Small child. Small baby Causes of low birth weight babies

No matter what average weight norms for newborns are taken by WHO, babies are unlikely to check with them: some are born heroes, others are crumbs, and still others fall exactly “in the middle”. What does it depend on? When is the weight of a newborn important? Is it possible to "correct" the baby's weight during pregnancy? Darya Alexandrovna KINSHT, head of the neonatology department, neonatologist, anesthesiologist-resuscitator of the highest category of the AVICENNA Medical Center of the Mother and Child Group of Companies, tells.

Weight norms in newborns

The standard indicators of weight at birth are 2.8 kg - 4 kg with growth - from 46 to 55 centimeters. Experts note that today larger children are being born more and more often - the “heroic” weight of a newborn of 5 kilograms has ceased to be such a rarity.

According to WHO, birth weight of children can be classified as follows:

Girls weight

Indicator score	Very low		Below the average		Above average		Very tall

Boys weight

Indicator score	Very low		Below the average		Above average		Very tall

According to these tables, as a norm, it is possible to evaluate indicators that fit into the framework from “below average” to “above average”. Indicators "low" and "very low", "high" and "very high" - a reason for closer attention of specialists.

” It is not so much the weight that is extremely important, but its compliance with the gestational age. For example, a baby born at 40 weeks with a weight of 2000 g and a baby at 32 weeks with the same weight are two completely different babies.

The main role is played not by the weight parameters themselves or their compliance with average indicators, but by the ratio of the height and weight of the baby. This value allows you to determine the Quetelet index - weight in grams divided by height in centimeters. If the value is in the range from 60 to 70, this is considered the norm for full-term babies.

” Important: all the above data and norms are valid only for babies born on time. For premature babies, there are other criteria.

Expert comment

There are special tables for matching the weight and height of the child to the gestational age - for boys and girls, respectively. Of course, the use of these tables can only give an approximate picture, since each country and each region may have its own characteristics. Correct data for such tables is a major problem, but WHO work is already underway. Regarding the tables that are used now, certain examples can be given, even for full-term newborns, different weights can be “correct”: for example, with a gestational age of 37 weeks (this is already a full-term baby), a weight of 2850 g can be considered “correct”, at the same time for a child with a gestational age of 41 weeks, this weight will be considered insufficient. On average, a full-term baby weighing between 3000 and 4000 g can be considered sufficient.

The weight of the newborn and the physique of the parents

There is an opinion that “heroes” are often born to large parents, and slender and short women bear miniature babies with low weight. It has also been observed that parents who themselves were born large are more likely to have a child weighing 4 kg or more.

Doctors say that in fact, the weight of the fetus and newborn child does not depend so much on the parental physique - in the mother's womb, all babies normally develop according to the same laws.

Expert comment

You can correlate the weight of the newborn with the weight and height of the parents, but to a greater extent this manifests itself later, when the baby grows up. A graceful woman with a height of 150 cm should not give birth to a full-term baby weighing two kilograms, and a tall woman weighing closer to 90 kg should not have a five-kilogram baby, not at all! Approximately the same indicators are relevant for them, although the compilation of special tables and programs that determine the ratio of the weight and height of the child with parental parameters is also under development.

Ultrasound weight and birth weight

Sometimes expectant mothers begin to worry about the weight of the baby long before the birth. During an ultrasound, the screening doctor always calculates the estimated fetal weight based on gestational age, head and tummy circumferences, femur length, and biparietal fetal head size ( the distance between the outer and inner contours of both parietal bones).

If the estimated weight of the baby differs from the accepted norms up or down, but no deviations in the state of the placenta and fetus have been identified, this is not a cause for concern.

Expert comment

It is impossible to accurately “weigh” the fetus on the basis of ultrasound, and the estimated weight of the baby very rarely exactly matches the real weight of the newborn.

Fetal weight during pregnancy

In some cases, the small size and weight of the fetus may indicate its developmental delay and the presence of pregnancy pathologies. A serious discrepancy between the physical development of the fetus and the gestational age is called fetal hypotrophy or intrauterine growth retardation syndrome.

There are 2 forms of malnutrition:

Symmetrical form of hypotrophy. It is noted already in the early stages of pregnancy, while all fetal parameters measured by ultrasound are less than the norm.

