Annexure

Planned teaching programme (English)

Topic: Effectiveness of planned teaching programme on care

of low birth weight newborns
Participants: Mothers of LBW newborns
Place: Hospital wards
Method of teaching: Lecture cum discussion
Teaching aids: LCD presentation
Time: 45 mint.

General objective
On completion of the teaching session, the mothers of LBW newborns will be
gain adequate knowledge and skill in caring a low birth weight newborn and will
apply this knowledge in caring for their newborn.
Specific objectives

On completion of this session the mothers will be able to:

1. Explain the meaning of LBW newborns.

2. List the types of LBW newborns.
3. Enumerate the causes of LBW newborns.
4. Discuss the difference between LBW newborns and normal newborns.
5. Describe the alteration in physical functioning in a LBW newborns..
6. Discuss the temperature regulation of LBW newborns.
7. Describe the maintenance of adequate respiratory functioning of LBW
newborns.
8. Describe the maintenance of adequate renal functioning of the LBW
newborns.
9. Explain infection control measures in LBW newborns.
10. Discuss maintenance of adequate gastrointestinal functioning.
11. Discuss the nutrition for LBW newborns.
12. Discuss the points to be remembered while feeding the LBW newborns.
13. Describe the routine care of LBW newborns.
14. Explain the follow-up schedule for the LBW newborns.
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Introduction LCD with Q: Please tell

T; lecture
1. Introduction PowerPoint me about the
1 mint The birth of a child is a significant event in any family. The health of a cum Presentation introduction
growing child is always a matter of great concern to the parents. discussion of LBW
S; listening newborns.
In India, about 25-35% of babies are born with low birth weight carefully
(LBW). Over 80 percent of the neonatal deaths and 50 percent of
infant deaths occur among low birth weight neonates. LBW is also a
major determinant of malnutrition during infancy because over 40
percent of LBW newborns are malnourished at one year of age. These
delicate newborns are susceptible to infections and many physical and
mental handicaps during their life. They need specialised care in order
to overcome the obstacles and it is the responsibility of the mother, the
family, and the community to help these newborns to adjust to their
life.

Meaning
2. Meaning 1 mint LCD with Q: Please tell
T; lecture
Any newborn or neonate weighing less than 2500 gms at birth PowerPoint me about the
cum
irrespective of the gestational age is known as low birth weight Presentation LBW
discussion newborns?
newborn(LBW).
S; listening
carefully
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Types
3. Types T; lecture LCD with Q: Please tell
1 min. A. Pre-term/premature: A baby born before 37 weeks of cum PowerPoint me about the
gestation is called a pre-term baby. Approximately one third discussion Presentation Type of LBW
of LBW neonates in our country are pre-term. newborn?
S; listening
B. Small for date or intrauterine growth retardation: Any carefully
newborn who, even after completion of 37 weeks of gestation is small
and underweight is called a small for date baby.

Causes of low birth weight

4. Causes 2mins. Mothers age is less than 20 years or more than 35 years- Q: Please tell
T; lecture LCD with
The foetus will get inadequate oxygen and nutrition from me about the
cum PowerPoint
the placenta which leads to growth retardation. causes of
discussion presentation
LBW
Mothers weight less than 40 kg during pregnancy When the S; listening newborn?
nutrition of the mother is poor the foetus suffers from growth carefully
retardation.

Mothers height is less than 145 cm Poor nutrition of the

mother can be a cause for decreased nutrition for the
growing foetus.

Maternal smoking Nicotine in the smoke can lead to decrease

oxygen to the placenta which will lead to
decreased nutrition to the foetus.
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Anaemia in pregnancy Decreased haemoglobin in the

maternal blood leads to decreased oxygen to the foetus.

Multiple pregnancy Single placenta cannot meet the needs of

more than one foetus and leads to nutritional deficiency.

Complications of pregnancy like increased blood pressure or

elcampsia These can lead to pre-term delivery and low birth
weight.
Characteristic LBW newborns Normal newborns

5. Gestational age Born before 37 weeks of Born after

Difference pregnancy or born after completion of 37
5min 37 weeks but are with weeks of gestation. LCD with Q: Please tell
T; lecture
low birth weight. cum PowerPoint me about the
discussion presentation difference
Less than 2500 Gms. 2500-3500 gms. between low
Birth weight birth weight
S; listening
carefully and normal
Bright pink. Pink. newborns?
Skin colour

Relaxed attitude. More flexed attitude.

Posture
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Ear Ear cartilages are poorly Ear cartilage well

developed developed.
and ear pinna may
fold easily.

Only a few creases. Well and deeply

Sole creased.

Weak, drowsy. Cry Active, wakes up

Appearance is weak, poor for feeds, has strong cry
sucking ability. and sucking.

