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Feeding the Larger Low-Birthweight Infant in a Resource-Poor Environment

Gert F Kirsten1

  • 1Division of Neonatology, Department of Paediatrics and Child Health, Tygerberg Children's Hospital and University of Stellenbosch, Western Cape, South Africa.

Nestle Nutrition Institute Workshop Series
|June 27, 2015
PubMed

Insights

Resource-poor countries face high rates of low birthweight infants. Implementing standardized triage and care protocols, including early breastfeeding and kangaroo mother care (KMC), optimizes nutritional support and improves outcomes for these vulnerable newborns.

Area of Science:

  • Neonatalogy
  • Public Health
  • Pediatrics

Background:

  • High prevalence of low birthweight (LBW) infants (16.5%) in resource-poor settings strains healthcare systems.
  • Effective triage and nutritional support are critical for LBW infants.

Purpose of the Study:

  • To outline guidelines for optimal nutritional support and care of low birthweight infants in labor wards, special care nurseries (SCN), and postnatal wards (PW).
  • To emphasize the prevention of mother-infant separation and promote early breastfeeding and kangaroo mother care (KMC).

Main Methods:

  • Development of written guidelines for triaging infants based on weight and gestational age into SCN or PW.
  • Implementation of feeding protocols (intravenous glucose, expressed breast milk, enteral feeding) and KMC.
  • Specific protocols for HIV+ mothers' expressed breast milk (EBM) and individualized discharge criteria.

Main Results:

  • SCN infants receive intravenous fluids, progressing to EBM and KMC; unstable infants have slower enteral feeding advancement.
  • PW infants initiate breastfeeding and KMC early, with discharge often before birthweight regain but after establishing breastfeeding.
  • Post-discharge nutritional support with multivitamins and iron is recommended for 12 months.

Conclusions:

  • Standardized triage and care protocols are essential for managing LBW infants in resource-limited settings.
  • Early initiation of breastfeeding and KMC, alongside appropriate nutritional support, improves outcomes.
  • Continued community-based nutritional support post-discharge is vital for long-term infant health.

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