DQ Professor’s comments: Responses such as “I agree”, “thanks for that information – I didn’t know that”, “I experienced that also”, etc. will not receive

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Professor’s comments:

Responses such as “I agree”, “thanks for that information – I didn’t know that”, “I experienced that also”, etc. will not receive participation credit. Please do not repeat what is already mentioned in the post. Responses should be a minimum of 150 words and minimum of 2 peer reviewed or scholarly sources with 5 years

Please do not to “cut and paste” answers from your references such as lists, bullet points, etc. This will not receive points for responses that are “cut and paste” even if you provide a citation.

Post 1.

Extremely low birth weight babies is defined as one with a birth weight of less that 2lb, 3 oz (1000g). Premature delivery is the main cause of extremely low birth weight babies (preemies) and has a survival rate of only around 68% even in developed countries (Drotar, et al, 2006). These infants have immense impact on family and community both long term & short-term. Some long-term effects of extremely low birth weight babies is the increased risk of chronic conditions such as respiratory problems, poor postnatal growth, cerebral palsy and other infections. Short- term effects include low oxygen levels at birth, trouble staying warm and maintaing blood glucose levels, trouble feeding and gaining weight as well as breathing problems associated with immature lungs. Low birth weight results in substantial costs to the health sector and imposes a significant burden on the society. It is a major determinant of mortality, morbidity and disability in neonatal, infancy and childhood and has a long term impact on health outcomes in adult life (Drotar, et al, 2006). These children have a need for ongoing care and require many resources beyond the NICU.

African Americans and Native Americans have the highest neonatal death rate associated with prematurity within the US. There exist several support systems in the local community that support these infants with round the clock care and blankets, as well as programs nationwide such as March of Dimes that support preterm infants and their 
families.
 Support organizations in the community play a very crucial role in promoting the health of babies who are born underweight. These organizations are within the community and understand the community needs and the factors that may influence low birth weight babies and are therefore in a better position to promote effective care. Prevention programs and early and consistent prenatal care are imperative factors in reducing early child birth and extremely low birthweight.

Drotar, D., Hack, M., Taylor, G., Schluchter, M., Andreias, L., & Klein, N. (2006). The impact of extremely low birth weight on the families of school-aged children. Pediatrics117(6).

Msall, M. E., & Tremont, M. R. (2002). Measuring functional outcomes after prematurity: developmental impact of very low birth weight and extremely low birth weight status on childhood disability. Mental retardation and developmental disabilities research reviews8(4), 258-272.

Post 2.

Low birth weight of babies is a global problem that negatively affects both the family and the community. The World Health Organization defines low birth weight as a weight at birth that is less than 5.5 pounds which accounts for 15-20% of all births globally (Kargbo et al., 2021). This is significant because low birth weight is associated with short- and long-term problems that result in social and economic repercussions. The immediate impact of low birth weight is its relation to infant mortality; low birth weight is associated with a higher rate of death among infants, especially within the first couple months of life (Hailu & Kebede, 2018). Death of an infant is an incredibly difficult event for the parents and the family to endure and can place stress on familial relationships. Additionally, there are many negative long-term effects of low birth weight. Low birth weight is associated with chronic health problems later in life and can result in delays in growth, and neurological and cognitive development (Hailu & Kebede, 2018). These long-term problems associated with low birth weight increase the need for ongoing care which can result in higher cost of care for both the individual and community. Additionally, children who suffer from cognitive and neurological delays have a harder time learning and succeeding in school, which has long-term effects on their lives. 

Disparities in health care among ethnic and cultural groups contribute to low birth weight. Social determinants of health directly affect maternal health care and influence maternal risk factors such as access to resources and health care (Ro et al., 2019). One support service that exists in my community is the Regional Center of Orange County (RCOC) which is a nonprofit organization that supports individuals with developmental disabilities. This organization addresses the needs of the community by providing many resources to parents and families of preterm babies. For example, through the Graham’s Foundation, the RCOC provides a NICU care package at no cost and the opportunity to connect with a preemie parent mentor. The website for this resource is: https://www.rcocdd.com/frc/ccfrc/resources/premature-babies/ 

 

References: 

Hailu, L. D., & Kebede, D. L. (2018). Determinants of Low Birth Weight among Deliveries at a Referral Hospital in Northern Ethiopia. BioMed Research International2018, 1–8. 
https://doi.org/10.1155/2018/8169615
 

Kargbo, D. K., Nyarko, K., Sackey, S., Addo-Lartey, A., Kenu, E., & Anto, F. (2021). Determinants of low birth weight deliveries at five referral hospitals in Western Area Urban district, Sierra Leone. Italian Journal of Pediatrics47(1). 
https://doi.org/10.1186/s13052-021-01160-y
 

Ro, A., Goldberg, R. E., & Kane, J. B. (2019). Racial and Ethnic Patterning of Low Birth Weight, Normal Birth Weight, and Macrosomia. Preventive Medicine118, 196–204. 
https://doi.org/10.1016/j.ypmed.2018.10.012
 

Post 3.