Asymmetric form of hypotrophy. Develops after 28 weeks of pregnancy. It is characterized by uneven development of the fetus. On ultrasound, the doctor can determine this if the dimensions of the head and body of the fetus do not correspond to the circumference of the abdomen.

Such intrauterine growth retardation begins if the fetus receives insufficient nutrition. As a rule, this is due to pathologies of the placenta.

The reasons for this may be:

malnutrition,
bad habits,
chronic diseases of the mother,
genetic pathology,
infections.

In other cases, the ultrasound doctor, on the contrary, notes that the size of the fetus is too large compared to the norm.

What to do if, during an ultrasound examination, they write “large fetus” in the conclusion, or vice versa - they suspect intrauterine growth retardation due to small size? Is it possible to somehow influence the weight of a baby who has not yet been born?

The term "small baby" means that the baby weighs less than his peers of the same sex. It is no secret that the existing pediatric book gives only approximate guidelines, and therefore a child is called underweight only when the difference in weight is really very noticeable. Often, a woman is informed that a child has a low body weight even during pregnancy - speaking of this situation, obstetricians use the term “intrauterine growth retardation”.

As you know, all people are different - some are simply smaller than others, although they are quite healthy and do not have other developmental abnormalities. In small people, in most cases, small children are born - such family features must be reported to the doctor.

Other causes of low birth weight babies are listed below:

The birth of a small child should not upset parents. A good start is, of course, not bad, but even if this did not happen, you can always help the baby catch up in the future.

To help a small baby catch up with their peers in intrauterine physical development, you need to start acting right when the problem is diagnosed.

The birth of a small child is not a reason to panic. Of course, such a baby needs special care and at first he will be nursed separately from his mother, but modern medicine quickly achieves the health of small crumbs.

If a specialist, speaking about your child, uses the term "small baby", do not get upset and nervous. Don't be afraid to admit the problem - the sooner you recognize it, the sooner you can solve it.

You will hear this term if your child, according to doctors, weighs less than other children of the same sex and on the same. When your baby is born, he will probably weigh less than most other babies.
If your baby weighs less than 2.5 kg at birth, they are considered to be low birth weight.
You may hear other terms with similar meanings. If your baby is not growing as fast in the womb as other babies at the same stage, they will be named. Other terms may be used: low weight for a given gestational age or intrauterine growth retardation (IGR).
Sometimes these definitions are imperfect because they are based on comparisons with average data. For example, your child may be small simply because it is a characteristic of your family.
It is not always easy for doctors and midwives to determine the body weight of a baby in the womb. Measuring your belly size is one method. If your child appears small, you will be referred for an ultrasound.

What can cause low body weight and the birth of a small child?

There are many reasons. Some people are just smaller than others.
Parents whose height and weight are less than average, or who themselves had a low birth weight, may have small children. If this applies to you, tell your doctor and midwife about it.
Other causes of low birth weight for a given gestational age include:

Problems with the placenta, such as preeclampsia, which reduces blood flow to the fetus. This can cause developmental delay (GAR) because the baby will not get enough oxygen and nutrients.
High blood pressure (hypertension) can also interfere with blood flow to the fetus through the placenta. This may lead to the birth of a small child.
Twins or triplets are more likely to be born small because they don't have enough room to grow.
Sometimes children are small because they have inherited some disease.

If you suffer from any physical or nervous disorders, this may slow down the growth of the child. The reason for the birth of a small child may be:

an advanced, untreated infection, such as a urinary tract or uterine infection
a diet that is severely deficient in nutrients and calories
chronic diseases such as heart, lung or kidney disease, diabetes
or serious financial difficulties
taking drugs such as heroin or cocaine
drinking too much
smoking

How can I help my child?

In many ways, a “good start” for the baby depends on you. You can get started right now:

if you have a medical condition, such as diabetes or diabetes, talk to your doctor about how it can be managed during pregnancy
don't drink more than one or two glasses of wine a week, or don't drink alcohol at all
eat a balanced diet and
seek help if you think you may be having trouble quitting drugs
quit smoking

Changes in your lifestyle will have a beneficial effect on the health of the unborn child. Quitting smoking during pregnancy has been shown to help reduce the risk of having a small baby. Special courses or programs will help you cope with smoking, drinking, or using drugs when you are pregnant. Be sure to visit your gynecologist regularly during your pregnancy so that any potential problems are identified and prevented in time.

