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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What is the reason for weight loss in a prematurely born 32-weeks-old baby?

Answered by
Dr.
Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3803 Questions

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Posted on Fri, 18 Oct 2019 in Child Health
Question: my baby was born prematurely in 29 weeks 2 days with weight 1.245kg. its been 18 days he is in nicu. currently he is in cpap with pressure 21% and air pressure at level 5. as per doc he is maintaining it well. he his also tolerating the feed well 17ml. but when his echo was done they mentioned he has got large pda 3.5mm. initially they gave him paracetemol then ibrufin. but it dint help. he is off liquids now solely on feed. he is been loosing weight. present weight is 1.160kg. doctor says its ok to loose weight initially then it will gradually increase since he is only 32 weeks now. they are also planning to increase his feedings. they also mentioned that pda is not giving him.any problems currently and is not the cause for his weight loss. i want to know is the weight loss ok or it may be because of pda problem? by which week we can expect the weight to increase?

he is off fluids now and solely on feeds.
doctor
Answered by Dr. Diptanshu Das 1 hour later
Brief Answer:
Wait and watch

Detailed Answer:

Hello,

I have gone through your query carefully and understand your concern. It is good to know that the child is stable.

Such preterm babies have poor lung maturity and may require CPAP support. It is not a cause for concern. It is good that full feeds have been established and are gradually being increased. The oral feeds will help in weight gain.

The weight drops for an initial couple of weeks (maybe slightly more in case of preterm babies where the establishment of full feeds is delayed). Adding HMF (human milk fortifier) to the feeds could ensure a good weight gain soon.

I would not be worried about the PDA. It may take some time and there are other medicines like Indomethacin which can be subsequently given to help in the closure.

Feel free to write back.

Regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Diptanshu Das 18 minutes later
dr he was already given ibuprofen. but it dint close the pda. is it same as Indomethacin? they said if it continues they will think about surgery where they insert a catherer through the leg and put a coil in the pda for it to close. will it be safe for such preterm baby? dr generally by what week we can expect the lungs to be mature?
doctor
Answered by Dr. Diptanshu Das 2 hours later
Brief Answer:
Usually, conservative management suffices

Detailed Answer:
No, Indomethacin is different from Ibuprofen. It is given when ibuprofen does not suffice. Surgery is an option but usually, conservative management suffices.

Unless there are respiratory indications like pulmonary hypertension (the treating physician would be able to comment better), surgical intervention might not be required immediately. If deemed required, the question of safety becomes secondary since in that case it would be considered life-saving.

The lungs should be mature by the expected date of delivery (since the baby was delivered prior to that) but usually matures prior to that.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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