The effects of children with very low birthweights are severe as it is shown to have  face a 2–3 fold greater risk for visual and hearing impairment, speech delays and attention disorders ( Lakshmanan 2017) Short term impacts would be having to be in a NICU longer than you would for a normal weight baby. One of the long term effects would include the expense and time that it would bring to the families that have low weight babies. its has shown that African American women have a two times likelihood of having a child with low-birth weight( LBW) compared to Caucasian women , there is an even higher prevalence in women to have children with LBW who have less than a high school education. (Ratnasiri 2018) . In My community is Las vegas, The Souther Nevada Health District (SNHD) has partnered with a organizations that specifically helps mothers with LBW babies in low socio economic area codes. This organization is called Embracing Healthy baby. This program follows mothers in these specific areas who are at risk for low birthweight from pregnancy up to a year after the baby is born. This program does not require the mother to be pregnant but does require the mother to have a child aged 0-6 months to qualify. Their link is 
https://www.southernnevadahealthdistrict.org/programs/maternal-child-health/embracing-healthy-baby/
 for all information needed to the mothers.

Lakshmanan, A., Agni, M., Lieu, T. et al. The impact of preterm birth <37 weeks on parents and families: a cross-sectional study in the 2 years after discharge from the neonatal intensive care unit. Health Qual Life Outcomes 15, 38 (2017). 
https://doi.org/10.1186/s12955-017-0602-3

Ratnasiri, A.W.G., Parry, S.S., Arief, V.N. et al. Recent trends, risk factors, and disparities in low birth weight in California, 2005–2014: a retrospective study. matern health, neonatol and perinatol 4, 15 (2018). 
https://doi.org/10.1186/s40748-018-0084-2

Post 4.

A nine-month-old baby with these measurements lands in the 25th percentile for height and head circumference, but is only in the 5th percentile for weight. This would be a strong indicator that she’s underweight as her weight is not proportional (Mares, S 2012).

Developmental markers that should be present when doing an assessment on a nine-month old baby would be crawls, feeds self finger foods, being able to pull self to standing position and sits without support. Other development markers that are for 9-12 month range include able to drink from a cup with help, stand alone, walk along the furniture, points at objects and get into sitting position by self. The nurse will also measure the capacity of the baby to interact with caregiver and strangers, babble, chuckle and mimmick (Mares, S 2012). The nurse would evaluate the general appearance as well as caregiver interactions in order to be able to give recommendations, much of the data collected would be objective, questions answered by the caregiver which can provide information on nutrition habits, daily routine, hygiene habits, interactions with others. Subjective assessment is also very important; the child’s mental alertness and movements.

As the nurse, I would give suggestions about the baby’s nutritional needs and offer education with strong emphasis, in this case I would talk about the diet of the child in detail with the mother and get verbalized understanding of continued breastfeeding or taking formula along with supplementation of nutritious snacks. It will be important for the mother to realize that for the first 12 months, the baby should continue to breastfeed and use formula and not use cow’s milk during this first year. Solid food should also be introduced around six months. Providing the mother with educational material and handouts as to what a child should eat & important milestones the child should be reaching at nine months of age would be important in addition to the verbal understanding (Flowers, et al 2020). I would offer recommendations for healthy food choices and iron-fortified baby cereals.

These recommendations are based on evidence-based practice for they followed the five steps of EBP; forming a clinical question to identify a problem, Gathering the best evidence, Analyzing the evidence, Applying the evidence to clinical practice, and scheduling follow up visits to asses / monitor the results.

Mares, S., & Graeff-Martins, A.S. (2012). The clinical assessment of infants, preschoolers and their families. In Rey JM (ed), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Available: 
http://iacapap.org/wp-content/uploads/A.4.-INFANT-ASSESSMENT-072012.pdf

Flower, K. B., Massie, S., Janies, K., Bassewitz, J. B., Coker, T. R., Gillespie, R. J., … & Earls, M. F. (2020). Increasing early childhood screening in primary care through a quality improvement collaborative. Pediatrics146(3).

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