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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Delivered Premature Baby Weighing 1.8kg. Not Gaining Weight. Gving Pro Nan. What Can Be Done?

Hello Doctor,
I am 25 yrs old got married last year on 9th of Dec and got pregnant in January stay in Pune, Clinical Nutritionist pursuing my PhD. My LMP was 23rd of Dec. I delivered normally on 26th of Aug, and my baby boy is premature (36 weeks), His birth wgt was 1.8 and its being 17 to 18 days now stil he has'nt catch up on his wgt gain, I am worried about his wgt and health. He is supplemented with Pre NAN twice or more times with MCT (8 drops) day n night within 2 hr of gap, also he is takin Hovite- 3 drops multivitamin drops and calcimax P- 2ml both twice in a day. He is on breast feed too but unable to suck till his stomach is full and so supplemented to cope up with hunger. He is active in all other activities, loud cry, good sleep, reflexes also good, He gets tired while sucking and sometimes at night or day he makes noise like a gaarrrrhhhhh,,, gaarrhhhhh,,,,, since last 3-4 days crying a lot its my first pregnancy with no history of abortion. I am worried about his weight what should i do.i stay in Nagpur Maharastra its hot here is dat the problem? his urine output is good more than 10 times in day, he passes stoll atleast 3-4 times day/night. Plz suggest and also clear my doubts,
Wed, 25 Sep 2013
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Pediatrician 's  Response
when a baby is born thn in earlier days it looses weight and thn it starts gaining weight.in case of premature babies it by day 10-12 of life baby is of birth weight again and thn it should start gaining weight.and gain of weight is not more thn 15-20 grams per day.wat is the weight of your baby at present and wat it should be you can calculate.otherwise ask your doctor he will provide you with growth chart to mointor babys weight.
in a premature baby plz be sure that the baby's temperature are normal and palms and soles are not cold and feels to be warm when touched.sometimes hypothermia in babies leads to poor weight gain.try to give breast milk only to baby.premature babys also need iron as supplement and deficiency of it can also lead to poor weight gain.
as per wat you have said babys activity is normal and he is passing urine and stool normally.thn he might not have any major problem.just continue with the breast milk and supplements and monitor weight routinely.if still problem persists thn have ful evaluation of your baby.
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Pediatrician Dr. NEERAJ ARORA's  Response
Hello. Thanks for posting on HCM. A normal baby loses weight for initial 7 - 10 days and then starts gaining weight to regain birth weight by D10 -D14. A premature baby might take longer time to regain birth weight. So at the outset, i would say that if the baby is gaining weight daily by about 20-30 gms and all other activities are normal, there might not be actually anything to worry about. Just, continue the supplements(MCT, hovite 3 drops, calcimax P) and feeds.
However, if the baby is not gaining weight as mentioned above, then the baby needs to be investigated. Overall, the common causes of not gaining weight are infections and cardiorespiratory diseases. So, we would approach with the following steps :
a). Monitor daily weight (without clothes) on a digital weigh scale to record daily weight gain/ loss. Also you can test the baby weight before and after taking breast feeds to assess the adequacy of the feeds (weight gain upto 25-30 gms is good enough).
b). Get a complete work up for infection, espp blood cultures, urine Routine examination, urine culture and urine for fungal hyphae. Get Liver and renal functions tested.
c). Complete cardiorespiratory evaluation (important if the baby gets tired while taking feeds and there is sweating while feeding).
d). Continue feeds, MCT, Hovite 3, calcimax P.
I hope to hear from you soon. Best of health.
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Pediatrician Dr. E Venkata Ramana's  Response
Hi,
Thank you for your query on Healthcare Magic.
Weight gain will starts in preterm from the 2nd week of life.
In the initial 2 weeks of life, the weigh decreases due to loss of water and inadequate feeds and weight gain starts from 2nd weeks onwards with adequate feeds.
Continue breast feeds and formula feeds.
As he is unable to such I suggest you to give expressed breast milk by using spoon.
Give feeds 2nd hourly.
Continue multivitamin, calcium, and MCT oil supplementation.
Crying is due to colic which can be managed by giving drops like colic aid in prescribed dose.
Hope I have answered your query.
Regards.
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Delivered Premature Baby Weighing 1.8kg. Not Gaining Weight. Gving Pro Nan. What Can Be Done?

when a baby is born thn in earlier days it looses weight and thn it starts gaining weight.in case of premature babies it by day 10-12 of life baby is of birth weight again and thn it should start gaining weight.and gain of weight is not more thn 15-20 grams per day.wat is the weight of your baby at present and wat it should be you can calculate.otherwise ask your doctor he will provide you with growth chart to mointor babys weight. in a premature baby plz be sure that the baby s temperature are normal and palms and soles are not cold and feels to be warm when touched.sometimes hypothermia in babies leads to poor weight gain.try to give breast milk only to baby.premature babys also need iron as supplement and deficiency of it can also lead to poor weight gain. as per wat you have said babys activity is normal and he is passing urine and stool normally.thn he might not have any major problem.just continue with the breast milk and supplements and monitor weight routinely.if still problem persists thn have ful evaluation of your baby.