Noisy breathing; Clear, rate 30-40per

can be fast or slow. minute.
Respiration

Physiological alterations in a low birth weight newborns T; lecture Q: Please tell

6. Physiological LCD with
1. The LBW newborns have less subcutaneous fat and also their cum me about the
alterations PowerPoint
5 mint body surface area is large compared to their weight which discussion normal
presentation respiration of
makes it difficult to maintain a normal body temperature which
can lead to reduced body temperature. S; listening a newborns?
carefully
2. Inadequate respiratory functioning: In a LBW newborns
the lungs are poorly developed and they have weak respiratory
muscles. The structures for respiration are also not developed
fully. This leads to the development of respiratory problems
like apnoea and cyanosis. The newborns respiration is faster
than that of an adult.
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3. Immaturity of liver: Liver is immature in LBW newborn. The

bilirubin excretion does not take place fast which can lead to
jaundice. The storage of glucose also is not done adequately
which can lead to hypoglycaemia. The signs and symptoms of
these problems should be carefully assessed.

4. Inadequate renal functioning: Kidneys of LBW newborn are

immature which can lead to inability to concentrate urine and
so there can be continuous excretion of urine which can lead to
loss of excessive fluid from the body.

5. Poor immunological functioning: In a normal newborn

immunologlobulin G is transferred to the baby which helps in
protecting the newborn from infection. In the premature infant
the level of IgG is low due to the reason that they have not
completed the term. So these newborns are prone to suffer from
infection. Infection is the entry of disease causing micro
organisms in to the body.
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6. Inadequate gastrointestinal functioning: In a low birth

weight newborns the size of the stomach is small and also
the muscles controlling the passage from upper tract to the
lower tract (cardiac sphincter) are immature. This can lead to
regurgitation. You may need to identify this problem while
feeding your LBW newborn.

7. Difficulty in feeding: Adequate nutrition is the essential

aspect for the growth of the newborn. In order to have
adequate feeding, sucking and swallowing reflexes are
important. The low birth weight newborn has poor sucking and
swallowing reflex which makes it difficult for the baby to have
adequate breastfeed. This can lead to decreased level of glucose
and calcium in the body.

Low birth weight newborns lose more heat compared to the normal T; lecture LCD with
7. Temperature 4min newborns. They need extra warmth to maintain their body temperature. cum PowerPoint Q: Please tell
regulation Body temperature of a low birth weight newborns can be maintained discussion presentation me about the
by: how you
S; listening maintain the
Dry quickly and thoroughly after bath. carefully
Keep the baby in a warm room; see that the newborn is not kept temperature
near the doors and windows. of a LBW
Keep the baby between the mothers breasts kangaroo mother newborns?
care.
Breastfeed the newborn.
These are some of the ways to keep your newborns from loss of heat.
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8. Respiratory If you find your baby has bluish discolouration of the nails, T; lecture LCD with Q: Please tell me
Functioning 3min sole and palms, and the newborns is breathing with prolonged cum PowerPoint about the how to
gap, then you should immediately: discussion Presentation Maintaining the
Loosen if any tight clothing is worn. adequate
Observe respiration. S; listening respiratory
Cover the baby, especially the extremities, because extreme carefully functioning in
cold causes bluish discolouration. LBW newborns?
Place the babys neck in extended position.
If these symptoms persist for more than 10 seconds, inform
the doctor.

Immaturity of kidney causes increased loss of fluid from T; lecture LCD with
3min. the body. So you need to observe the baby for signs of Q: Please tell me
cum PowerPoint about the how to
9. Renal dehydration like: discussion Presentation prevent
Functioning Dry lips.
Sunken eyes. S; listening dehydration in
Poor skin turgor. carefully LBW newborn?
Reduction in urine volume.
So you need to feed the baby at regular interval.
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10. 3min. LBW newborns have less immunity and are prone to infection. So T; lecture LCD with How do you
Infection the following measures can be used to prevent infection: cum PowerPoint prevent the
Control Clean the breast before you could feed the baby. discussion Presentation spread of
Measures Wash hands with soap and water before you touch the infection
newborn. S; listening among LBW
Keep separate linen and articles for the baby. This helps carefully newborns?
prevent contamination.
Restrict visitors who have respiratory tact infection or any
other communicable diseases.
Limit the number of visitors; this can help reduce
unnecessary handling of the newborn.
The mother has to maintain her cleanliness by taking daily
bath and changing clothes.
Before you wash the babys clothes soak them in Dettol
solution for one hour.
Dry the clothes under sunlight to kill the micro-organisms.
Immunise the baby with vaccination. This helps create
immunity against most of childhood diseases.
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11. Gastrointestinal The newborns stomach is small and it can cause regurgitation T; lecture LCD with Q: Please tell me
Functioning. 2 min immediately after the feed. You can prevent this by: cum PowerPoint about the
Feeding your baby when he/she demands. discussion Presentation gastrointestinal
Burping the baby after each feed. functioning.
Keeping the bay in right lateral position immediately after S; listening
feeding. This reduces the pressure on the stomach. carefully