Where can I get help?

Talk to your doctor about any concerns or concerns about your pregnancy. You can also read our articles and find out:

principles of healthy eating during pregnancy
how to quit smoking

Body weight is an important criterion for the development of the baby. Birth weight is included in the mandatory primary system for assessing the condition of the baby - the Apgar scale. The way a baby gains weight after birth is important for determining its general condition, which is why the crumbs are weighed at each appointment with the pediatrician.

In this article, we will talk about the age norms of weight, as well as give the opinion of the famous pediatrician Evgeny Komarovsky on what to do if the child is overweight or does not gain the desired mass.

About norms

All children are individual, this also applies to weight. Some are born large, other newborns born at the same time weigh less and this is not unusual, because their parents are different (big and thin, tall or short). Birth weight plays a big role for premature babies, according to it, as well as the exact gestational age, determine the degree of prematurity.

Normal weight for a full-term baby averages 2.6-4 kilograms. The range of normal values is quite wide.

After birth, weight gain will be monitored monthly for up to a year.

Unlike growth, which is a more stable indicator of the correct development of the baby, his body weight can be more labile: weight decreases or increases under the influence of various reasons. Even within one day, according to Komarovsky, parents can see different values on the scales.

if the child is not a year old, then its weight is m + 800n, where m is the weight at birth, and n is the age in months;
if the child is already a year old and up to the age of ten, they use a different formula, in which the body weight is normally 10 + 2n, where n is the age in years;
if the child is older than 10 years old, then for the calculation they use a formula in which the normal weight is 30 + 4 * (n-10), where n is the age in years.

Thus, it is easy to understand that a baby at 7 months old, if he was born with a weight of 3500 grams, should weigh no less than 3500+ 800x7, that is, 9 kilograms 100 grams. A child at 2 years old weighs 10 + 2x2, that is, 14 kilograms. Just substitute your values and you will be able to focus on the norm.

You can make it easier and use a table or calculator for matching height and weight depending on age. Tables are also used by pediatricians at the reception, since this significantly reduces the time for receiving a child, because the doctor does not need to do mathematical calculations.

Naturally, with a significant excess of the norm and in situations where the child is not gaining weight well, you need to carefully consider and eliminate the possible reasons why this happens.

Height and weight calculator

Reasons for the backlog

The most active weight gain occurs in the first six months of a child's life, then the pace slows down, because the child's physical activity increases - he learns to crawl, sit, and this requires large energy costs. Small children sometimes gain weight more actively than crumbs born as heroes, the increase in such babies can be more intense.

A strong lag of real body weight from norms can be the result of malnutrition and malnutrition, diseases of the gastrointestinal tract, as well as any other congenital or acquired diseases.

Naturally, the pediatrician will identify the causes, prescribe tests, and give recommendations on the diet.

If the child is a little behind the norm in weight, but he is active, mobile, inquisitive, feels great and has normal tests, there is nothing to worry about, says Komarovsky. It is dangerous if a small increase and lagging behind the standards are accompanied by pallor, lethargy, and some other symptoms that make parents think about a possible illness, it is important to urgently go to the doctor, says Yevgeny Komarovsky.

Complaints of parents that the child has a big belly at 2 years old and weighs 10 kg at the same time, as well as that the child in his year weighs only 8 kilograms instead of the prescribed 10, should be considered in each case, taking into account a complete anamnesis. The doctor needs to know how much the child was born with, how he feels in everyday life, and also to see what kind of physique the parents have.

It is quite clear that a sharp decrease in body weight can be a sign of both quite serious diseases and common helminthic invasions, and therefore laboratory diagnostics in this case is indispensable.

Komarovsky advises parents of small children who eat a little and not every time to calm down and stop trying at any cost to fatten the child up to the age standard. The approach is the same: if he feels normal and healthy, then nothing needs to be done to improve.

Why is there an excess?

Excess weight gain is most often due to the fact that the parents of the baby overfeed. Excess weight is formed when the degree of energy consumption does not correspond to the amount of food received. An infant who sleeps most of the day gains weight better and faster than an active and moving two-year-old.

