less than 1.5 kg require hospital-based care. A life-threatening problem in such tiny babies is that suckling, swallowing and breathing are not well coordinated, so they require special attention in order to feed adequately and safely.

They also have difficulty in maintaining their body temperature, so they are at increased risk of hypothermia,” he explains.

Causes of low birth weight

Dr Tharcisse Ngambe, a paediatrician at King Faisal Hospital, Kigali says the most underlying causes of low birth weight are related to nutrition ,the mothers weight or health condition while pregnant.

"A baby needs proper nutrients to help it to develop properly in the womb. A mother’s diet affects her baby’s weight and growth rate. Women are strongly advised to stay away from poor eating habits and quit consumption of alcohol, smoking and drugs for the duration of their pregnancy as these affect foetal development,” he says.

Muganda also says the size of the parents affects the birth weight of the baby. If the parents are either skinny or short, the baby will be born smaller-than-average and vice-versa. A mother’s health during pregnancy can also have a big impact on the baby’s weight.

"If the mother is anaemic or diabetic during pregnancy, or suffers from uterine problems, it will affect the baby adversely. The blood supply to the placenta may be reduced in case of a low-lying placenta, or high blood pressure in pregnancy; which will decrease the amount of oxygen and nutrients reaching the baby thereby restricting its growth and development,” he says.

"Rh incompatibilities, infections such as toxoplasmosis or sexually transmitted diseases such as HIV/AIDS will also cause the baby to be born with a low birth weight,” he adds.

Care for a low birth weight baby

According to pediatricians and obstetricians, appropriate care of LBW infants including their feeding, temperature maintenance, hygienic cord and skin care, and early detection and treatment of infections can substantially reduce mortality.

Ngambe says it is vital to keep LBW babies warm . Hypothermia or rapid loss of heat is common in LBW babies, as they have less skin fat.

Breastfeeding

Breastfeeding is a key element of taking care of a LBW baby. Dieudonné Bukaba, a nutrition expert, says breastfeeding is the best way of nourishing a LBW baby.

"Breast milk promotes the adequate growth of low birth weight babies. A mother can definitely try to breastfeed the baby if the baby is above 1.8 Kg. However, if the baby is born before 34 weeks, they can’t suckle sufficiently due to poor suck- swallow coordination, weak suck reflex and many other factors.

"The mother is advised give an extra support by squeezing her breast lightly while the baby suck or try cup feeding- in that case, the baby can be fed expressed breast milk of the mother with a small, sterilised cup,” he says.

Sometimes, a mother can be short of breast milk. In this case, the nutritionist advises use of only those formulas recommended by doctors for LBW babies.

Kangaroo mother care

Ngambe says kangaroo mother care, a method of care for preterm infants weighing at least 1kg, is also very important.

"It includes exclusive and frequent breastfeeding in addition to skin-to-skin contact between the baby’s front and the mother’s chest. The more skin-to-skin contact, the better. It should ideally start at birth, but is helpful at any time. It should ideally be continuous day and night, but even shorter periods are still helpful, "he says.

Ngambe adds that LBW babies are at higher risk of catching respiratory tract infections, and for this, he says while at home parents should make sure the baby is not exposed to infections by avoiding contact with people who may have a cold, cough or other infection, or not to go too near or touch him until they’re better.

Can low birth weight be prevented?

According to pediatricians, prevention of preterm births is one of the best ways to prevent babies born with low birth weight. Here, antenatal care is a key factor in preventing preterm births and low birth weight babies.

"At prenatal visits, the health of both mother and fetus can be checked. A mother may be prescribed medications or guided on how to take care of herself to make sure the baby grows healthy in the fetus”, says Ngambe

He adds that due to the fact that maternal nutrition and weight gain are linked with foetal weight gain and birth weight, eating a healthy diet and gaining the proper amount of weight during pregnancy are essential.