T; lecture LCD with Q: Please tell me

12. Breast milk is the best milk for the baby. The baby has to
Nutrition PowerPoint about the
3min be fed exclusively breast milk for six months. There are many cum
presentation advantages of
advantages of breast feeding. discussion breastfeeding?
They are:
Breast milk is best natural food for the newborn. S; listening
Breast milk does not cost anything. carefully
Breast milk protects the newborns from diseases.
Breast milk is always clean.
Breast milk is available 24 hours.
Breast feeding promotes close physical and
emotional bond between the mother and the newborn.
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13. Points of 5mins. The nutritional requirements of a low birth weight newborn are T; lecture LCD with Q: Please tell me
feeding higher than that of the normal newborn because of the need cum PowerPoint about the
for postnatal growth. But the decreased ability in discussion presentation points to be
sucking and swallowing makes it difficult for them to get kept in mind
adequate nutrition. S; listening while feeding
Therefore no one routine can be established for feeding carefully LBW newborn?
such newborns:
Each newborn need is unique, so in the beginning feed the
newborn every 2 hours for 10 minutes on each breast.
Slowly increase the time interval and practice demand
feeding.
Be patient while feeding the LBW newborns because they
take time while feeding.

a. Put the baby on the breast To stimulate sucking.

for non-nutritive sucking.
b. Place the baby in upright
position.
c. Take the required amount
of expressed milk in the
paladai.
d. Fill the paladai spoon with
milk little short of the
brim.
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e. Place at the lips of the

baby in the corner of the
mouth and let the milk
flow in the babys mouth
without spill.
f. Repeat the procedure until
the required amount has
been fed.
g. Keep the baby awake by
moving and patting.
h. After feeding the utensils
should be washed with soap
and water. Boil for 10 minutes. To prevent infection.

14.
A. Eye care T; lecture LCD with Q: Please tell me
cum PowerPoint about the
Routine care Clean the eyes with a clean cloth during bath.Clean from discussion presentation Eye care of
5mins. the part near to the nose to the outer side. the LBW
Clean hands with soap and water before touching the S; listening newborns ?
newborns. carefully
Use only clean cloth to clean the eyes.
Do not apply kajal.
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B. Bath: Low birth weight newborns should not be bathed until

there is progressive weight gain and is able to tolerate
adequate amount of breastfeed.

Points to be remembered while giving bath

Do not bath the newborn immediately after feeding.
Check the temperature of the water with the outer aspect of
the palm. Q: Please tell
Do not take too much time for bathing. me about the
Take care not to allow the water to enter into the eyes, nose, points to be
mouth and ears. remembered
Dry the newborn immediately. while bathing
Cover the newborn with warm clothes. LBW
Keep the newborn near the mother. newborns?
Allow the newborn to rest for sometimes and then feed.

15. Follow-up The newborns needs to have regular follow-up till 5 years of T; lecture cum LCD with Q: Please tell
Schedule 2 min. age. discussion PowerPoint me about the
During the first years of life once a month the assessment of presentation follow-up
growth and development. S; listening during the
During the second year once in two months. carefully first year of
Till five years once in three months the follow-up has to be life?
continued.
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Conclusion

16. Conclusion 2 mint. Children are the wealth of tomorrow. Take care of them if
you wish to have a strong India, ever ready to meet various
challenges Pandit Jawaharlal Nehru.
Care of a low birth weight newborn is a challenging situation
to the mother. The mother should gain adequate knowledge
and skill in taking care of low birth weight newborn so that
she can make her child able to meet various challenges in life.
SUMMARY

In this lesson plan we will discuss about the LBW newborn, meaning, type, causes, difference between LBW newborns and normal newborns,
temperature regulation, infection control measures, adequate gastrointestinal functioning, nutrition, points to be remembered while feeding, routine
care, follow-up schedule for the LBW newborns.

ASSIGNMENT

Write an assignment on the infection control measures of LBW newborns.

BOOKS

1. Data parul. Pediatric nursing. Third edition.(2014) jaypee brother medical publishers(P) LTD.
2. Paul & Bagga. Ghai essential pediatrics. Eighth edition.(2013) CBS publishers & distributors (P) ltd.
3. Jacob alphonsa. Pediatric nursing. Fourth edition(2008) reprint (2009). NR brothers publishers
4. Gupta piyush. Essential pediatric nursing. Second edition. 2013 CBS publishers & distributors (P) ltd.
5. Nair MKC. Text book of pediatrics. Third edition. Jaypee Brothers Publishers.
6. Mrs. R.S. Tambulwadkar, Pediatric Nursing, Third edition, Vora medical publications, Mumbai,2009
7. Meharban singh. Pediatric clinical methods. Fifth edition, 2016 CBS publishers & distributors (P) ltd.
8. Ghai. Essential pediatrics ,eighth edition, 2013 CBS publishers & distributors (P) ltd.