Weight fluctuations up (or down) are also possible with intense hormonal changes, for example, this is how a teenager loses weight or gets better during puberty. Some pathologies of the thyroid gland and other endocrine disorders can cause childhood obesity, but this happens much less frequently than the banal and widespread overfeeding of your beloved child.

A child over 2 years old may be overweight due to a sedentary lifestyle and low activity, the risk of gaining extra pounds is higher in children who are allowed to eat and drink harmful, but very tasty fast food, lemonade, chips.

What to do? Show the child to the doctor, if necessary, examine him, do blood tests, check the functioning of the gastrointestinal tract and get recommendations for smooth and accurate weight loss.

An adequate increase in physical activity at the same time as stopping the practice of force feeding usually helps well. Yevgeny Komarovsky advises giving food to a child only when he himself asks for it.

You can not feed the child in front of the TV screen: being carried away by the picture, he eats more than what he is supposed to.

Also, parents should pay attention to their own eating habits, usually malnutrition is family. Fatty and fried foods, smoked meats, spicy, fast food, an abundance of sweets should disappear from the child's diet. Instead, vegetables and fruits, stewed, boiled and baked meat and fish should come. It is worth giving up lemonade and various store-bought sweets.

Why is it important to monitor a child's weight? Excess weight is dangerous at the beginning of walking, because it creates increased stress on the bones, joints, cartilage, ligaments and spine. In overweight children, flat feet are more often recorded at a later age. Obesity is a fertile ground for the development of various diseases, as well as a factor in reducing immunity.

For more information about weight norms, see the next program of Dr. Komarovsky.

The World Health Organization has adopted average weight norms for newborns. But not all kids want to fit into them: some are born heroes, while others are just crumbs. And despite the fact that today there is a trend towards the birth of babies with a body weight of about 5 kg, small children in our time are also not uncommon. As a rule, such crumbs are born on time or a little earlier than the due time, and due to underweight and weakness, they do not eat well and may lag behind their peers in their development. We will talk about the features of nutrition, development and care for such babies in our article.

Small children - who are they?

In the mother's womb, all children develop according to the same laws of nature, of course, if nothing prevents them from doing so. That's just some babies are born big, while others are too small. It is they who are called low-weight, since their body weight at birth does not fit into generally accepted norms. Such babies who were born at term, but with a small weight, are often diagnosed with intrauterine growth retardation.

Separately, it is necessary to consider such a thing as a prematurely small child. These babies are usually born weighing less than 2.5 kg and require special attention and care. Premature babies gain weight and develop in general according to separate, specially developed norms. Later than their peers, they begin to hold their heads, sit down, crawl and walk.

As a rule, babies who were born small are reluctant to gain weight further. This problem worries their parents very much, as it may indicate deviations in their physical development.

Birth weight norms and deviations

Normally, the body weight of a newborn at his birth is 2800-4000 g. Children who do not fit into this framework require close attention from neonatologists and pediatricians.

But it is also important to consider at what stage of pregnancy the baby appeared. It is one thing if a small child, full-term up to 40 weeks, was born with a weight of 2 kg, and another if a baby was born with the same weight for a period of 32 weeks. In the maternity hospital, neonatologists use specially designed tables to match the baby's weight and height to the gestational age.

By the way, the growth of the child must also be taken into account when determining deviations from the norm. This can be done using the Quetelet index. To determine its value, the child's weight in grams must be divided by his height in centimeters. The resulting value should normally be in the range of 60-70 units. But before making unreasonable diagnoses, it is important to take into account the height and weight of the child's parents, as well as with what body weight they were born.

Causes of low birth weight babies

There are a lot of factors that contribute to the fact that a child is not gaining enough weight. In medical practice, the following main reasons for the birth of small children are distinguished:

mother's age is less than 20 or more than 40;
diseases of the expectant mother during pregnancy: chronic pyelonephritis, diabetes mellitus, high blood pressure, anemia and others;
gestosis (late toxicosis) of pregnant women;
malnutrition, bad habits, poor social and living conditions;
harmful working conditions.

All these factors contribute to the baby gaining too little in the womb.

But the reasons for a small weight gain after birth are slightly different:

refusal of the baby to suckle the breast due to physical weakness;
non-compliance with breastfeeding tactics, as a result of which the newborn receives only foremilk, which is less high-calorie and nutritious;
previous infectious disease.

