Self-Assessment Questions (SAQs) for Study Session 8

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the questions below. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 8.1 (tests Learning Outcome 8.2)

What are the main characteristics of preterm and low birth weight babies which mean they need special care?

Answer

The main points that mean preterm and low birth weight babies need special care are:

  • The immaturity of their immune system and therefore vulnerability to infections;
  • The risk of complications in the function of their immature nervous system and lungs;
  • Their vulnerability to hypothermia, because they have little fat protection, and a high ratio of surface area to body weight, and inability to generate much heat for themselves;
  • Potential difficulties in breastfeeding, so lack of nourishment can lead to further weakness and even less protection against infection and heat loss;
  • Their vulnerability to careless handing, for example causing damage to their delicate skin, which creates further entry points for infection.

SAQ 8.2 (tests Learning Outcome 8.1 and 8.3)

Fill in the gaps in Table 8.2.

Table 8.2 Classification of newborn babies according to birth weight and gestational age, and actions to take.

Birth weight and gestational ageClassificationAction

Weight less than 1,500 gm

Very preterm

Low birth weight

Gestational age 32-36 weeks

If there is no other problem counsel on optimal breast feeding, prevention of infection and keeping the baby warm

Normal weight and full term

Answer

Refer back to Table 8.1 in Section 8.2.1 and compare it with the entries you wrote in Table 8.2.

SAQ 8.3 (tests Learning Outcome 8.4)

You make the first antenatal visit at 12 hours after the birth to the mother of a baby that weighs 2,000 gm. It seems able to suckle but not for long, and the mother is worried if it is getting enough breast milk. How would you advise her?

Answer

At 2,000 gm this baby has a low birth weight, but it does appear to be able to suckle. However, if the mother thinks it is not getting enough milk because it quickly tires when it suckles, you could suggest additional feeding of expressed breast milk. You will need to explain first how to express her milk and how to store it safely (re-read Section 8.3.3 if you can’t remember), and then show her how to cup feed the baby (Section 8.3.4).

SAQ 8.4 (tests Learning Outcome 8.5)

  • a.What are the key things not to do with a preterm baby in order to protect it from hypothermia?
  • b.And what are the advantages of Kangaroo Mother Care in relation to hypothermia?

Answer

  • a.To prevent heat loss in a premature or low birth weight baby, you should not:

    • bathe the baby until at least 48 hours after delivery;
    • leave the baby without a hat (90% of heat is lost through the head if uncovered);
    • leave the baby in a room with the doors or windows open;
    • forget to provide an extra heat source in the room where the baby is kept;
    • undress it completely to change the diaper.
  • b.The advantages of KMC are:

    • the baby is kept in skin-to-skin contact day and night, which provides effective warmth and temperature control;
    • the baby is only removed from skin-to-skin contact for specific purposes (changing its diaper, checking if the cord stump is drying normally), so there is little danger of it being left in a room that is too cold;
    • the baby feeds better and gains weight more rapidly (so it develops more body fat to help keep it warm);
    • the advantages of KMC can be provided by other members of the family if the mother is unwell or needs a break.

Summary of Study Session 8