Features of feeding newborns

The problem of feeding small children remains one of the most serious today. Many babies, premature or born with a critically low birth weight, cannot suckle for a long time at the mother's breast or they do not have this reflex at all. In this case, it is recommended to feed the child with expressed milk, and until lactation is established, with colostrum. The choice of how to feed a child depends on his age. In general, a baby who has reached the term of 36 weeks or his weight has exceeded 2500 g may well suck on his mother's breast on his own.

The calculation of the milk needed by the child is carried out as follows:

If the weight of the crumbs exceeds 2500 g, the total amount of milk he needs per day is calculated by multiplying 150 ml by 1 kg of his body weight. The resulting value should be divided by 8 feedings. Give the baby the calculated amount of milk every 3 hours.
If the baby weighed less than 2500 g at birth, in the first 24 hours after birth, he should be given 60 ml of milk. Further, this amount is increased daily by 20 ml, until the total daily volume reaches 400 ml. This amount should be divided into 8-12 feedings every 2-3 hours.

If the child does not eat up and does not stand 3 hours between feedings, it is recommended that he additionally breastfeed on demand.

Indications for tube feeding small babies

If breastfeeding or bottle feeding becomes impossible for a baby born with insufficient body weight or before the due date, then the baby is fed through a tube. Usually, such a decision is made by doctors due to the lack of a sucking or swallowing reflex in the crumbs. The volume of milk needed by the child is calculated based on the date of birth, body weight and general condition.

Tube feeding is indicated in the following cases:

with a deep immaturity of the body of a newborn, when his sucking and swallowing reflexes are not developed;
in critical conditions of the newborn after childbirth;
with low Apgar scores.

It is worth noting that underweight and premature babies are especially in dire need of mother's milk. It is natural nutrition, laid down by nature itself, that will allow the baby to quickly catch up with his peers. If breastfeeding is not possible, then the baby needs to choose a special mixture for small children. It has a high calorie content and contains more protein and other nutrients that the baby needs so much for an accelerated set of muscle mass.

Development of underweight children

Small children have a high risk of abnormalities in the nervous and cardiovascular systems. And since such babies, due to their weakness, continue to gain weight poorly, their physical and mental development, the formation of immunity is also at risk.

Pediatricians and neonatologists draw a parallel between the weight and height parameters of underweight children and their development:

Children born with normal height but low weight tend to be restless, have low and uneven weight gain, but generally develop normally. By the year they practically do not differ from their peers.
Children who are low birth weight, but their height is only slightly behind the norm, may lag behind their peers in psychomotor development. They are dominated by inhibitory reactions of the body.
Children with proportionately low weight and height also develop more slowly. They also get sick for a long time and often due to reduced immunity.
Children with deep lags in growth and weight as a result of intrauterine development disorders. They have a delay in the development of bone tissue, the psyche and other body systems.

Caring for a premature newborn at home

Children weighing less than 2500 g at birth are placed in a hospital. In a hospital setting, the baby, along with his mother, is under the constant supervision of doctors until he begins to eat well and absorb food. Then the baby is discharged home, where for the first time he will need special care and a specially designed feeding regimen so that he can quickly catch up with his peers in weight.

Since small children have weak immunity, hardening is recommended for them. But they should be carried out in a strictly individual manner, since such babies easily overheat and supercool. You should start with air baths for 3-5 minutes, gradually increasing this time. It is equally important to ensure close bodily contact with the baby.

How to help a child gain weight and catch up with peers in development?

If the child is breastfed, the mother needs to pay special attention to her diet. It is recommended to increase the consumption of liquids: low-fat milk, compotes, fruit drinks. Boiled or baked meat must be present in the diet. Vitamins should be taken on the advice of a doctor. The breast should be offered to the baby on demand, when he is in a good mood and does not want to sleep.

How quickly a baby will gain weight is influenced by both internal and external factors. In order for the baby to get stronger faster and get enough oxygen, it is recommended to walk with him longer in the fresh air. In addition, underweight children need constant monitoring by specialists.

Small children are often only outwardly different from their peers. But due to their weakness, they need even more care and maternal warmth. They are recommended to apply skin to skin as often as possible, providing the necessary bodily contact. It is equally important to provide adequate nutrition and conditions for normal mental development. Only in this case, small babies will be able to outgrow all their problems and grow up to be full-fledged, in every sense of the word, people.